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Objective: The aim of this study was to evaluate strain distribution in peri-implant bone,stress in the abutments and denture stability of mandibular overdentures anchored bydifferent numbers of implants under different loading conditions, through three-dimen-sional finite element analysis (3D FEA).Methods: Four 3D finite element models of mandibular overdentures were established, usingbetween one and four Straumann implants with Locator attachments. Three types of loadwere applied to the overdenture in each model: 100 N vertical and inclined loads on the leftfirst molar and 43811
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N vertical load on the lower incisors. The biomechanical behaviours ofperi-implant bone, implants, abutments and overdentures were recorded.Results: Under vertical load on the lower incisors, the single-implant overdenture rotatedover the implant from side to side, and no obvious increase of strain was found in peri-implant bone. Under the same loading conditions, the two-implant-retained overdentureshowed more apparent rotation around the fulcrum line passing through the two implants,and the maximum equivalent stress in the abutments was higher than in the other models.In the three-implant-supported overdenture, no strain concentration was found in corticalbone around the middle implant under three loading conditions.Conclusions and clinical significance: Single-implant-retained mandibular overdentures do notshow damaging strain concentration in the bone around the only implant and may be a cost-effective treatment option for edentulous patients. A third implant can be placed betweenthe original two when patients rehabilitated by two-implant overdentures report constantand obvious denture rotation around the fulcrum line. choice of treatment for the edentulous mandible.5Recently,there have been reports suggesting that a single implant isadequate for overdenture retention and can result in a highsuccess rate comparable to overdentures supported bymultiple implants.6–11Walton et al. compared patient satis-faction and prosthetic outcome for mandibular overdenturesretained by one or two implants in 86 participants for one year.In this randomized clinical trial, researchers found lowercomponent costs and treatment times, with comparablesatisfaction and maintenance time, for overdentures retainedby a single midline implant.8However, some authors havereported unexpectedly high failure rates for single-implantretained mandibular overdentures using an immediate load-ing protocol.12,13Other researchers have investigated mandibular over-dentures using three or four implants.