The effects of bone density and crestal cortical bone thickness on micromotion and peri-implant bone strain distribution in an immediately loaded implant: a nonlinear finite element analysis

Tsutomu Sugiura, Kazuhiko Yamamoto, Satoshi Horita, Kazuhiro Murakami, Sadami Tsutsumi, Tadaaki Kirita, Tsutomu Sugiura, Kazuhiko Yamamoto, Satoshi Horita, Kazuhiro Murakami, Sadami Tsutsumi, Tadaaki Kirita

Abstract

Purpose: This study investigated the effects of bone density and crestal cortical bone thickness at the implant-placement site on micromotion (relative displacement between the implant and bone) and the peri-implant bone strain distribution under immediate-loading conditions.

Methods: A three-dimensional finite element model of the posterior mandible with an implant was constructed. Various bone parameters were simulated, including low or high cancellous bone density, low or high crestal cortical bone density, and crestal cortical bone thicknesses ranging from 0.5 to 2.5 mm. Delayed- and immediate-loading conditions were simulated. A buccolingual oblique load of 200 N was applied to the top of the abutment.

Results: The maximum extent of micromotion was approximately 100 μm in the low-density cancellous bone models, whereas it was under 30 μm in the high-density cancellous bone models. Crestal cortical bone thickness significantly affected the maximum micromotion in the low-density cancellous bone models. The minimum principal strain in the peri-implant cortical bone was affected by the density of the crestal cortical bone and cancellous bone to the same degree for both delayed and immediate loading. In the low-density cancellous bone models under immediate loading, the minimum principal strain in the peri-implant cortical bone decreased with an increase in crestal cortical bone thickness.

Conclusions: Cancellous bone density may be a critical factor for avoiding excessive micromotion in immediately loaded implants. Crestal cortical bone thickness significantly affected the maximum extent of micromotion and peri-implant bone strain in simulations of low-density cancellous bone under immediate loading.

Keywords: Bone density; Dental implants; Finite element analysis.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Finite element model. (A) The right posterior mandible model consisted of cancellous bone and cortical bone. The cortical bone comprised the crestal cortical bone and the buccal, lingual, and inferior borders of the mandible. The three independent parameters included: (1) the density of cancellous bone, (2) the density of crestal cortical bone, and (3) the thickness of crestal cortical bone. (B) Implant and abutment.
Figure 2
Figure 2
The results of convergence tests in the standard model with 1.0-mm crestal cortical bone under delayed loading.
Figure 3
Figure 3
Displacement of the implant and abutment in the immediate-loading models with 2.0-mm crestal cortical bone. The cortical bone and the implant and abutment before deformation are also illustrated. Displacement of the implant and abutment is represented at 15× magnification in all models. B, buccal; L, lingual.
Figure 4
Figure 4
Maximum micromotion in the immediate-loading models.
Figure 5
Figure 5
Minimum principal strain distribution in the cortical bone in 2.0-mm crestal cortical bone models. (A) Delayed loading. (B) Immediate loading. B, buccal; L, lingual.
Figure 6
Figure 6
The effect of crestal cortical bone thickness on the minimum principal strain distribution in the cortical bone in the standard model under immediate loading. (A) 0.5 mm of thickness. (B) 1.0 mm of thickness. (C) 2.0 mm of thickness. (D) 2.5 mm of thickness. Similar trends in the minimum principal strain distributions were observed in the delayed-loading models, although the strain levels were different (data not shown).
Figure 7
Figure 7
The peak values of minimum principal strains in the peri-implant cortical bone.

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