A finite element study on the risk of bone loss around posterior short implants in an atrophic mandible.

PURPOSE: This study aimed to evaluate the risk of bone loss around single short molar crown-supporting implants in an atrophic mandible. METHODS: Implants of different lengths (L = 4 or 6 mm) and diameters (Ø = 4.1 or 4.8 mm) were placed in the molar area of an atrophic mandible. Additional control mandible models were simulated for 4.1 mm diameter implants (L = 4, 6, 8, and 10 mm). A vertical masticatory load of 200 N was applied to three or six occlusal contact areas (3ca or 6ca) of the prosthetic crown. The bone strain energy density (SED) of 109.6 µJ/mm3 was assumed to be the pathological threshold for cortical bone. The peri-implant bone resorption risk index (PIBRri) was calculated by dividing the maximum SED of the crestal cortical bone by the SED pathological threshold. RESULTS: Increasing the implant length from 4 to 6 mm, implant diameter from 4.1 to 4.8 mm, and number of contact areas from 3 to 6 reduced the SED and PIBRri values by approximately 20%, 35%, and 40%, respectively, when comparing pairs of models that isolated a specific variable. All models with 6ca had a low bone resorption risk (PIBRri<0.8), while the Ø4.1 short implant with 3ca had a medium (0.8≤PIBRri≤1.0) or high (PIBRri>1.0) resorption risk. CONCLUSIONS: Increasing the diameter or occlusal contact area of a 4 mm short implant in an atrophic mandible resulted in reduced bone resorption risks, similar to or lower than those observed in a regular mandible with standard-length implants.

Assessment of Occlusal Load Strength of Glass Ionomer Cement and Composite in Class V Cavities: An In-Vitro Study.

BACKGROUND:  Glass ionomer cement (GIC) is widely used in dentistry due to its chemical adhesion to dental tissues, biocompatibility, and anti-cariogenic potential but they have relatively weak mechanical properties. Resin composites have been widely regarded as the first choice for direct restorations but their polymerization shrinkage has remained a major problem. It has the potential to cause tooth debonding. The composite interface leads to postoperative sensitivity, secondary caries, enamel cracks, and microleakage. A restorative material's capacity to withstand occlusal stresses and support the remaining tooth structure depends on this property. Although class V restorations are predominantly done with GIC, this study was done to compare the strength of composite with the same. The GIC restore glass which is commonly used was tested against restofill composite. The main objective of conducting the study was to compare the compressive strength of the composite vs GIC in cervical cavities. So the aim of the study is to assess the occlusal load strength of GIC and composite in class V cavities using the universal testing machine. MATERIALS AND METHODS:  This study was employed as an in vitro study involving 20 natural central incisor teeth without any carious lesions. Class V cavity preparation was done and the selected teeth were divided into two groups of ten each. The cavities were filled with D Tech Restore GIC and composite restorations (restofill), respectively, polished, and then subjected to testing. An eccentric load was applied to the tooth structure using an Instron (Instron E3000 Electropuls, Instron, Norwood, United States) - Universal testing machine with a cross-head speed of 1mm per minute, and the stresses were further analyzed in the presence of an occlusal loading test using a stainless steel jig of 1mm diameter which led to the sectioning of the tooth buccolingually under the applied load. RESULTS:  An independent t-test was used to assess the results, and it was concluded that the results were statistically significant (p<0.05) at p=0.034. CONCLUSION:  Conclusively, the results suggested that the occlusal load strength of the composite is greater when compared to GIC.

Can bite-force measurement play a role in dental treatment planning, clinical trials, and survival outcomes? A literature review and clinical recommendations.

Bite force (occlusal force) may play a significant role in patient treatment outcomes. However, as a diagnostic risk assessment tool, it has been examined in the literature but is not commonly utilized by practicing clinicians and in academic studies. This diagnostic evaluation may assist the dental clinician in planning tooth- and implant-supported restorations, as damage to the tooth, implant, or restoration may be dependent upon a restoration's resistance to loading conditions. The overall bite force has been estimated to be up to 2,000 N, with a clear sexual dimorphism and age dependence. The magnitude of these forces along the dental arch have been shown to be elevated in the posterior compared to the anterior region. The bite force magnitude has been inversely related to the proprioception, as a significant increase in bite force is seen in patients with endodontically treated teeth as compared to their vital teeth. Bite force has been linked to chewing efficiency, quality of life, and implicated in the life expectancy of the restorations. Restoration life expectancies have been associated with the material selection and preparation design parameters, both of which may be affected by masticatory bite force. Treatment planning criteria for preparation strategies affected by bite force include tooth location, material selection, occlusion pathways, and subsequent occlusal reduction amounts. When implants are used in patients with elevated magnitude of bite force, an increase in the number and diameter of the implants as well as occlusions with reduced occlusal tables buccolingually and lighter contacts may be recommended. An understanding of the magnitude and load of a patient's bite force can assist the dental clinician in the design of dental treatments along with other standard risk assessment criteria.

A Theoretical Iteration for Predicting the Feasibility for Immediate Functional Dental Implant Loading.

When planning an implant-supported restoration, the dentist is faced with surgical and prosthetic technical issues as well as the patient's expectations. Many patients wish an immediate solution to an edentulous condition. This may be especially true in the esthetic zone, and that zone is determined by the patient. The dentist may consider when it is feasible to load the supporting implants with definitive or provisional prosthetics. In this work, many parameters were theoretically assessed for inclusion: bone density, cortical thickness, insertion torque, parafunction, bite load capacity, number of implants under load, implant/crown ratio, implant diameter, and length. After assessment, the most influential parameters were selected. An iteration, using patient age, implant diameter, bite load capacity, and cortical thickness, is now presented to aid the implant dentist in determining the feasibility for immediate functional loading of a just-placed dental implant in a healed site. Extensive testing is required to develop this concept. According to this iteration, most immediate functional loaded implants would fail. A future refined and definitive formula may enable the clinician to safely and immediately functionally load an implant with a definitive prosthesis. For access to the applet, please go to https://implantloading.shinyapps.io/shiny_app/.

Rationale for Mini Dental Implant Treatment.

Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone, and thus, control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes, and placement only in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment. However, past research on dental implants has been directed at standard sized implants. While mini implants are indeed dental implants, they behave somewhat differently under functional load, and the clinician should be circumspect and very judicious in their use. This article is a mini review and not a systematic review. The topics covered are not pervasive because each would require a monograph or textbook for a complete discussion.

Influence of cavity depth and restoration of non-carious cervical root lesions on strain distribution from various loading sites.

BACKGROUND: We aimed to investigate the load-induced strain variation in teeth with unrestored and resin-based composite restored non-carious cervical lesions (NCCLs). METHODS: Twelve extracted premolars were provided for measuring buccal-side root NCCLs. Strain gauges were fixed at four measuring sites of each tooth, two at the buccal surface and two at the lingual surface. NCCLs were prepared with occlusal margins at the cemento-enamel junction. A static 9-kg load was applied at seven occlusal loading points: buccal cusp tip (BC), inner inclination of the BC, lingual cusp tip (LC), inner inclination of the LC, center of the mesial marginal ridge or distal marginal ridge, and center of the central groove. The strain was detected at each site in teeth with NCCL depths of 0 (control), 0.5, 1.0, and 1.5 mm. Each NCCL was restored using an adhesive composite resin, and the strains were re-measured. RESULTS: The strains at the NCCL occlusal and gingival margins decreased with increasing defect depths, and the effect was significant when the depth of the defect was 1.5 mm. Loading on the buccal and lingual cusps induced prominent strain variation. The strains at all depth distribution recovered to nearly intact conditions when the NCCLs were restored. CONCLUSIONS: NCCLs at 1.5 mm depth are detrimental, but they can be restored using resin composites. CLINICAL SIGNIFICANCE: The existence of NCCLs should not be ignored. The depth of the NCCL may affect the progression of the lesion. Resin composite restoration is an appropriate method for preventing persistent NCCL deterioration.

Occlusal load modelling significantly impacts the predicted tooth stress response during biting: a simulation study.

Computational models of the masticatory system can provide estimates of occlusal loading during (static) biting or (dynamic) chewing and therefore can be used to evaluate and optimize functional performance of prosthodontic devices and guide dental surgery planning. The modelling assumptions, however, need to be chosen carefully in order to obtain meaningful predictions. The objectives of this study were two-fold: (i) develop a computational model to calculate the stress response of the first molar during biting of a rubber sample and (ii) evaluate the influence of different occlusal load models on the stress response of dental structures. A three-dimensional finite element model was developed comprising the mandible, first molar, associated dental structures, and the articular fossa and discs. Simulations of a maximum force bite on a rubber sample were performed by applying muscle forces as boundary conditions on the mandible and computing the contact between the rubber and molars (GS case). The molar occlusal force was then modelled as a single point force (CF1 case), four point forces (CF2 case), and as a sphere compressing against the occlusal surface (SL case). The peak enamel stress for the GS case was 110 MPa and 677 MPa, 270 MPa and 305 MPa for the CF1, CF2 and SL cases, respectively. Peak dentin stress for the GS case was 44 MPa and 46 MPa, 50 MPa and 63 MPa for the CF1, CF2 and SL cases, respectively. Furthermore, the enamel stress distribution was also strongly correlated to the occlusal load model. The way in which occlusal load is modelled has a substantial influence on the stress response of enamel during biting, but has relatively little impact on the behavior of dentin. The use of point forces or sphere contact to model occlusal loading during mastication overestimates enamel stress magnitude and also influences enamel stress distribution.

Excessive occlusal load on chemically modified and moderately rough titanium implants restored with cantilever reconstructions. An experimental study in dogs.

OBJECTIVE: To evaluate the outcomes of excessively loaded implants. MATERIAL AND METHODS: In five dogs, all mandibular premolars were extracted. After 3 months, six implants (three SLA® and three SLActive®) were placed (S). After 4 weeks, implants were restored: one single crown with stable occlusal contacts (SC), one crown and a cantilever unit with excessive occlusal contacts (OL), and a non-loaded implant (NL). Bleeding-on-probing (BoP), attachment level (AL), mucosal margin (GM) were assessed. Resonance frequency analysis (RFA) was assessed weekly. Standardized X-rays were taken at S, 4 and 24 weeks. RESULTS: Similar findings were observed for SLA® and SLActive® implants regarding PlI, GI, GM, AL, and BL. No significant differences were detected between baseline and 24-weeks or between treatment modalities for all clinical parameters (p > .05). Six months after loading, RFA values were significantly greater than at implant placement. No significant differences between treatment modalities were found. Linear radiographic measurements yielded similar results between SLA® and SLActive® implants. SLA® OL implants yielded a statistically significant gain on peri-implant bone density over all other groups (p = .012). Radiographic results were confirmed by descriptive histology. Technically, loosened occlusal screws occurred in 13.3% (SC = 3.3%; OL = 10%), while abutment fractures totalized 23.3% (SC = 6.6%; OL = 16.6%). CONCLUSIONS: Excessive occlusal load applied to implants (SLA® or SLActive®) restored with cantilevers did not cause loss of osseointegration or significant changes in their clinical, radiographic, or histologic outcomes. Early excessive occlusal load on SLA® implants promoted a gain in peri-implant bone density. Excessively loaded implants showed more technical complications.

[Comparative analysis of different types of implant-abutment interface on the basis of three-dimensional finite element analysis data]. / Sravnitel'nyi analiz biomekhaniki pri razlichnykh uzlakh sopriazheniia implantata i abatmenta na osnovanii dannykh trekhmernogo konechno-élementnogo modelirovaniia.

The purpose of the study was to perform a comparative static and dynamic finite element analysis of various taper and cylindrical implant-abutment connections in three-dimensional (3D) models including: abutment, fixing screw, implant, cortical bone, cancellous bone. 3D implant model was IRIS LIKO-M system (Russia) 4 mm diameter and 10 mm length. All the models (M1-M6) were built in the same way. While maintaining the external design of IRIS LIKO-M implant, they differed only by taper angle 1.25°, 5°, 9° and its height - 0.45 and 1.85 mm; the models (M7, M8) had a cylindrical connection with a joint height of 0.45 and 1.85 mm. The bone model was 6 mm width, included cortical layer was 3 mm and the inner cancellous bone. The results of static FEA of an occlusal load showed that implant with 1.85 mm abutment connection transfer strain from edge of a cortical bone to its inner layer thus preventing marginal bone resorption. The best results showed implant model with conical taper 5° and 1.85 mm height: the smallest von Mises stress in cortical layer at tightening of the fixing screw and at masticatory load, and the larger margin of safety of an implant, the abutment and the fixing screw. The results of dynamic FEA of implant with cylindrical connection demonstrate that the gap between an abutment and an implant may occur and lead to fixing screw loosening or fracture. At the same time, the implant design with knot of interface of conical type 5° remains tight at dynamic load.

Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study.

PURPOSE: The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS: Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS: Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION: The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

Influence of Implant Positions and Occlusal Forces on Peri-Implant Bone Stress in Mandibular Two-Implant Overdentures: A 3-Dimensional Finite Element Analysis.

The aim of this study was to evaluate and compare the bone stress around implants in mandibular 2-implant overdentures depending on the implant location and different loading conditions. Four 3-dimensional finite element models simulating a mandibular 2-implant overdenture and a Locator attachment system were designed. The implants were located at the lateral incisor, canine, second premolar, and crossed-implant levels. A 150 N unilateral and bilateral vertical load of different location was applied, as was 40 N when combined with midline load. Data for von Mises stress were produced numerically, color coded, and compared between the models for peri-implant bone and loading conditions. With unilateral loading, in all 4 models much higher peri-implant bone stress values were recorded on the load side compared with the no-load side, while with bilateral occlusal loading, the stress distribution was similar on both sides. In all models, the posterior unilateral load showed the highest stress, which decreased as the load was applied more mesially. In general, the best biomechanical environment in the peri-implant bone was found in the model with implants at premolar level. In the crossed-implant model, the load side greatly altered the biomechanical environment. Overall, the overdenture with implants at second premolar level should be the chosen design, regardless of where the load is applied. The occlusal loading application site influences the bone stress around the implant. Bilateral occlusal loading distributes the peri-implant bone stress symmetrically, while unilateral loading increases it greatly on the load side, no matter where the implants are located.

Bite force and dental implant treatment: a short review.

Dental implants are placed endosseously, and the bone is the ultimate bearer of the occlusal load. Patients are not uniform in the maximum bite force they can generate. The occlusal biting load in the posterior jaw is usually about three times of that found in the anterior. It is possible for supporting implants to be overloaded by the patients' biting force, resulting in bone loss and failure of the fixture. Bite force measurement may be an important parameter when planning dental implant treatment. Some patients can generate extreme biting loads that may cause a luxation of the fixture and subsequent loss of osseointegration. A patient with low biting force may be able to have a successful long-term outcome even with poor anatomical bone qualities. Patients with a high bite force capability may have an increased risk for late component fracture or implant failure. There is no correlation of any bite force value that would indicate any overload of a given implant in a given osseous site. Nonetheless, after bite force measurement, a qualitative judgement may be made by the clinician for the selection of an implant diameter and length and prosthetic design.

Effect of Different Ferrule Length on Fracture Resistance of Endodontically Treated Teeth: An In vitro Study.

INTRODUCTION: A ferrule has been described as a key element of tooth preparation when using a post and a core. It is a vertical band of tooth structure at the gingival aspect of crown preparation. It lessens the stress transmission to the root which is due to forces from posts or bending during seating of the post. The incorporation of a ferrule can help to withstand the forces of occlusion, preserve the hermetic seal of the luting cement, and minimize the concentration of stresses at the junction of post and core. AIM: To evaluate and compare the effect of ferrule length on fracture resistance of endodontically treated mandibular premolar teeth, restored with prefabricated glass fiber post luted with resin cement, composite core and a full coverage metal crown. MATERIALS AND METHODS: Forty freshly extracted mandibular premolars were treated endodontically. They were randomly divided into four groups according to their ferrule height: 3 mm, 2 mm, 1 mm and 0 mm (no ferrule). All specimens were restored with prefabricated glass fibre posts (Reforpost, Angelus) and composite resin (Filtek™ Z250XT). Standardized preparation was done on each specimen to receive a cast metal crown. The specimens were thermocycled and compressive static load at a crosshead speed of 1 mm/min was applied at an angle of 30° on lingual incline of buccal cusp of the crown until failure occurred. The load (N) at failure and mode of failure were recorded. Statistical analysis was performed with Kruskal Wallis test. RESULT: Fracture resistance values among the groups was found to be statistically significant (p<0.001). The 3 mm ferrule group had significantly higher failure load (971.99±133.07) compared to 2 mm (848.84±109.60), 1 mm (714.64±133.89) and 0 mm ferrule groups (529.36±119.95). More favourable failure modes were observed in almost all groups. CONCLUSION: The results of this study showed that fracture resistance of endodontically treated teeth increases as ferrule length increases.

Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study

PURPOSE: The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS: Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS: Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION: The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

Occlusal status of implant superstructures at mandibular first molar immediately after setting.

BACKGROUND: Occlusal contact on the implant superstructures is important for successful treatment. The purpose of this study was to investigate the occlusal contact of single implant superstructures at the mandibular first molar immediately after seating from weak to strong clenching. METHODS: Subjects were nine patients who had just been fitted with an implant prosthesis in the mandibular first molar region, with no missing teeth other than in the implant region. First, while masseter muscle activity was monitored, maximum clenching strength (100 % maximum voluntary contraction (MVC)) was determined with an electromyogram. Next, occlusal load and occlusal contact area were measured three times at clenching intensities of 40, 60, 80, and 100 % MVC by the use of pressure-sensitive film for occlusal force diagnostic and Occluzer for occlusal force measurement. Finally, the occlusal contact area was measured once each at 20, 40, and 60 % MVC using a silicone testing material and BiteEye for occlusal contact measurement. A two-way analysis of variance (ANOVA) was used to determine occlusal loading and occlusal area as dependent variables, and clenching strength and presence or absence of implant as between-subject factors. A multiple comparison test was performed using the Bonferroni method. RESULTS: The occlusal contact area and occlusal load of the implant prosthesis increased with clenching strength, and the increases in occlusal contact area and occlusal load of the implant prosthesis were less than those of the contralateral tooth at high clenching strength. However, significant difference was not observed when compared with both sides of the molar region regardless of clenching strength. CONCLUSIONS: The occlusal contact area of the implant had a tendency to be adjusted smaller than the natural tooth by a dental technician and a dentist. On the other hand, despite the small tissue displaceability of the implant, occlusal load on the implant prosthesis was smaller than on the natural tooth at high clenching strength.

Influence of occlusal loading force on occlusal contacts in natural dentition.

PURPOSE: Proper occlusal contact is important for the long-term success of prosthodontic therapy. We clarified the effects of occlusal loading force on occlusal contact in natural dentition by comparing measured values for occlusal loading and occlusal contact area. METHODS: Masseter muscle activity was measured in 10 subjects (2 male, 8 female; mean age, 27 years) with natural dentition using electromyography, with clenching at full strength with nothing interposed between the upper and lower teeth defined as 100% maximum voluntary contraction (MVC). Pressure-sensitive film (Occluzer) was used to examine occlusal contact points at 20, 40, 60, 80, 100 and 120% MVC. A material for checking accuracy of fit (BiteEye) was used to examine occlusal contact points at 20, 40, 60 and 80% MVC. ANOVA and the Bonferroni method were used to assess the results, with the level of significance set at 5%. Coefficients of variation (CV) were also calculated by dividing the standard deviation by the mean. RESULTS: Occlusal loading and occlusal contact area increased with clenching strength; however, CV showed differences between the methods at low and high MVC. CONCLUSIONS: With Occluzer, testing should be carried out at clenching strength ≥ 60% MVC. With BiteEye, testing should be carried out from light clenching strength at 20% MVC to moderate clenching strengths at 40-60% MVC. Occluzer and BiteEye (10 µm) gave similar occlusal contact areas at 60-80% MVC. These results suggest that combined use of Occluzer and BiteEye gives an accurate picture of occlusion from weak to strong clenching strength.

Hoop stress and the conical connection.

Dental implant-abutment connection design has developed into the use of a conical, shank and socket connection between the implant abutment and fixture. The connection between these two elements is, in effect, a conical wedge that may exert lateral forces under load that may result in fracture of the coronal implant socket fixture walls. This study evaluated the axial loading on a conical connection and found that axial loads were well tolerated but off-axial loads were not. Fracture of the implant coronal socket fixture wall occurred under off-axial loading.

Effect of Offset Implant Placement on the Stress Distribution Around a Dental Implant: A Three-Dimensional Finite Element Analysis.

There are some anatomical restrictions in which implants are not possible to be inserted in their conventional configuration. Offset placement of implants in relation to the prosthetic unit could be a treatment solution. The aim of this study was to evaluate the effect of the offset placement of implant-supported prosthesis on the stress distribution around a dental implant using 3D finite element analysis. 3D finite element models of implant placement in the position of a mandibular molar with 4 configurations (0, 0.5, 1, 1.5 mm offset) were created in order to investigate resultant stress/strain distribution. A vertical load of 100 N was applied on the center of the crown of the models. The least stress in peri-implant tissue was found in in-line configuration (0 mm offset). Stress concentration in the peri-implant tissue increased by increasing the amount of offset placement. Maximum stress concentration in all models was detected at the neck of the implant. It can be concluded that the offset placement of a single dental implant does not offer biomechanical advantages regarding reducing stress concentration over the in-line implant configuration. It is suggested that the amount of offset should be as minimum as possible.

FE study of bone quality effect on load-carrying ability of dental implants.

Extreme stresses in surrounding bone are among the most important reasons for implant failure. Bone density (quality) is a variable that plays a decisive role in achieving predictable osseointegration and long-term survival of implants. The magnitudes of ultimate occlusal load, which generate ultimate von Mises stress at the critical point of peri-implant area for the spectrum of implants inserted into mandible with four different bone qualities (Lekholm and Zarb classification), were calculated. Geometric models of mandible segment were generated from computed tomography images and analysed with osseointegrated cylindrical implants of various dimensions. Occlusal loads were applied in their natural direction. All materials were assumed to be linearly elastic and isotropic. The investigation suggests that an implant's ultimate occlusal load indicates its load-carrying capacity. As a result, bone loss can be predicted, and viable implants can be selected by comparing the values of their ultimate occlusal load in different clinical conditions.

Importância da tensão na perda óssea marginal ao redor de implantes / The importance of the stress in the marginal bone loss around implants

Uma das principais causas de complicações na implantodontia relaciona-se à concentração de tensões perimplantares. A compreensão da etiologia destas complicações é muito importante para minimizar a perda óssea marginal. O objetivo deste trabalho foi realizar uma revisão bibliográfica correlacionando as tensões com alguns fatores biomecânicos como projeto do implante, tipo de carga oclusal, localização do implante e desajuste protético, verificando-se quais as possibilidades de minimizar a tensão na interface implante-osso

One of the most important causes of complication in implantology is related to the peri-implant stress concentration. The etiology comprehension of these complications is very important to minimize the bone loss. The aim of this study was to realize a literature review to correlate the stress with some biomechanical factors as implant design, type of occlusal load, implant localization and prosthetic misfit, to verify the possibilities to minimize the stress in the bone to implant interface