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Abstract
Statement of problem
Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses.
Purpose
To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses.
Material and methods
A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at 30° with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone.
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Fig. 1.
A: A thin one piece implant model (NobelDirect® 3.0, TiUnite® surface-99kb). B: NobelDirect® TiUnite® surface (111 kb) for flapless surgical procedure with soft tissue integration and immediate function. ∗straight profile
Fig. 2.
Comparison of actual morse-taper 2-Piece (A) and monoblock 1-Piece ITI® implants (B) on the left and right sides, respectively. ∗concave profile, ∗∗straight profile
Fig. 3.
Five different cervical profiles. Base model: straight line, Model-1: concavity 0.1 mm, Model-2: concavity 0.3 mm, Model-3 and Model-4: concavity 0.6 mm.
Fig. 4.
Comparison of the from top to bottom curvilinear distance along the external surface of transgingival part.
Fig. 5.
A typical axisymmetric finite element mesh model (Base model). For simplicity, soft tissue is not included in the model.
Fig. 6.
The mesh model at the cervix of five different models. A: Base model, B: Model-1, C: Model-2, D: Model-3, and E: Model-4.
Fig. 7.
Stress monitoring points; 5 points at the either of right and left sides in the mid plane of cervical cortical plate, which are 0.2, 0.4, 0.6, 0.8, and 1.0 mm distant from the bone/implant interface, and 5 points in the either side along the length of the implant, i. e. located at the cervix, 0.25 L, 0.5 L, 0.75 L and the apex. (L= length of the threaded part)
Fig. 8.
Typical overall stress distribution in the implant/bone complex (Base model subject to a vertical load of 50 N).
Fig. 9.
Stress distribution at the cervix of five different models subject to a vertical load of 50 N. A: Base model, B: Model-1, C: Model-2, D: Model-3, and E: Model-4, F: Stress band.
Fig. 10.
Stress distribution at the cervix of five different models subject to a obliquely acting load of 50 N at an angle of 30° to the long axis of implant. A: Base model, B: Model-1, C: Model-2, D: Model-3, and E: Model-4, F: Stress band.
Fig. 11.
The maximum compressive stress distribution in the cortical bone surrounding the five different models subject to a vertical load of 50 N.
Fig. 12.
The maximum compressive stress distribution in the cancellous bone surrounding the five different models subject to a vertical load of 50 N.
Fig. 13.
The maximum compressive stress distribution in the cortical bone surrounding the five different models subject to an obliquely acting load of 50 N at 30° to the implant's long axis.
Fig. 14.
The maximum compressive stress distribution in the cancellous bone surrounding the five different models subject to an obliquely acting load of 50 N at 30° to the implant's long axis.
Fig. 15.
The peak stress at the cervical region of five different implant models subject to a vertical load of 50 N estimated by a regression analysis.
Fig. 16.
The peak stress at the cervical region of five different implant models subject to an obliquely acting load of 50 N at 30° to the implant's long axis is estimated by a regression analysis.
Fig. 17.
Stress distribution at the implant cervix subject to an obliquely acting load of 50 N at an angle of 30° to the long axis of implant (maximum tensile stress, Model-4).
Table I.
Mechanical properties (bone and implant materials)
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