This study compares ball, bar-clip and bar-ball attachment systems for implant-retained mandibular overdentures with three implants. The first implant is placed in the middle of the mandible and the other two are imbedded in the first premolar regions. Linear elastic finite element analysis is used for design analysis. Three dimensional geometry of the mandible is generated from computed tomography. Other parts are modeled using SolidWorks software. The foodstuff is positioned at the right first molar, representing the most frequent masticating situation. To obtain accurate mesh-independent results, finite element models are solved using several mesh grids. They are then validated by means of a detailed convergence analysis. The results demonstrate that the highest von-Mises stress in the bone is always located around the neck of the implant, at its upper threads. Ball and bar-ball attachments transfer the highest and lowest stresses to the bone surrounding the implants, respectively. The lowest stresses in the cortical and cancellous bones are due to bar-ball attachment. Yet, the overdenture gets its maximum movement for this arrangement. Consequently, the use of bar-ball attachment is only recommended for the cases in which stress transferred to peri-implant bone is more important than overdenture stability. Among the three treatment designs, ball attachment seems to exhibit the lowest lateral and overall displacements and hence, better overdenture stability.
Overdenture stability; cortical bone; cancellous bone; implant