Biomechanical evaluation of bridge span with three implant abutment designs and two connectors for tooth-implant supported prosthesis: A finite element analysis.

Background/purpose: Bridge stability under loading was influenced by bridge span with the connector and implant abutment design. Thus, the purpose of this study was to evaluate the effects of rigid and non-rigid connector designs and pontic connections of different abutment systems in the tooth-implant supported prosthesis (TISP) at different span distances on the biomechanical stress distribution of the overall system components. Materials and methods: For comparative analysis, rigid and non-rigid bridge connections were fitted with three implant abutment systems (one-piece, two-piece and three-piece), and five implant-to-natural tooth distance configurations (12 mm, 14 mm, 16 mm, 18 mm, and 20 mm) were provided. Results: The maximum stress between TISP components occurred at the distal side of crown margin of cement1 in rigid connector with one-piece group and the bottom of the crown3 in non-rigid connector with one-piece group, while the other groups were more concentrated at the junction between the mesial side of the implant collar and the abutment. In addition, neither the rigid nor non-rigid connector model showed that stress distribution increased proportionally with the bridge span distance. Conclusion: It was clinically recommended that if the implant with a shorter bridge distance of 12 mm from the natural tooth, the rigid connection of the three-piece abutment can be used as the TISP design. If the bridge distance was 18 mm longer, the non-rigid connection of the three-piece abutment could maintain the physiological movement of the natural tooth and avoid the excessive stress on the bone crest around the implant.