BACKGROUND: The follow-up of the peri-implant marginal bone loss is the most important criterion for the determination of implant success. PURPOSE: The purpose of this study is to measure marginal bone loss using panoramic radiographic images (PRI) of patients treated using a mandibular, two implant-supported, locator-retained denture and to evaluate the compatibility of these findings with those of the finite element analysis (FEA). MATERIALS AND METHODS: The PRI of patients who had a mandibular, two implant-supported, locator-retained denture were assessed, and the mesial and distal marginal bone loss of both right- and left-sided implants was measured. Mandibular and maxillary models, which have the features of bilateral balanced occlusion, were created. The surfaces of the generated models were converted in a computer-aided design model that could be transferred to the FEA software, and the forces were defined on contacts formed in maximum intercuspation, lateral, and protrusive movement position for bilateral balanced occlusion. RESULTS: The bone loss in the mesial and distal regions at the right- and left-sided implants was not statistically significant. Higher stresses were formed on the vestibular side under protrusive movement, on the lingual side under maximum intercuspation, on the distolingual side under left unilateral biting, and on the mesiolingual side under right unilateral biting in the FEA. CONCLUSION: According to FEA, peri-implant bone resorption may be higher in the buccal and palatal regions, implying that panoramic radiographs can be misleading in understanding the amount of peri-implant bone resorption.
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