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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Falcinelli C, Valente F, Vasta M, Traini T. Finite element analysis in implant dentistry: State of the art and future directions. Dent Mater 2023:S0109-5641(23)00092-1. [PMID: 37080880 DOI: 10.1016/j.dental.2023.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
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.
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Affiliation(s)
- Cristina Falcinelli
- Department of Engineering and Geology, University "G. d'Annunzio" of Chieti-Pescara, Viale Pindaro 42, Pescara 65127, Italy.
| | - Francesco Valente
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti 66100, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti 66100, Italy
| | - Marcello Vasta
- Department of Engineering and Geology, University "G. d'Annunzio" of Chieti-Pescara, Viale Pindaro 42, Pescara 65127, Italy
| | - Tonino Traini
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti 66100, Italy; Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti 66100, Italy
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Braesch-Andersen A, Wu D, Ferguson SJ, Persson C, Isaksson P. Application of phase-field fracture theories and digital volume correlation to synchrotron X-ray monitored fractures in human trabecular bone: A case study. J Mech Behav Biomed Mater 2022; 135:105446. [PMID: 36154992 DOI: 10.1016/j.jmbbm.2022.105446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/10/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022]
Abstract
Fracture processes of trabecular bone have been studied using various approaches over the years. However, reliable methods to analyse fracture at the single trabecula level are limited. In this study, a digital volume correlation (DVC) and a phase-field fracture model are applied and contrasted for human trabecular bone to analyse its failure under global compression at high resolution. A human trabecular bone sample was fractured in situ under synchrotron-based X-ray micro computed tomography (CT). Reconstructed CT data was then used in DVC algorithms to obtain high-resolution displacement fields in the bone at different load steps. A high-resolution specimen-specific structural mesh was discretized from the CT data and used for the phase-field simulation of the fracturing bone. The DVC analysis showed opening mode cracks as well as shear mode cracks. Strains in cracked regions were analysed. The load distribution in the trabecular structure resulted in two completely separated fracture regions in the sample body. A phenomenon that was also captured in the phase-field model. The results encourage us to believe improvements in boundary conditions and material models are worthwhile pursuing. Findings in this study support further development of a phase-field method to analyse fracture in samples with complex morphology, such as trabecular bone, and the capacity of DVC to quantify strains and slowly growing stable fractures during step-wise loading of trabecular bone.
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Affiliation(s)
| | - Dan Wu
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | | | - Cecilia Persson
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Per Isaksson
- Department of Materials Science and Engineering, Uppsala University, Sweden.
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Li N, Li Y, Gao Y, Jiang L. Biomechanical Assessment of Tilted Mandibular Second Molars with Full-Crown Adjacent to Implant-Supported Restoration: 3D Finite Element Analysis. Int J Gen Med 2022; 15:3459-3470. [PMID: 35378916 PMCID: PMC8976503 DOI: 10.2147/ijgm.s353134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Ning Li
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Yusi Li
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Yiming Gao
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Liting Jiang
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
- Correspondence: Liting Jiang; Yiming Gao, Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, No. 197, The Second Ruijin Road, Huangpu District, Shanghai, 200025, People’s Republic of China, Tel +86 21 64370045, Email ;
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Zhang S, Lü C, Li JH, Zhu BM, Wang WQ. [Three-dimensional finite element analysis of the influence of an abutment buffer layer on implant stress distribution]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:537-540. [PMID: 33085238 PMCID: PMC7573768 DOI: 10.7518/hxkq.2020.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 06/19/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To study the stress distribution under dynamic loading in the presence or absence of an abutment buffer layer by using three-dimensional finite element analysis. METHODS A three-dimensional solid geometric model of an implant in a human mandible was established on the basis of CT scan data. A buffer-free abutment prosthesis and a buffer-abutment abutment prosthesis were installed above the implant. The buffer layer was made of high-density polyethylene. A vertical load of 200 N and a horizontal load of 100 N (45°) were concentrated on the centers of the implant restorations of the two groups. Stresses on the implant neck and body, abutment neck and body, central bolt neck and body, and bone interface were compared via three-dimensional finite element analysis. RESULTS Stresses on the implant neck and body, abutment neck and body, central bolt neck and body, and bone interface on the abutment with a buffer layer were significantly lower than those on the abutment without a buffer layer. CONCLUSIONS The increase in the buffer layer of the abutment neck significantly reduced stress on the implant neck, abutment, central bolt neck, and bone interface.
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Affiliation(s)
- Shuai Zhang
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Chuan Lü
- Hangzhou Dongning Road Dental Clinic, Hangzhou 310017, China
| | - Jin-Hong Li
- Guangxing Hospital, Zhejiang Chinese Medical University, Hangzhou 310021, China
| | - Bao-Min Zhu
- VIP Center, Hangzhou Dental Hospital, Hangzhou 310002, China
| | - Wei-Qian Wang
- VIP Center, Hangzhou Dental Hospital, Hangzhou 310002, China
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Delgado-Ruiz RA, Calvo-Guirado JL, Romanos GE. Effects of occlusal forces on the peri-implant-bone interface stability. Periodontol 2000 2019; 81:179-193. [PMID: 31407438 DOI: 10.1111/prd.12291] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The occlusal forces and their influence on the initiation of peri-implant bone loss or their relationship with peri-implantitis have created discussion during the past 30 years given the discrepancies observed in clinical, animal, and finite element analysis studies. Beyond these contradictions, in the case of an osseointegrated implant, the occlusal forces can influence the implant-bone interface and the cells responsible for the bone remodeling in different ways that may result in the maintenance or loss of the osseointegration. This comprehensive review focuses on the information available about the forces transmitted through the implant-crown system to the implant-bone interface and the mechano-transduction phenomena responsible for the bone cells' behavior and their interactions. Knowledge of the basic molecular biology of the peri-implant bone would help clinicians to understand the complex phenomenon of occlusal forces and their effects on the implant-bone interface, and would allow better control of the negative effects of mechanical stresses, leading to therapy with fewer risks and complications.
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Affiliation(s)
- Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Jose Luis Calvo-Guirado
- International Dentistry Research Cathedra, Faculty of Medicine and Dentistry, Universidad Catolica San Antonio De Murcia (UCAM), Murcia, Spain
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA.,Department of Oral Surgery and Implant Dentistry, Johann Wolfgang Goethe University, Frankfurt, Germany
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Numerical Method for the Design of Healing Chamber in Additive-Manufactured Dental Implants. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1970680. [PMID: 28293628 PMCID: PMC5331164 DOI: 10.1155/2017/1970680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/13/2016] [Accepted: 01/11/2017] [Indexed: 01/22/2023]
Abstract
The inclusion of a healing chamber in dental implants has been shown to promote biological healing. In this paper, a novel numerical approach to the design of the healing chamber for additive-manufactured dental implants is proposed. This study developed an algorithm for the modeling of bone growth and employed finite element method in ANSYS to facilitate the design of healing chambers with a highly complex configuration. The model was then applied to the design of dental implants for insertion into the posterior maxillary bones. Two types of ITI® solid cylindrical screwed implant with extra rectangular-shaped healing chamber as an initial design are adopted, with which to evaluate the proposed system. This resulted in several configurations for the healing chamber, which were then evaluated based on the corresponding volume fraction of healthy surrounding bone. The best of these implants resulted in a healing chamber surrounded by around 9.2% more healthy bone than that obtained from the original design. The optimal design increased the contact area between the bone and implant by around 52.9%, which is expected to have a significant effect on osseointegration. The proposed approach is highly efficient which typically completes the optimization of each implant within 3–5 days on an ordinary personal computer. It is also sufficiently general to permit extension to various loading conditions.
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