Mandibular flexure and stress build-up in mandibular full-arch fixed prostheses supported by osseointegrated implants

The biomechanical effect of mandibular functional flexure on stress build-up in implant-supported fixed restorations is discussed. The relative deformations and stress distributions in six different designs of implant-supported prosthetic systems (six or four implants, with or without distal cantilevers, cross-arch or midline-divided bar into two free-standing bridges) were analysed by a three-dimensional finite element (FE) model of a human edentulous mandible. A significant amount of stress in the more distal implants and the superstructure at the symphysis arises as a consequence of mandible functional flexure. The analysis of the stress distributions generated by the different restorative patterns suggests that a division of the superstructure at the level of the symphysis significantly restores the natural functional flexure of the mandible.