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Akbas O, Greuling A, Stiesch M. The effects of different grading approaches in additively manufactured dental implants on peri-implant bone stress: A finite element analysis. J Mech Behav Biomed Mater 2024; 154:106530. [PMID: 38552334 DOI: 10.1016/j.jmbbm.2024.106530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
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.
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Affiliation(s)
- Osman Akbas
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Andreas Greuling
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany.
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
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Rodríguez-Montaño ÓL, Vaiani L, Boccaccio A, Uva AE, Lo Muzio L, Spirito F, Dioguardi M, Santacroce L, Di Cosola M, Cantore S, Ballini A. Optimization of Cobalt-Chromium (Co-Cr) Scaffolds for Bone Tissue Engineering in Endocrine, Metabolic and Immune Disorders. Endocr Metab Immune Disord Drug Targets 2024; 24:430-440. [PMID: 37946349 DOI: 10.2174/0118715303258126231025115956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/01/2023] [Accepted: 09/21/2023] [Indexed: 11/12/2023]
Abstract
Approximately 50% of the adult global population is projected to suffer from some form of metabolic disease by 2050, including metabolic syndrome and diabetes mellitus. At the same time, this trend indicates a potential increase in the number of patients who will be in need of implant-supported reconstructions of specific bone regions subjected to inflammatory states. Moreover, physiological conditions associated with dysmetabolic subjects have been suggested to contribute to the severity of bone loss after bone implant insertion. However, there is a perspective evidence strengthening the hypothesis that custom-fabricated bioengineered scaffolds may produce favorable bone healing effects in case of altered endocrine or metabolic conditions. This perspective review aims to share a comprehensive knowledge of the mechanisms implicated in bone resorption and remodelling processes, which have driven researchers to develop metallic implants as the cobalt-chromium (Co-Cr) bioscaffolds, presenting optimized geometries that interact in an effective way with the osteogenetic precursor cells, especially in the cases of perturbed endocrine or metabolic conditions.
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Affiliation(s)
| | - Lorenzo Vaiani
- Department of Mechanics, Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Antonio Boccaccio
- Department of Mechanics, Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Antonio Emmanuele Uva
- Department of Mechanics, Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, Microbiology and Virology Unit, University of Bari Aldo Moro, Bari, Apulia, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Stefania Cantore
- Department of Mechanics, Mathematics and Management, Polytechnic University of Bari, Bari, Italy
- Independent Researcher, Sorriso & Benessere - Ricerca e Clinica, Bari, Italy
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Ballini
- Department of Mechanics, Mathematics and Management, Polytechnic University of Bari, Bari, Italy
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Zhang C, Wang Y. Biomechanical Analysis of Axial Gradient Porous Dental Implants: A Finite Element Analysis. J Funct Biomater 2023; 14:557. [PMID: 38132811 PMCID: PMC10743419 DOI: 10.3390/jfb14120557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
The porous structure can reduce the elastic modulus of a dental implant and better approximate the elastic characteristics of the material to the alveolar bone. Therefore, it has the potential to alleviate bone stress shielding around the implant. However, natural bone is heterogeneous, and, thus, introducing a porous structure may produce pathological bone stress. Herein, we designed a porous implant with axial gradient variation in porosity to alleviate stress shielding in the cancellous bone while controlling the peak stress value in the cortical bone margin region. The biomechanical distribution characteristics of axial gradient porous implants were studied using a finite element method. The analysis showed that a porous implant with an axial gradient variation in porosity ranging from 55% to 75% was the best structure. Under vertical and oblique loads, the proportion of the area with a stress value within the optimal stress interval at the bone-implant interface (BII) was 40.34% and 34.57%, respectively, which was 99% and 65% higher compared with that of the non-porous implant in the control group. Moreover, the maximum equivalent stress value in the implant with this pore parameter was 64.4 MPa, which was less than 1/7 of its theoretical yield strength. Axial gradient porous implants meet the strength requirements for bone implant applications. They can alleviate stress shielding in cancellous bone without increasing the stress concentration in the cortical bone margin, thereby optimizing the stress distribution pattern at the BII.
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Affiliation(s)
- Chunyu Zhang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China;
- Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China
- Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha 410008, China
| | - Yuehong Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China;
- Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China
- Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha 410008, China
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Khaohoen A, Sornsuwan T, Chaijareenont P, Poovarodom P, Rungsiyakull C, Rungsiyakull P. Biomaterials and Clinical Application of Dental Implants in Relation to Bone Density-A Narrative Review. J Clin Med 2023; 12:6924. [PMID: 37959389 PMCID: PMC10649288 DOI: 10.3390/jcm12216924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Titanium has been the material of choice for dental implant fixtures due to its exceptional qualities, such as its excellent balance of rigidity and stiffness. Since zirconia is a soft-tissue-friendly material and caters to esthetic demands, it is an alternative to titanium for use in implants. Nevertheless, bone density plays a vital role in determining the material and design of implants. Compromised bone density leads to both early and late implant failures due to a lack of implant stability. Therefore, this narrative review aims to investigate the influence of implant material/design and surgical technique on bone density from both biomechanical and biological standpoints. Relevant articles were included for analysis. Dental implant materials can be fabricated from titanium, zirconia, and PEEK. In terms of mechanical and biological aspects, titanium is still the gold standard for dental implant materials. Additionally, the macro- and microgeometry of dental implants play a role in determining and planning the appropriate treatment because it can enhance the mechanical stress transmitted to the bone tissue. Under low-density conditions, a conical titanium implant design, longer length, large diameter, reverse buttress with self-tapping, small thread pitch, and deep thread depth are recommended. Implant material, implant design, surgical techniques, and bone density are pivotal factors affecting the success rates of dental implant placement in low-density bone. Further study is required to find the optimal implant material for a clinical setting's bone state.
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Affiliation(s)
- Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Tanapon Sornsuwan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok 65000, Thailand;
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Pongsakorn Poovarodom
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
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Tardelli JDC, de Barros Ciribelli Alves BM, da Costa Valente ML, dos Reis AC. Influence of the modulus of elasticity of dental implants on the distribution of stresses in the alveolar bone by the finite element method: a systematic review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023. [DOI: 10.1016/j.ajoms.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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