The effect of direct and indirect force transmission on peri-implant bone stress - a contact finite element analysis

Improved stomatognathic model for highly realistic finite element analysis of temporomandibular joint biomechanics

BACKGROUND

Mechanical response analysis of the temporomandibular joint (TMJ) is crucial for understanding the occurrence and development of diseases. However, the realistic modeling of the TMJ remains challenging because of its complex composition and multivariate associations.

OBJECTIVE

This study aims to develop a highly realistic stomatognathic model that accurately represents the geometric accuracy, structural integrity, and material properties. And further optimizes the interference and establishes the application range of the simplifications and the assumptions.

METHODS

Geometric reconstruction of the bone was based on high-resolution image data, with the accuracy of the occlusal surface ensured by plaster cast model registration. Soft tissues such as cartilage, the disc, the periodontal ligament (PDL), and disc attachments often need to be approximated or assumed. Therefore, the finite element methods (FEM) was used to optimize these assumptions, including 1) the biomechanical effects of the thickness and modulus of the PDL, 2) the approximation of the geometry and material behavior of the disc, and 3) the simplification of the loading and boundary conditions.

RESULTS

1) The deformation of the PDL causes tooth movement, which spreads to the distal condyle and further effects the TMJ load situation, 2) Disc reconstructed by MRI and hyperelastic material behavior are necessary for accurate TMJ loading analyses, 3) The loss of relative sliding movement between teeth interferes with realistic TMJ loading.

CONCLUSION

The improved stomatognathic model delivers highly realistic and validated simulation, offering theoretical guidance for virtual treatments and TMJ multivariate overload studies.

Semi-automated generation of bone loss defects around dental implants and its application in finite element analysis

This study aimed to develop an algorithm for modelling bone loss defects in a given mandibular geometry, with a user-defined depth, width, place, and defect type. The algorithm was implemented using Grasshopper and models with different bone loss types and depths around a dental implant were built. The models were used in a finite element analysis (FEA) to predict the stresses in peri-implant bone. The FEA showed that the stresses in peri-implant bone depend primarily on the depth of bone loss, whereas the type of bone loss showed no major influence.

The effects of different grading approaches in additively manufactured dental implants on peri-implant bone stress: A finite element analysis

Additive manufacturing enables local grading of the stiffness of dental implants through targeted adjustment of the manufacturing parameters to meet patient specific requirements. The extent to which such a manufacturing approach affects the interaction between the implant body and the surrounding bone, and what grading is optimal, is currently insufficiently investigated. This study investigates the effect of different Young's modulus grading approaches on stresses in the peri-implant bone via finite element analysis. The implant geometry was kept constant and in the case of the implant a node-dependent elastic modulus was assigned. In this way, a vertical, a radial and three torus based grading approaches were created and examined. A load was then applied directly to the occlusal surface of the implant crown. It was found that a local grading utilizing a torus shape was most favourable in terms of an effective stress peak reduction. The best torus shape tested achieved a 22 % reduction of maximum principal stress and 6 % reduction of minimum principal stress compared to the uniform material. In clinical settings, this may provide benefits in situations of overload. Based on the results, a graded stiffness in dental implants appears to be of interest for developing advanced, patient-specific implant solutions.

Preventing stress singularities in peri-implant bone - a finite element analysis using a graded bone model

In finite element analysis bone is often treated as two-layered material that has a discontinuity between the cortical and cancellous bone, which leads to a singularity and incorrect stresses. The goal of this study was to eliminate this singularity and to create a more realistic representation of bone which also considers the transition zone between cortical and cancellous bone as observed in natural bone. This was achieved by modelling bone as a graded material and inserting node-specific values for Young's modulus in the finite element simulation, whereas the transition zone thickness was derived from a CT scan. The modelling was performed semi-automatically, and the maximum principal stresses of the new approach were compared to those of a conventional approach. The new approach was found to effectively avoid singularities and provides more accurate predictions of stress in areas of the bone transition zone. As the approach is automatable and causes rather small overhead it is recommended for use in future work, when the problem at hand requires evaluating stresses close to the former singularity.

Automated Remodelling of Connectors in Fixed Partial Dentures

In this study, an approach for automated parametric remodelling of the connector cross-sectional area in a CAD model of a given fixed partial denture (FPD) geometry was developed and then applied to a 4-unit FPD. The remodelling algorithm was implemented using Rhinoceros and the Grasshopper plugin. The generated CAD models were used to perform a finite element analysis with Ansys to analyse the stress distribution in an implant-supported 4-unit FPD for different connector designs. The results showed that the type of connector adjustment matters and that the resulting stress can be significantly different even for connectors with the same cross-sectional area. For tensile stresses, a reduction in the connector cross-sectional area from the gingival side showed the highest influence on each connector type. It can be concluded that the developed algorithm is suitable for automatic connector detection and adjustment.

Distribution of mature and newly regenerated nerve fibers after tooth extraction and dental implant placement: an immunohistological study

BACKGROUND

The time-dependent peri-implant innervation needs to be elucidated in detail.

OBJECTIVES

To examine the distribution of mature and newly regenerated nerves around the implant with immunofluorescence during 28-days follow-up after implantation.

METHODS

35 male Sprague-Dawley rats were grouped into non-operated(n=5), extraction(n=5), and implant(n=25) groups. For rats in the extraction and implant groups, three right maxillary molars were extracted. One month later, a titanium implant was placed into the healed alveolar ridge in the implant group. The implant group was further divided into 5 subgroups according to day 1, 3, 7, 14, or 28 after implantation, on which day serial histological sections were prepared for immunohistochemistry. On day 28, the serial sections were also prepared in the non-operated and extraction groups. Soluble protein-100 and growth-associated protein-43 were used to immunolabel mature and newly regenerated nerve fibers respectively.

RESULTS

In the peri-implant soft tissues, the number of both mature and newly regenerated nerves showed an increasing trend in 28 days. In the bone tissues, the number of mature or newly regenerated nerves in both areas at less than 100 μm and 100-200 μm from the implant surface on day 28 grew significantly compared with that on day 1 or 3. In addition, the closest distance from mature nerves to the implant surface decreased evidently.

CONCLUSION

The number of peri-implant nerves increased in 28 days since implantation. The innervation in the soft tissue took place faster than in the bone tissue. The mature nerves in the bone tissue approached the implant gradually.

Finite Element Analysis of effect of cusp inclination and occlusal contacts in PFM and PEEK implant-supported crowns on resultant stresses

BACKGROUND

Effect of prosthesis design on occlusal overload and long-term implant stability cannot be overstated. In Porcelain Fused to Metal (PFM) crowns, low cusp inclination and occlusal contacts limited to central fossa ensure axially directed forces on an implant but often pose esthetic and functional challenges. It is theorized that resilient Polyetheretherketone (PEEK) crowns have shock absorption capacity for favorable stress distribution. This study compared two implant crown materials and evaluated the effect of cusp inclination and occlusal contact distribution on resultant stresses.

METHODS

Thirty 3D finite element models of implant-supported PFM and PEEK crowns, generated using Solidedge 3D CAD solid modeling software (v19, Siemens PLM Software Inc.,US), were used to study the effect of 3 cups inclinations (0°, 15°, 30°) under five load conditions, with 300N force distributed over one, two, or three contact areas and exported to ANSYS (v18.1, ANSYS Inc. Pennsylvania, US) for stress analysis.

RESULTS

Maximum stress in both PFM and PEEK models was at the neck of the implant under Load 3(300N distributed over three contact areas: central fossa, buccal cusp tip, marginal ridge). Minimum stress in all models was under Load 1(300N applied at one contact area in central fossa). Maximum stresses were recorded for 30° cusp inclination in PFM models.

CONCLUSION

In both PFM and PEEK crown models, contact areas placed away from the implant axis generated greater implant and peri-implant stresses and had more effect on resultant stresses than that of increase in cusp inclination. The effect of cusp inclination on the resultant stresses was dependent on the crown material.

[Study of the effect of the occlusal surface of a natural tooth and fixed partial dentures supported by dental implants on the stress distribution by finite element analysis]

OBJECTIVE

To study the effect of the occlusal surface of a natural tooth, cement-retained and screw-retained fixed partial dentures supported by dental implants and the coefficient of friction on the stress distribution in the peri-implant bone at maximum and minimum principal stresses.

MATERIAL AND METHODS

Study of maximum and minimum principal stresses in models with natural teeth and artificial crowns supported by dental implants, taking into account the coefficient of friction using the finite element analysis.

RESULTS

In models represented by fixed partial dentures supported by dental implants and a natural tooth, the maximum tensile stresses arise in the cortical bone in the cervical region of the artificial crown, and the maximum compressive stresses occur both in the cortical layer in the cervical region of the artificial crown and in the cervical region of the tooth. In models with two fixed partial dentures supported by dental implants or two natural teeth, the stress distributions in the cortical layers in the upper and lower jaw are almost identical.

CONCLUSION

Modeling the antagonist and adding to the FEA model is important in order to determine the precise and realistic direction of the resulting force vector. Amplification of the number of contact areas should be considered when modeling the occlusal surface of artificial crowns supported by dental implants.

Comparative Numerical Analysis between Two Types of Orthodontic Wire for the Lingual Technique, Using the Finite Element Method

In the lingual orthodontic technique, there are two paradigms regarding the type of wire used. Regardless of the material or gauge, some orthodontists choose to use the straight wire and resin and bond it to the surface of the tooth; they call it compensations. Other orthodontists prefer to bend the wire, giving it a mushroom shape. There is no specific indication for the use of each type of wire, so orthodontists use them according to their criteria. The present study establishes the bases so that it is possible to find the indications for each type of wire. A clinical trial of a lingual orthodontic patient was used. To carry out the comparative study, a straight arch was placed in his right arch and a mushroom arch in the left arch. Using 3D imaging, a high-biofidelity biomodel of the patient's mandible was generated, with which the FEM analysis was performed, which allowed comparing the reactions of the mandibular bone and appliances with the different arches. It was found that, on the side with the straight arch, there were greater deformations, and in the mushroom arch, there were greater stresses. With this, it is possible to find which clinical cases in each type of wire are indicated.

The all-on-4 concept in the maxilla-A biomechanical analysis involving high performance polymers

A finite element analysis was used to determine the loading behavior of a full "All-on-4" bridge in the maxilla made from different framework materials. The model was generated based on data from an edentulous maxilla. Four implants were positioned according to the All-on-4 concept and a full arch restoration was created on top of the implants. Separate thrust dies were modeled directly above each of the units of the bridge. Forces of 500 N were applied to each thrust die separately. Simulations were repeated with the following variations and results were compared to determine the influence of each variation: point of force application (from tooth 16 to 26), framework material (high performance polymer HPP, titanium Ti, cobalt chromium CoCr), and healing state of the bone/implant interface. Depending on the point of force application, the bone below the HPP framework showed increased stresses (median: 180 MPa at 13) compared to the CoCr and Ti frameworks (110 MPa at 16) under immediate loading. After osseointegration, the framework material had no obvious influence on the stresses in the bone. In the osseointegrated state, maximum stresses are decreased by the tenfold. Stresses in the framework were clearly decreased with HPP compared to CoCr and Ti (75, 125, 115 MPa). Loading the anterior teeth induced higher stresses than loading the molar region due to torsional deformation. This effect increased with decreasing framework material stiffness. The framework stiffness had less distinct influence on the stresses in the restoration than the point of force application.

Effects of overdenture attachment systems with different working principles on stress transmission: A three-dimensional finite element study

PURPOSE

The aim of the present study was to compare the stress distributions on the dental implants, abutments, and bone caused by different overdenture attachment types under functional chewing forces.

MATERIALS AND METHODS

The 3D finite element models of the mandible, dental implants, attachment types, and prostheses were prepared. In accordance with a conventional dental implant supported overdenture design, the dental implants were positioned at the bone level in the canine teeth region bilaterally. A total of eight models using eight different attachment systems were used in this study. All the models were loaded to simulate chewing forces generated during the centric relationship (450 N), lateral movement (400 N), protrusive movement (400 N), and also in the presence of a food mass unilaterally (200 N). Stress outputs were obtained as the maximum principal stress and the equivalent von-Mises stress.

RESULTS

In all attachment types, higher stress values were observed in the abutments, dental implants, and bone in the magnet attachments in different loading conditions. The highest stress values were observed among the magnet systems in the components of the Titanmagnetics model in all loading conditions (stresses were 15.4, 17.7, and 33.1 MPa on abutment, dental implant, and bone, respectively). The lowest stress value was observed in the models of Zest and O-Ring attachments.

CONCLUSION

The results of the present study implied that attachment types permitting rotation and tolerating various angles created lower stresses on the bone, dental implants, and abutments.

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.

The effect of different occlusal contact situations on peri-implant bone stress - A contact finite element analysis of indirect axial loading

Implant restoration is one of the basic treatments in dentistry today, yet implant loss from occlusal overload is still a problem. Complex biomechanical problems such as occlusal overload are often analyzed by means of the finite element method. This numerical method makes it possible to analyze in detail the influence that different loading situations have upon implants and tissues, which is a key element in optimizing these dental procedures. This study was designed to investigate the stress distribution in peri-implant bone of a single-tooth implant crown using the finite element method. The load was applied indirectly via an occluding tooth through a three and five contact setup into the implant crown. The friction coefficient values between the crown and antagonist were varied between 0.1 and 1.0. Additionally, three crowns with cusp inclinations of 20°, 30° and 40° were modeled. Non-linear contact computations indicated that an increase in friction changed the direction and magnitude of contact forces, which also led to reduced stresses in the bone. Furthermore, the stress magnitudes were higher when cusps of a greater inclination were used. The intensity of stress alterations was strongly dependent on the distribution and number of contacts, and the contact force vector. In maximum intercuspation, a resulting axial load due to well-distributed contacts prevented high stresses in bone even with high cusp inclinations and low friction. Therefore for long-term clinical success, particular attention should be paid to occlusal adjustment so as to prevent oblique loading onto dental implant restorations.

The effect of low-magnitude high-frequency loading on peri-implant bone healing and implant osseointegration in Beagle dogs

PURPOSE

Low-magnitude, high-frequency (LMHF) loading plays an important role in bone healing. The present study aimed to evaluate the effect of LMHF loading applied directly to titanium dental implants on peri-implant bone healing and implant osseointegration.

METHODS

The mandibular premolars and molars were extracted from six male Beagle dogs. Three months post-extraction, each of the six dogs had three titanium implants (Aadva Standard Implant Narrow, Φ3.3×8mm) inserted into the mandibular premolar and molar area (three implants per side). In each animal, one side was randomly selected to undergo daily LMHF loading (treatment group), while the other side had no further intervention (control). The loading was applied directly to the implant abutment using an individual jig and a custom-made loading device (8μm, 100Hz). The implant stability quotient (ISQ) was tested every week. Three dogs were euthanized after 2 weeks, and three were euthanized after 8 weeks. Tissue samples were fixed and stained for micro-computed tomography (micro-CT) and histomorphometric analyses. Data were analyzed statistically, with significance set at p<0.05.

RESULTS

The treatment group had significantly increased peri-implant bone volume relative to tissue volume in region of interest 2 (100-500μm) compared with the control group after 2 weeks of loading (p<0.05); however, there was no significant difference between groups after 8 weeks. The ISQ value and the micro-CT results did not differ between groups during the study period.

CONCLUSIONS

LMHF loading positively influenced peri-implant bone healing in the early healing period.

Numerical Analysis of Masticatory Forces on a Lower First Molar considering the Contact between Dental Tissues

The aim of the present work is to identify the reactions of the dental organs to the different forces that occur during chewing and the transcendence of the union and contact maintained by the dental tissues. The study used a lower first molar biomodel with a real morphology and morphometry and consisting of the three dental tissues (enamel, dentin, and pulp) each with its mechanical properties. In it, two simulations were carried out, as would the process of chewing a food. One of the simulations considers the contact between the enamel and the dentin, and the other does not take it into account. The results obtained differ significantly between the simulations that consider contact and those that do not, establishing the importance of taking this contact into account. In this way, the theories that establish horizontal and lateral occlusion forces are present during the functional chewing process which are viable to be correct. The case studies carried out present not only the reasons for the failure of enamel but also the failure of the restoration materials used. This reflection will allow the development of more adequate materials, mechanical design of prostheses, implants, and treatment.