Objectives: The purpose of the study was to analyze the load distributions of abutment teeth of distal extension removable partial denture (RPD) with different splinting designs and periodontal bone levels to find the optimal splinting protocols for clinical application with finite element (FE) analysis.

Methods: A plane-stress FE model with framework and denture base of extracoronal resilient attachments (ERA; Stern ERA Attachment System, APM-Sterngold, Attleboro, Mass.) was constructed. The edentulous ridge of mandibular first and second molars was restored with an RPD with ERA attachment on the second premolar. The canine, first premolar and second premolar were all crowned with metal crowns. The average width of periodontal ligament (PDL) and mucosa were 0.25 mm and 2.0 mm, retrospectively. Three splinting situations (single or two or three natural teeth) and two periodontal supports (normal and 50% loss) were observed when vertical forces (10N) were applied to the prosthesis in 6 simulated models.

Results: Stress concentration in the female ring of the ERA abutment is noted. Splinting adjacent tooth to the abutment does help to redistribute the stress transferred from the distal extension RPD. For normal bone level, splinting one adjacent tooth seems to be enough to reduce the stress on the abutment tooth in the periodontium. For reduced bone level, splinting two adjacent teeth is appropriate to reduce the stress concentration on the abutment tooth in the periodontium.

Conclusion: The results found that, it is appropriate to splint at least one adjacent tooth to reduce the stress on the abutment tooth in the periodontium. For reduced bone level, additional splinting is recommended to reduce the stress concentration on the abutment tooth in the periodontium.

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