Two
essentially different implant-prosthetic concepts are
known for the treatment of edentulous maxillae. One concept
propagates a "concentrated" arrangement of four to six
implants the premolar and anterior regions with fixed
cantilever superstructure. An alternative is a "spread-out"
implant arrengement of six implants placed in the tuberosity,
premolar, and anterior regions. The prosthetic rehabilitation
consists of a fixed horseshoe-shaped bar and a removable
prosthesis. A cantilever situation is avoided. The biomechanical
aspects of these implant-prosthetic concepts were studied
with clinical strain-gauge measurements and theoretical
three-dimensional analysis using the finite element method.
Results revealed that the distribution of bone stresses
is more favorable with a spread-out implant arrangement
than with a concentrated implant arrangement and cantilever
restoration. The resistance to bending of a superstructure
has an influence on bone stress concentration that should
not be ignored. Stresses are controlled not only by the
number or distribution of implants, but also by the material
and design of the superstructure.