Minimization of dental implant diameter and length according to bone quality determined by finite element analysis and optimized calculation

A finite element study on the risk of bone loss around posterior short implants in an atrophic mandible

PURPOSE

This study aimed to evaluate the risk of bone loss around single short molar crown-supporting implants in an atrophic mandible.

METHODS

Implants of different lengths (L = 4 or 6 mm) and diameters (Ø = 4.1 or 4.8 mm) were placed in the molar area of an atrophic mandible. Additional control mandible models were simulated for 4.1 mm diameter implants (L = 4, 6, 8, and 10 mm). A vertical masticatory load of 200 N was applied to three or six occlusal contact areas (3ca or 6ca) of the prosthetic crown. The bone strain energy density (SED) of 109.6 µJ/mm3 was assumed to be the pathological threshold for cortical bone. The peri-implant bone resorption risk index (PIBRri) was calculated by dividing the maximum SED of the crestal cortical bone by the SED pathological threshold.

RESULTS

Increasing the implant length from 4 to 6 mm, implant diameter from 4.1 to 4.8 mm, and number of contact areas from 3 to 6 reduced the SED and PIBRri values by approximately 20%, 35%, and 40%, respectively, when comparing pairs of models that isolated a specific variable. All models with 6ca had a low bone resorption risk (PIBRri<0.8), while the Ø4.1 short implant with 3ca had a medium (0.8≤PIBRri≤1.0) or high (PIBRri>1.0) resorption risk.

CONCLUSIONS

Increasing the diameter or occlusal contact area of a 4 mm short implant in an atrophic mandible resulted in reduced bone resorption risks, similar to or lower than those observed in a regular mandible with standard-length implants.

Using optimization approach to design dental implant in three types of bone quality - A finite element analysis

Background/Purpose

The use of finite element (FE) analysis in implant biomechanics offers many advantages over other approaches in simulating the complexity of clinical situations. The aim of this study was to perform an optimization analysis of dental implants with different thread designs in three types of bone quality.

Materials and methods

The three-dimensional FE model of a mandibular bone block with a screw-shaped dental implant and superstructure was simulated. In the optimization analysis, the design variables included the thread pitch and the thread depth of the implant. The objective was to minimize the displacement of the implant to the target value. Three FE models with different bone qualities (D2: better bone quality; D3: ordinary bone quality; D4: poor bone quality) were created.

Results

The FE results showed that the displacement of the implant and the stress of the cortical bone increased, while the Young's modulus of the cancellous bone decreased. In the D2 bone, changing the thread pitch and thread depth had little effect on cortical stress and implant displacement. However, in D3 and D4 bone, increasing thread depth reduced cortical stress by 40 % and implant displacement by at least 9 %.

Conclusion

Adjusted thread depth for D3 and D4 bone would reduce crestal bone stress and increase implant stability, but only a little alteration on crestal bone stress and implant stability for D2 bone.

Finite element models: A road to in-silico modeling in the age of personalized dentistry

OBJECTIVE

This article reviews the applications of Finite Element Models (FEMs) in personalized dentistry, focusing on treatment planning, material selection, and CAD-CAM processes. It also discusses the challenges and future directions of using finite element analysis (FEA) in dental care.

DATA

This study synthesizes current literature and case studies on FEMs in personalized dentistry, analyzing research articles, clinical reports, and technical papers on the application of FEA in dental biomechanics.

SOURCES

Sources for this review include peer-reviewed journals, academic publications, clinical case studies, and technical papers on dental biomechanics and finite element analysis. Key databases such as PubMed, Scopus, Embase, and ArXiv were used to identify relevant studies.

STUDY SELECTION

Studies were selected based on their relevance to the application of FEMs in personalized dentistry. Inclusion criteria were studies that discussed the use of FEA in treatment planning, material selection, and CAD-CAM processes in dentistry. Exclusion criteria included studies that did not focus on personalized dental treatments or did not utilize FEMs as a primary tool.

CONCLUSIONS

FEMs are essential for personalized dentistry, offering a versatile platform for in-silico dental biomechanics modeling. They can help predict biomechanical behavior, optimize treatment outcomes, and minimize clinical complications. Despite needing further advancements, FEMs could help significantly enhance treatment precision and efficacy in personalized dental care.

CLINICAL SIGNIFICANCE

FEMs in personalized dentistry hold the potential to significantly improve treatment precision and efficacy, optimizing outcomes and reducing complications. Their integration underscores the need for interdisciplinary collaboration and advancements in computational techniques to enhance personalized dental care.

Exploring Non-conventional Dental Implants Beyond Traditional Paradigms Part I: Bridging the Gap in Bone Deficiency Cases

Dental implants have revolutionized tooth replacement, offering a functional and aesthetically pleasing alternative to traditional dentures and bridges. While conventional implants, typically titanium screws placed into the jawbone, have become the gold standard, many studies explore non-conventional implant designs and materials to address specific challenges and patient needs. This series of literature reviews aimed to delve into non-conventional dental implants, examining their unique features and applications and the current state of evidence supporting their use. The short and mini dental implants represent a cutting-edge area of research within the field of implant dentistry. Its potential application in the management of cases with limited bone availability has emerged as a viable alternative to the use of bone augmentation procedures. To date, significant progress has been made in the field of dental implants, particularly with the introduction of short and mini dental implants in the management of cases with significant bone deficiency. However, it remains a remarkable challenge that continues to be actively researched.

Effect of customized abutment taper configuration on bone remodeling and peri-implant tissue around implant-supported single crown: A 3D nonlinear finite element study

PURPOSE

The optimal configuration of a customized implant abutment plays a crucial role in promoting bone remodeling and maintaining the peri-implant gingival contour. However, the biomechanical effects of abutment configuration on bone remodeling and peri-implant tissue remain unclear. This study aimed to evaluate the influence of abutment taper configurations on bone remodeling and peri-implant tissue.

MATERIALS AND METHODS

Five models with different abutment taper configurations (10°, 20°, 30°, 40°, and 50°) were analyzed using finite element analysis (FEA) to evaluate the biomechanical responses in peri-implant bone and the hydrostatic pressure in peri-implant tissue.

RESULTS

The results demonstrated that the rate of increase in bone density was similar in all models. On the other hand, the hydrostatic pressure in peri-implant gingiva revealed significantly different results. Model 10° showed the highest maximum and volume-averaged hydrostatic pressures (69.31 and 4.5 mmHg), whereas Model 30° demonstrated the lowest values (57.83 and 3.88 mmHg) with the lowest excessive pressure area. The area of excessive hydrostatic pressure decreased in all models as the degree of abutment taper increased from 10° to 30°. In contrast, Models 40° and 50° exhibited greater hydrostatic pressure concentration at the cervical region.

CONCLUSION

In conclusion, the abutment taper configuration had a slight effect on bone remodeling but exerted a significant effect on the peri-implant gingiva above the implant platform via hydrostatic pressure. Significant decreases in greatest and average hydrostatic pressures were observed in the peri-implant tissues of Model 30°. However, the results indicate that implant abutment tapering wider than 40° could result in a larger area of excessive hydrostatic pressure in peri-implant tissue, which could induce gingival recession.

Biomechanics of Dental Implantation in the Giant Panda (Ailuropoda melanoleuca): A Comparative Study Using Finite Element Analysis

Giant pandas have a high incidence of tooth wear, loss, and fracture since their diet is specifically bamboo. Dental implantation is a common treatment for tooth loss in humans while rarely reported in wild animals. To explore the applicability of dental implantation in giant pandas, this study measured mandible parameters of the giant panda, from an adult skeletal specimen. The mandible bone block model was developed using computer-aided design 3D mechanical drawing software. Implants of different radius and thread types of the third premolar tooth (PM3) were assembled and imported into an analysis software system for finite element analysis. As a result, the reverse buttress implant with a radius of 7.5 mm and 8.3 mm, and a length of 15 mm was found to be the most suitable implant for use in the giant panda PM3. This study provides a reference for appropriate clinical giant panda dental implantation, although, the feasibility of giant panda dental implantation needs to be studied further.

Developing Advanced Patient-Specific In Silico Models: A New Era in Biomechanical Analysis of Tooth Autotransplantation

INTRODUCTION

As personalized medicine advances, there is an escalating need for sophisticated tools to understand complex biomechanical phenomena in clinical research. Recognizing a significant gap, this study pioneers the development of patient-specific in silico models for tooth autotransplantation (TAT), setting a new standard for predictive accuracy and reliability in evaluating TAT outcomes.

METHODS

Development of the models relied on 6 consecutive cases of young patients (mean age 11.66 years ± 0.79), all undergoing TAT procedures. The development process involved creating detailed in silico replicas of patient oral structures, focusing on transplanting upper premolars to central incisors. These models underpinned finite element analysis simulations, testing various masticatory and traumatic scenarios.

RESULTS

The models highlighted critical biomechanical insights. The finite element models indicated homogeneous stress distribution in control teeth, contrasted by shape-dependent stress patterns in transplanted teeth. The surface deviation in the postoperative year for the transplanted elements showed a mean deviation of 0.33 mm (±0.28), significantly higher than their contralateral counterparts at 0.05 mm (±0.04).

CONCLUSIONS

By developing advanced patient-specific in silico models, we are ushering in a transformative era in TAT research and practice. These models are not just analytical tools; they are predictive instruments capturing patient uniqueness, including anatomical, masticatory, and tissue variables, essential for understanding biomechanical responses in TAT. This foundational work paves the way for future studies, where applying these models to larger cohorts will further validate their predictive capabilities and influence on TAT success parameters.

Evaluating the effect of functionally graded materials on bone remodeling around dental implants

OBJECTIVES

This study evaluates the potential for osseointegration and remodeling of customized dental implants made from Titanium-Hydroxyapatite Functionally Graded Material (Ti-HAP FGM) with optimized geometry, using the finite element method (FEM).

METHODS

The study utilized CT scan images to model and assemble various geometrical designs of dental implants in a mandibular slice. The mechanical properties of Ti-HAP FGMs were computed by varying volume fractions (VF) of hydroxyapatite (0-20%), and a bone remodeling algorithm was used to evaluate the biomechanical characteristics of the ultimate bone configuration in the peri-implant tissue.

RESULTS

The findings of the FEA reveal that osseointegration improves with changes in the density and mechanical properties of the bone surrounding Ti-HAP implants, which are influenced by the varying VF of hydroxyapatite in the FGM.

SIGNIFICANCE

Increasing the hydroxyapatite fraction improves osseointegration, and appropriate length and diameter selection of Ti-HAP dental implants contribute to their stability and longevity.

A comprehensive biomechanical evaluation of length and diameter of dental implants using finite element analyses: A systematic review

Background

With a wide range of dental implants currently used in clinical scenarios, evidence is limited on selecting the type of dental implant best suited to endure the biting force of missing teeth. Finite Element Analysis (FEA) is a reliable technology which has been applied in dental implantology to study the distribution of biomechanical stress within the bone and dental implants.

Purpose

This study aimed to perform a systematic review to evaluate the biomechanical properties of dental implants regarding their length and diameter using FEA.

Material and methods

A comprehensive search was performed in PubMed/MEDLINE, Scopus, Embase, and Web of Science for peer-reviewed studies published in English from October 2003 to October 2023. Data were organized based on the following topics: area, bone layers, type of bone, design of implant, implant material, diameter of implant, length of implant, stress units, type of loading, experimental validation, convergence analysis, boundary conditions, parts of Finite Element Model, stability factor, study variables, and main findings. The present study is registered in PROSPERO under number CRD42022382211.

Results

The query yielded 852 results, of which 40 studies met the inclusion criteria and were selected in this study. The diameter and length of the dental implants were found to significantly influence the stress distribution in cortical and cancellous bone, respectively. Implant diameter was identified as a key factor in minimizing peri-implant stress concentrations and avoiding crestal overloading. In terms of stress reduction, implant length becomes increasingly important as bone density decreases.

Conclusions

The diameter of dental implants is more important than implant length in reducing bone stress distribution and improving implant stability under both static and immediate loading conditions. Short implants with a larger diameter were found to generate lower stresses than longer implants with a smaller diameter. Other potential influential design factors including implant system, cantilever length, thread features, and abutment collar height should also be considered in future implant design as they may also have an impact on implant performance.

Improving dental implant stability by optimizing thread design: Simultaneous application of finite element method and data mining approach

STATEMENT OF PROBLEM

Lack of knowledge regarding the optimal design of thread configuration in dental implants, which can offer a satisfactory level of stability in the implant-bone construct, is a significant challenge in the field of dental biomechanics.

PURPOSE

The purpose of this finite element analysis study was to identify the optimal thread design by investigating the effects of thread parameters such as thread depth (TD), thread width (TW), and thread pitch (TP), as well as upper (α) and lower (β) thread angles, on the maximum principal stress in cancellous and cortical bone, maximum von Mises stress in the dental implant, and maximum shear stress at the implant-bone interface.

MATERIAL AND METHODS

A finite element model of an alveolar bone segment with a dental implant was developed. The Latin hypercube sampling method was used to generate a dataset of virtual experiments, which were analyzed by using the decision tree method to identify suitable thread designs that minimize mechanical stimuli. Additionally, the effectiveness of thread parameters on stress levels in the bone, implant, and their interface were assessed.

RESULTS

The results of this study, verified by comparison with previous literature, indicated that TD, TW, and upper thread angle were the most effective parameters in promoting implant stability.

CONCLUSIONS

By analyzing the decision trees, optimum ranges for all the thread parameters were determined as follows: 0.25 Collapse

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Affiliation(s)

Masoud Arabbeiki Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
Mohammad Reza Niroomand Department of Mechanical Engineering, Payame Noor University, Tehran, Iran.
Gholamreza Rouhi Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran

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Mandibular bone remodeling around osseointegrated functionally graded biomaterial implant using three dimensional finite element model

Dental implantation surgery has been progressed as one of the most efficient prosthetic technologies, however, it still fails very often and one of the main causes is the large difference between implant mechanical properties and those in welcoming bony tissues, making it problematical in osseointegration and bone remodeling. Biomaterial and tissue engineering research shows that there is a requirement in developing implants with Functionally Graded Materials (FGM). Indeed, the great potential of FGM lies not only in the field of bone tissue engineering but also in dentistry. To improve the acceptance of dental implants inside the living bone, FGM were proposed to step up the challenge of ensuring a better match of mechanical properties between biologically and mechanically compatible biomaterials. The aim of the present work is to investigate mandibular bone remodeling induced by FGM dental implant. Three-dimensional (3D) mandibular bone structure around an osseointegrated dental implant has been created to analyze the biomechanical behavior of the bone-implant system depending on implant material composition. In order to implement the numerical algorithm into ABAQUS software, UMAT subroutines and user-defined material were employed. Finite element analysis have been conducted to determine the stress distributions in implant and bony system, and to evaluate bone remodeling induced by the use of various FGM and pure titanium dental implants over the period of 48 months.

Agglomeration effect on biomechanical performance of CNT-reinforced dental implant using micromechanics-based approach

Dental implants have long played an important role in restoring lost teeth, but there are still concerns about their durability and long-term success. Commercial dental implants have traditionally been made of metallic and ceramic materials like titanium and zirconia; however, each kind of material has restrictions regarding osseointegration and mechanical characteristics that differ between native bone and the implant material, limiting the implant's longevity and reliability. To address these concerns, this research explores the use of carbon nanotubes (CNTs) in restorative dentistry, their excellent properties make them an ideal candidate for promoting bone growth around implanted device and ensuring long-lasting success. The objective of this study was to understand how CNT properties when incorporated into the titanium matrix may be able to better adapt to the oral environment taking into consideration the CNT agglomeration effects when designing reinforced nanocomposite materials for dental implant. A mathematical formulation of the micromechanics model was developed and improved to extend its application for the case of CNT-based composite materials for dental implants. A three dimensional (3D) model of bone structure around the osseointegrated dental implant was established considering different compositions of implant material. Finite Element Analysis (FEA) were conducted to assess the aggregation effect of implant incorporating CNTs into the titanium matrix, considering CNTs with both spherical inclusions (CNT clusters), and randomly dispersive ones (CNTs) in the titanium matrix, on osseointegration and bone remodeling around the dental implant and supporting bone system over a period of 48 months. Firstly, the effects of CNT-Ti implantation on time-dependent performance are evaluated in a computational remodeling framework. Then, Von Mises equivalent stresses are investigated to evaluate the stress distributions and micromotions in jaw bones of loaded implant with different composition of prosthetic material. Three agglomeration patterns are considered, particularly without agglomeration (ζ = ξ), partial and complete agglomeration (ζ < ξ, ξ = 1). Further, the influence of CNTs volume fraction variation is taken into account to predict the mechanical response of the bony system after CNT-reinforced dental implantation. It can be inferred that the agglomeration of CNTs reduces the elastic stiffness of the matrix. This is due to the fact that when CNTs are agglomerated, the inter-tube contacts are reduced and the effective stiffness of the matrix is decreased.

Finite element analysis in implant dentistry: State of the art and future directions

OBJECTIVE

To discuss the state of the art of Finite Element (FE) modeling in implant dentistry, to highlight the principal features and the current limitations, and giving recommendations to pave the way for future studies.

METHODS

The articles' search was performed through PubMed, Web of Science, Scopus, Science Direct, and Google Scholar using specific keywords. The articles were selected based on the inclusion and exclusion criteria, after title, abstract and full-text evaluation. A total of 147 studies were included in this review.

RESULTS

To date, the FE analysis of the bone-dental implant system has been investigated by analyzing several types of implants; modeling only a portion of bone considered as isotropic material, despite its anisotropic behavior; assuming in most cases complete osseointegration; considering compressive or oblique forces acting on the implant; neglecting muscle forces and the bone remodeling process. Finally, there is no standardized approach for FE modeling in the dentistry field.

SIGNIFICANCE

FE modeling is an effective computational tool to investigate the long-term stability of implants. The ultimate aim is to transfer such technology into clinical practice to help dentists in the diagnostic and therapeutic phases. To do this, future research should deeply investigate the loading influence on the bone-implant complex at a microscale level. This is a key factor still not adequately studied. Thus, a multiscale model could be useful, allowing to account for this information through multiple length scales. It could help to obtain information about the relationship among implant design, distribution of bone stress, and bone growth. Finally, the adoption of a standardized approach will be necessary, in order to make FE modeling highly predictive of the implant's long-term stability.

Optimization of thread configuration in dental implants through regulating the mechanical stimuli in neighboring bone

BACKGROUND AND OBJECTIVE

The threads, as the most critical component of dental implants, transfer the imposed occlusal loads to the adjacent bone. Moreover, regulation of the mechanical stimuli in the implant adjacent bone is crucial to maximize the bone-implant construct stability. An optimal thread design can be resulted when the distribution of mechanical stimuli within the bone, and at the implant-bone interface, lie in an advised confined range. In this work, with the goal of finding the optimal thread design, which can provide the maximum level of stability, the effects of thread parameters, namely, thread depth, thread width, and thread pitch, together with upper and lower thread angles, on maximum principal strain within the cortical and cancellous bone, and shear strain at the implant-bone interface, were investigated.

METHODS

In this study, the response surface methodology (RSM), due to the central composite design (CCD), was employed to obtain a set of 53 experiments. Following that, they were numerically simulated using the finite element method (FEM). The polynomial regression model was then used to predict the response functions based on the magnitude of thread parameters. The effectiveness of each thread parameter was also evaluated through statistical tools. Moreover, the non-dominated sorting genetic algorithm (NSGA-II) was performed to find the optimum dimensions of the thread.

RESULTS

Through comparing the results obtained from analyzing initial and optimized configuration of threads, it was shown that the latter causes a reduction in the maximum principal strains in cancellous and cortical bones by about 25% and 30%, respectively, which is in favor of making a higher quality bone, and thus greater stability in dental implant-bone construct. Moreover, the maximum shear strains at the implant-bone interface in different planes were reduced by about 40%, in the optimized thread, compared with the initial design.

CONCLUSIONS

The optimized design found in this study is a buttress thread with a fine pitch, but deep thread, which keeps the mechanical stimuli in a safe range to grant an acceptable level of stability.

Effect of implant placement depth on bone remodeling on implant-supported single zirconia abutment crown: A 3D finite element study

PURPOSE

This study aimed to evaluate the influence of subcrestal implant placement depth on bone remodeling using time-dependent finite element analysis (FEA) with a bone-remodeling algorithm over 12 months.

METHODS

Seven models of different subcrestal implant placement depths (0, 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm) were analyzed using FEA to evaluate the biomechanical responses in the bone and implant, including von Mises equivalent stress, strain energy density (SED), and overloading elements. SED was used as a mechanical stimulus to simulate cortical and cancellous bone remodeling over the first 12 months after final prosthesis delivery.

RESULTS

The highest increase in cortical bone density was observed at Depth 1.5, whereas the lowest increase was observed at Depth 3.0. In contrast, the highest increase in bone density was observed at Depth 3.0 in the cancellous bone, whereas the lowest increase was observed at Depth 0. The highest peak von Mises stress in the cortical bone occurred at Depth 2.5 (107.24 MPa), while that in the cancellous bone was at Depth 2.5 (34.55 MPa). Notably, the maximum von Mises stress values in the cancellous bone exceeded the natural limit of the bony material, as indicated by the overloading elements observed at the depths of 2.0, 2.5, and 3.0 mm.

CONCLUSION

Greater bone density apposition is observed with deeper implant placement. An implant depth of more than 1.5 mm exhibited a higher maximum von Mises stress and greater overloading elements.

Biomechanical evaluations of the long-term stability of dental implant using finite element modeling method: a systematic review

PURPOSE

The aim of this study is to summarize various biomechanical aspects in evaluating the long-term stability of dental implants based on finite element method (FEM).

MATERIALS AND METHODS

A comprehensive search was performed among published studies over the last 20 years in three databases; PubMed, Scopus, and Google Scholar. The studies are arranged in a comparative table based on their publication date. Also, the variety of modeling is shown in the form of graphs and tables. Various aspects of the studies conducted were discussed here.

RESULTS

By reviewing the titles and abstracts, 9 main categories were extracted and discussed as follows: implant materials, the focus of the study on bone or implant as well as the interface area, type of loading, element shape, parts of the model, boundary conditions, failure criteria, statistical analysis, and experimental tests performed to validate the results. It was found that most of the studied articles contain a model of the jaw bone (cortical and cancellous bone). The material properties were generally derived from the literature. Approximately 43% of the studies attempted to examine the implant and surrounding bone simultaneously. Almost 42% of the studies performed experimental tests to validate the modeling.

CONCLUSION

Based on the results of the studies reviewed, there is no "optimal" design guideline, but more reliable design of implant is possible. This review study can be a starting point for more detailed investigations of dental implant longevity.

Bone quality effect on short implants in the edentulous mandible: a finite element study

Introduction

The aim of this study was to verify whether the use of short implants could optimize stress distribution of bone surrounding implants in atrophic mandibles with different bone qualities.

Methods

A three-dimensional model of the atrophic mandible with three levels of bone quality was made using computer software. Short implants (6 mm) and standard implants (10 mm) were used in four designs: Design 1 "All-On four", Design 2 "All-On-four" with two short implants, Design 3 four vertical implants with two short implants, and Design 4 six short implants. The distal short implants were placed at the first molar position. All twelve models were imported into finite element analysis software, and 110 N oblique force was loaded on the left second premolar. Maximum principal stress values of peri-implant bone and the volumes of bone with over 3000 microstrians (overload)were analyzed.

Result

Stress values and volumes of overload bone increased in all four groups with the decline of bone quality. The highest stress values were found in the cortical bone surrounding the Design 1 inclined implant in two lower bone quality mandibles, and the lowest in Design 3. However, Design 1 had less overload bone tissue than all three designs with short implants.

Conclusion

Short implants placed posteriorly helped decrease stress values in peri-implant bone, while bone surrounding short implants had a high resorption risk in low bone quality mandible.

Multi-objective design optimization of dental implant geometrical parameters

In-silico investigations are becoming an integral part of the development of novel biomedical devices, including dental implants. Using computer simulations can streamline the process by tuning different geometrical and structural features, emphasizing the osseointegration of the implant design a priori, leading to the optimal designs in preparation for in-vivo trails. This research aims to elucidate the interrelationship between 12 geometrical variables that holistically define the shape of the implant. The approach to achieve optimality hinged on coupling the finite element analysis results with the fractional factorial design method. The latter was used to determine the most influential variables during the screening process, followed by the parameter optimization process using the response surface method, regarding four different objectives, namely: bone-implant contact area, volume of trabecular bone dead cells, volume of cortical bone dead cells, and axial displacement. This resulted in reducing the number of virtual experiments and substantially decreasing the computational cost without compromising the accuracy of the solution. It was found that the optimized values improved the performance significantly. The validity of all models was verified by comparing optimized responses with simulation results. A sensitivity analysis was performed on all five optimized models to address the effect of friction coefficient on the implant-bone joint interaction. It was shown that the mechanical behavior of implant-bone would be independent in higher friction coefficients. The significance of this study is demonstrated in determining the most effective and optimized values of all possible geometrical parameters considering their singular or interactive effects.

Novel and simplified optimisation pathway using response surface and design of experiments methodologies for dental implants based on the stress of the cortical bone

Dental implants are widely used as a long-term treatment solution for missing teeth. A titanium implant is inserted into the jawbone, acting as a replacement for the lost tooth root and can then support a denture, crown or bridge. This allows discreet and high-quality aesthetic and functional improvement, boosting patient confidence. The use of implants also restores normal functions such as speech and mastication. Once an implant is placed, the surrounding bone will fuse to the titanium in a process known as osseointegration. The success of osseointegration is dependent on stress distribution within the surrounding bone and thus implant geometry plays an important role in it. Optimisation analyses are used to identify the geometry which results in the most favourable stress distribution, but the traditional methodology is inefficient, requiring analysis of numerous models and parameter combinations to identify the optimal solution. A proposed improvement to the traditional methodology includes the use of Design of Experiments (DOE) together with Response Surface Methodology (RSM). This would allow for a well-reasoned combination of parameters to be proposed. This study aims to use DOE, RSM and finite element models to develop a simplified optimisation analysis method for dental implant design. Drawing on data and results from previous studies, two-dimensional finite element models of a single Branemark implant, a multi-unit abutment, two prosthetic screws, a prosthetic crown and a region of mandibular bone were built. A small number of combinations of implant diameter and length were set based on the DOE method to analyse the influence of geometry on stress distribution at the bone-implant interface. The results agreed with previous studies and indicated that implant length is the critical parameter in reducing stress on cortical bone. The proposed method represents a more efficient analysis of multiple geometrical combinations with reduced time and computational cost, using fewer than a third of the models required by the traditional methods. Further work should include the application of this methodology to optimisation analyses using three-dimensional finite element models.

Effect of different design of abutment and implant on stress distribution in 2 implants and peripheral bone: A finite element analysis study

STATEMENT OF PROBLEM

How adjacent dental implants with different sizes, designs, and abutment connection shapes affect stress on the prosthetic structure is unclear.

PURPOSE

The purpose of this finite element analysis (FEA) study was to analyze stress distribution around bone and around 2 implants with different sizes, diameters, shapes, and loading directions placed next to each other in splinted and unsplinted prostheses.

MATERIAL AND METHODS

On 3D FEA models representing the posterior right lateral segment of the mandible, 1 implant (Ø3.5×12 mm) and 1 implant (Ø5.5×8 mm) were placed adjacent. Three different contemporary implant models were created with different teeth, pitch, spiral numbers, and self-taping features, and different abutments for them were modeled in 3D. The implant-abutment connection was internal hexagonal (MIH), stepped conical (MSC), and internal conical (MIC). Vertical and oblique loads of 365 N for molar teeth and of 200 N for premolar teeth were applied as boundary conditions to the cusp ridges and grooves in a nonlinear FEA.

RESULTS

The MIH implants resulted in improved stress conditions. According to the von Mises stresses occurring on the screw, abutment, and implant, especially under oblique loads, MIH was exposed to less stress than MSC, and MSC was exposed to less stress than MIC.

CONCLUSIONS

When a standard implant and a short implant were placed adjacent and splinted by crowns, the implants, abutments, and screws had unfavorable stress levels; therefore, adjacent splinted implants should be of similar size. The form of the implant-abutment junction is also an important factor affecting stress.

Comparative analysis of stress distribution in one-piece and two-piece implants with narrow and extra-narrow diameters: A finite element study

OBJECTIVES

The aim of this in vitro study was to evaluate the stress distribution on three implant models with narrow and extra-narrow diameters using the finite element method (FEA).

MATERIALS AND METHODS

Dental implants of extra-narrow diameter of 2.5 mm for a one-piece implant (group G1), a narrow diameter of 3.0 mm for a one-piece implant (group G2) and a narrow diameter of 3.5 mm for a two-piece implant with a Morse taper connection (group G3). A three-dimensional model was designed with cortical and cancellous bone, a crown and an implant/abutment set of each group. Axial and angled (30°) loads of 150 N was applied. The equivalent von Mises stress was used for the implants and peri-implant bone plus the Mohr-Coulomb analysis to confirm the data of the peri-implant bone.

RESULTS

In the axial load, the maximum stress value of the cortical bone for the group G1 was 22.35% higher than that the group G2 and 321.23% than the group G3. Whereas in angled load, the groups G1 and G2 showing a similar value (# 3.5%) and a highest difference for the group G3 (391.8%). In the implant structure, the group G1 showed a value of 2188MPa, 93.6% higher than the limit.

CONCLUSIONS

The results of this study show that the extra-narrow one-piece implant should be used with great caution, especially in areas of non-axial loads, whereas the one- and two-piece narrow-diameter implants show adequate behavior in both directions of the applied load.

Design optimization of implant geometrical characteristics enhancing primary stability using FEA of stress distribution around dental prosthesis

The main objective of this study was to investigate the influence of implant geometrical characteristics: diameter, length and thread's pitch, on stress distribution around dental prosthesis. A set of numerical simulations using FEM were conducted and responses surfaces were generated. With the aim of optimizing the equivalent stresses responses; desirability function approach was adopted to solve this multi-objective problem. Results showed that implant diameter had most significant influence on generated stresses and high concentration of stresses were identified in the lower part of the implant. This study is helpful in choosing the optimal dental implant for clinical application.

Influence of Implant Dimensions in the Resorbed and Bone Augmented Mandible: A Finite Element Study

Aims:

The scope of this study was to analyze the influence of clinically feasible implant diameter and length on the stress transmitted to the peri-implant bone in the case of a resorbed and bone augmented mandible through finite element analysis.

Settings and Design:

The study was carried out in silico.

Subjects and Methods:

Resorbed and bone-augmented 3D models were derived from in vivo cone-beam computed tomography scans of the same patient. Corresponding implant systems were modeled with the diameter ranging from 3.3 to 6 mm and length ranging from 5 to 13 mm, and masticatory loads were applied on the abutment surface.

Statistical Analysis Used:

None.

Results:

In the bone augmented ridge, maximum stress values in the peri-implant region drastically decreased only when using implants of a diameter of 5 mm and 6 mm. Implants up to 4 mm in diameter led to comparable stress values with the ones obtained in the resorbed ridge, when using the larger implants. The increase of length reduced stress in the resorbed mandible, whereas in the bone augmented model, it led to small variations only in implants up to 4 mm in diameter.

Conclusions:

It was concluded that bone augmentation provides the optimal framework for clinicians to use larger implants, which, in turn, reduces stress in the peri-implant region. Diameter and length play an equally important role in decreasing stress. Implant dimensions should be carefully considered with ridge geometry.

Finite Element Analysis of the Stress Field in Peri-Implant Bone: A Parametric Study of Influencing Parameters and Their Interactions for Multi-Objective Optimization

The present work proposes a parametric finite element model of the general case of a single loaded dental implant. The objective is to estimate and quantify the main effects of several parameters on stress distribution and load transfer between a loaded dental implant and its surrounding bone. The interactions between them are particularly investigated. Seven parameters (implant design and material) were considered as input variables to build the parametric finite element model: the implant diameter, length, taper and angle of inclination, Young’s modulus, the thickness of the cortical bone and Young’s modulus of the cancellous bone. All parameter combinations were tested with a full factorial design for a total of 512 models. Two biomechanical responses were identified to highlight the main effects of the full factorial design and first-order interaction between parameters: peri-implant bone stress and load transfer between bones and implants. The description of the two responses using the identified coefficients then makes it possible to optimize the implant configuration in a case study with type IV. The influence of the seven considered parameters was quantified, and objective information was given to support surgeon choices for implant design and placement. The implant diameter and Young’s modulus and the cortical thickness were the most influential parameters on the two responses. The importance of a low Young’s modulus alloy was highlighted to reduce the stress shielding between implants and the surrounding bone. This method allows obtaining optimized configurations for several case studies with a custom-made design implant.

Effect of the mixture of mulberry leaf powder and KGM flour on promoting calcium absorption and bone mineral density in vivo

BACKGROUND

In this paper, mulberry leaf powder (MLP) and konjac glucomannan (KGM) flour were used as raw materials, and animal experiments were designed to evaluate the effects of a mixture of MLP and KGM on bone density. The femoral bone microstructure of mice and pathological changes were observed by using micro-computed tomography) and haematoxylin and eosin (HE) staining methods, respectively. A three-point bending test was used to determine the biomechanical properties of the femur.

RESULTS

Results indicated that the calcium content of MLP was high, reaching 16 148.5 mg kg^-1 , and the total proportion of water-soluble calcium, calcium pectinate, and calcium carbonate accounted for about 60% of the total calcium content. Serum alkaline phosphatase (AKP) activity was significantly lower, and serum calcium content was significantly higher (P < 0.05), in the MLP + KGM group (KM) than in the low-calcium control group, whereas no significant difference (P > 0.05) was found for serum phosphorus content. KM had a longer femur length, a higher bone mineral density (BMD) (P > 0.05), and significantly greater femur diameter, dry weight, index and bone calcium content (P < 0.05). However, these parameters were not significantly different from those of the calcium carbonate control group (P > 0.05).

CONCLUSION

The results indicate that the MLP/KGM mixture can reduce the high rate of bone turnover and the corresponding loss of bone mass caused by calcium deficiency and is thus effective in enhancing bone density. © 2019 Society of Chemical Industry.

Effect of the dimensions of implant body and thread on bone resorption and stability in trapezoidal threaded dental implants: a sensitivity analysis and optimization

Implant body and threads direct the functional loads from implant to bones. Appropriate design of implant helps implant stability. Therefore, implant length, diameter, and thread depth, width, pitch, and inner angle are assessed to recognize their effects on von-Mises stress and micromotion of implant and bones. The FE model of mandible with a threaded dental implant is modeled then the central composite design is used to assess the effects of parameters. The optimization is conducted to find the optimum design; however, it reduced the Max von-Mises stress in implant-abutment, cancellous, and cortical bones by 10%, 35%, and 27%, respectively.

Finite element analysis of narrow dental implants

Narrow-diameter implants (NDIs) traditionally have been associated to higher rates of failure in comparison with regular-diameter implants (RDIs) and wide-diameter implants (WDIs), since they generate a more unfavorable stress distribution in peri-implant bone. However, it is well known that the load sharing effect associated with prostheses supported by multiple implants (also called splinted prostheses) affords mechanical benefits. The present study involves finite element analysis (FEA) to determine whether the risks linked to NDIs could be mitigated by the mechanical advantages afforded by the splinting concept. For this purpose, a three-dimensional (3D) model of a real maxilla was reconstructed from computed tomography (CT) images, and different implants (NDIs, RDIs and WDIs) and prostheses were created using computer-aided design (CAD) tools. Biting forces were simulated on the prostheses corresponding to three different rehabilitation solutions: single-implant restoration, three-unit bridge and all-on-four treatment. Stress distribution around the implants was calculated, and overloading in bone was quantified within peri-implant volumes enclosed by cylinders with a diameter 0.1mm greater than that of each implant. The mechanical benefits of the splinting concept were confirmed: the peri-implant overloaded volume around NDIs splinted by means of the three-unit bridge was significantly reduced in comparison with the nonsplinted condition and, most importantly, proved even smaller than that around nonsplinted implants with a larger diameter (RDIs). However, splinted NDIs supporting the all-on-four prosthesis led to the highest risk of overloading found in the study, due to the increase in compressive stress generated around the tilted implant when loading the cantilevered molar.

Finite element analysis and experimental evaluation on stress distribution and sensitivity of dental implants to assess optimum length and thread pitch

BACKGROUND AND OBJECTIVE

The dental implant is one of the long term proper remedies to recover a missed tooth as a different prosthetic rehabilitation way. The finite element (FE) method and photoelasticity test are employed to achieve stress distribution and sensitivity in dental implants in order to obtain optimum length and thread pitch.

METHODS

The finite element method and experimental test are developed to evaluate stress distribution and sensitivity around dental implants. Three dimensional FE models of implant-abutment, cortical bone and cancellous bone are created by considering a variation of 0.6 to -1 mm on threads pitch while the implant lengths range from 8.5 mm to 13 mm. Then, axial and oblique forces are applied to the models to obtain the resultant stress contours.

RESULTS

The results indicate that the resultant von Mises stresses in the implant-abutment, cortical bones, and cancellous bones are different. The optimized setting for length and pitch is suggested according to maximum von Mises stress and sensitivity analysis.

CONCLUSIONS

It is concluded that the present FE model accurately predicts stress distribution pattern in dental implants. The results indicate that sensitivity of length play a more significant role in comparison with thread pitch. The accuracy of FEM results in comparison with those of the photoelasticity test recommends applying computation methods in medical practice as great potential in terms of future studies.

Evaluation of Stress in Tilted Implant Concept With Variable Diameters in the Atrophic Mandible: Three-Dimensional Finite Element Analysis

The beneficial mechanical properties provided by greater diameter or short implants increases their usage in the tilted implant concept. The aim of the present study is to compare the stress distribution of 4 different treatment models including variable implant numbers and diameters under a static loading protocol in the atrophic mandible using 3-dimensional finite element analysis. Three models included 2 tilted and 2 vertically positioned implants with different diameters, whereas 2 distally placed short implants were added to the fourth model. The von Mises stress as well as the maximum and minimum principal stress values were evaluated after applying 200 N bilateral oblique loads to the first molar teeth with the inclination of 45° to the longitudinal axis. Tilted implants were associated with higher stress values when compared with vertical implants in all models. The lowest stress values were obtained in the fourth model, including short implants. Although all stress values showed slight increases by descending implant diameters, the stress values of the model including implants with 3.3-mm diameter were within physiologic limits. All in all, an increasing number or diameter of implants may have a positive effect on implant survival. In addition, when narrow-diameter implants need to be inserted in the tilted implant concept, combination with short implants may be recommended for long-term success.

Virtual Bone Augmentation in Atrophic Mandible to Assess Optimal Implant-Prosthetic Rehabilitation—A Finite Element Study

The scope of our study was to analyze the impact of implant prosthetic rehabilitation, in bilateral terminal partial edentulism with mandibular bone atrophy, and potential benefits of mandibular bone augmentation through finite element analysis. A 3D mandible model was made using patient-derived cone-beam computed tomography (CBCT) images, presenting a bilateral terminal edentation and mandibular atrophy. A virtual simulation of bone augmentation was then made. Implant-supported restorations were modeled for each edentulous area. Forces corresponding to the pterygoid and the masseter muscles, as well as mastication conditions for each quadrant, were applied. The resorbed mandible presented high values of strain and stress. A considerable variation between strain values among the two implant sites in each quadrant was found. In the augmented model, values of strain and stress showed a uniformization in both quadrants. Virtually increasing bone mass in the resorbed areas of the mandible showed that enabling larger implants drastically reduces strain and stress values in the implant sites. Also, although ridge height difference between the two quadrants was kept even after bone augmentation, there is a uniformization of the strain values between the two implant sites in each of the augmented mandible quadrants.

Fabrication and evaluation of dental fillers using customized molds via 3D printing technology

In view of the high incidence and long-term treatment of dental caries, personalized dental fillers with long therapeutic action have broad application prospects in the dental clinic. The objective of this study was to fabricate and evaluate novel dental fillers using state-of-the-art 3D printing technology. Tinidazole (TNZ), a commonly used antibacterial drug in the dental clinic, was chosen as the model compound. Models of molars with carious cavities were obtained via 3D scanning. TNZ dental fillers were indirectly produced by thermal pressing using customized 3D printed molds. In addition, bio-relevant in vitro dissolution and mechanical testing methods were developed using customized 3D printed release and compression molds, respectively. It was observed that the formability, mechanical properties, and release behavior of the TNZ dental fillers were affected by mold materials, plasticizers, and release modifiers. The developed dental fillers were capable of sustained releasing TNZ over one week. The TNZ release characteristics can be tailored based on clinical requirements by varying hydroxypropyl methylcellulose E5 (HPMC-E5) concentrations and filler dimensions. Moreover, computational simulation based on the finite element method showed that the biomechanical behavior of the TNZ dental fillers met the daily use requirement. The present study demonstrated that the state-of-the-art 3D printing technology can be used to design and fabricate personalized dental fillers with high mechanical strength and "on-demand" drug release characteristics.