Biomechanical performance of dental implants inserted in different mandible locations and at different angles: A finite element study.

STATEMENT OF PROBLEM: Accurate implant placement is essential for the success of dental implants. This placement influences osseointegration and occlusal forces. The freehand technique, despite its cost-effectiveness and time efficiency, may result in significant angular deviations compared with guided implantation, but the effect of angular deviations on the stress-strain state of peri-implant bone is unclear. PURPOSE: The purpose of this finite element analysis (FEA) study was to examine the effects of angular deviations on stress-strain states in peri-implant bone. MATERIAL AND METHODS: Computational modeling was used to investigate 4 different configurations of dental implant positions, each with 3 angles of insertion. The model was developed using computed tomography images, and typical mastication forces were considered. Strains were analyzed using the mechanostat hypothesis. RESULTS: The location of the implant had a significant impact on bone strain intensity. An angular deviation of ±5 degrees from the planned inclination did not significantly affect cancellous bone strains, which primarily support the implant. However, it had a substantial effect on strains in the cortical bone near the implant. Such deviations also significantly influenced implant stresses, especially when the support from the cortical bone was uneven or poorly localized. CONCLUSIONS: In extreme situations, angular deviations can lead to overstraining the cortical bone, risking implant failure from unfavorable interaction with the implant. Accurate implant placement is essential to mitigate these risks.

On the limits of finite element models created from (micro)CT datasets and used in studies of bone-implant-related biomechanical problems.

Patient-specific approach is gaining a wide popularity in computational simulations of biomechanical systems. Simulations (most often based on the finite element method) are to date routinely created using data from imaging devices such as computed tomography which makes the models seemingly very complex and sophisticated. However, using a computed tomography in finite element calculations does not necessarily enhance the quality or even credibility of the models as these depend on the quality of the input images. Low-resolution (medical-)CT datasets do not always offer detailed representation of trabecular bone in FE models and thus might lead to incorrect calculation of mechanical response to external loading. The effect of image resolution on mechanical simulations of bone-implant interaction has not been thoroughly studied yet. In this study, the effect of image resolution on the modeling procedure and resulting mechanical strains in bone was analyzed on the example of cranial implant. For this purpose, several finite element models of bone interacting with fixation-screws were generated using seven computed tomography datasets of a bone specimen but with different image resolutions (ranging from micro-CT resolution of 25 µm to medical-CT resolution of 1250 µm). The comparative analysis revealed that FE models created from images of low resolution (obtained from medical computed tomography) can produce biased results. There are two main reasons: 1. Medical computed tomography images do not allow generating models with complex trabecular architecture which leads to substituting of the intertrabecular pores with a fictitious mass; 2. Image gray value distribution can be distorted resulting in incorrect mechanical properties of the bone and thus in unrealistic or even completely fictitious mechanical strains. The biased results of calculated mechanical strains can lead to incorrect conclusion, especially when bone-implant interaction is investigated. The image resolution was observed not to significantly affect stresses in the fixation screw itself; however, selection of bone material representation might result in significantly different stresses in the screw.

Effect of load-induced local mechanical strain on peri-implant bone cell activity related to bone resorption and formation in mice: An analysis of histology and strain distributions.

The purpose of this study was to investigate the effect of load-induced local mechanical strain on bone cell activity of peri-implant bone in mice. Titanium implants were placed in the maxillae of 13-week-old male C57BL/6J mice and subjected to intermittent 0.15 N, 0.3 N, or 0.6 N loads for 30 min/day for 6 days. The animals were sacrificed 2 days after the final loading. Unloaded mice were used as controls. An animal-specific three-dimensional finite element model was constructed based on morphological data retrieved from in vivo microfocus computed tomography for each mouse to calculate the mechanical strain distribution. Strain distribution images were overlaid on corresponding histological images of the same site in the same animal. The buccal cervical region of the peri-implant bone was predetermined as the region of interest (ROI). Each ROI was divided by four strain intensity levels: 0-20 µÎµ, 20-60 µÎµ, 60-100 µÎµ, and ≥100 µÎµ, and the bone histomorphometric parameters were analyzed by the total area of each strain range for all loaded samples. The distance between the calcified front and calcein labeling as a parameter representing the mineral apposition rate was significantly greater in the areas with strain intensity ≥100 µÎµ than in the area with strain intensity <100 µÎµ, suggesting that the bone formation activity of osteoblasts was locally enhanced by a higher mechanical strain. However, the shrunken osteocytes and the empty osteocyte lacunae were significantly lower in the highest strain area, suggesting that osteoclastogenesis was more retarded in higher strain areas than in lower strain areas. The histomorphometric parameters were not affected geometrically in the unloaded animals, suggesting that the load-induced mechanical strain caused differences in the histomorphometric parameters. Our findings support the hypothesis that bone cell activity related to bone resorption and formation is local strain-dependent on implant loading.

Trees as net sinks for methane (CH4 ) and nitrous oxide (N2 O) in the lowland tropical rain forest on volcanic Réunion Island.

Trees are known to emit methane (CH4 ) and nitrous oxide (N2 O), with tropical wetland trees being considerable CH4 sources. Little is known about CH4 and especially N2 O exchange of trees growing in tropical rain forests under nonflooded conditions. We determined CH4 and N2 O exchange of stems of six dominant tree species, cryptogamic stem covers, soils and volcanic surfaces at the start of the rainy season in a 400-yr-old tropical lowland rain forest situated on a basaltic lava flow (Réunion Island). We aimed to understand the unknown role in greenhouse gas fluxes of these atypical tropical rain forests on basaltic lava flows. The stems studied were net sinks for atmospheric CH4 and N2 O, as were cryptogams, which seemed to be co-responsible for the stem uptake. In contrast with more commonly studied rain forests, the soil and previously unexplored volcanic surfaces consumed CH4 . Their N2 O fluxes were negligible. Greenhouse gas uptake potential by trees and cryptogams constitutes a novel and unique finding, thus showing that plants can serve not only as emitters, but also as consumers of CH4 and N2 O. The volcanic tropical lowland rain forest appears to be an important CH4 sink, as well as a possible N2 O sink.

Biomechanical performance of cranial implants with different thicknesses and material properties: A finite element study.

This study investigated the effect of implant thickness and material on deformation and stress distribution within different components of cranial implant assemblies. Using the finite element method, two cranial implants, differing in size and shape, and thicknesses (1, 2, 3 and 4 mm, respectively), were simulated under three loading scenarios. The implant assembly model included the detailed geometries of the mini-plates and micro-screws and was simulated using a sub-modeling approach. Statistical assessments based on the Design of Experiment methodology and on multiple regression analysis revealed that peak stresses in the components are influenced primarily by implant thickness, while the effect of implant material is secondary. On the contrary, the implant deflection is influenced predominantly by implant material followed by implant thickness. The highest values of deformation under a 50 N load were observed in the thinnest (1 mm) Polymethyl Methacrylate implant (Small defect: 0.296 mm; Large defect: 0.390 mm). The thinnest Polymethyl Methacrylate and Polyether Ether Ketone implants also generated stresses in the implants that can potentially breach the materials' yield limit. In terms of stress distribution, the change of implant thickness had a more significant impact on the implant performance than the change of Young's modulus of the implant material. The results indicated that the stresses are concentrated in the locations of fixation; therefore, the detailed models of mini-plates and micro-screws implemented in the finite element simulation provided a better insight into the mechanical performance of the implant-skull system.

Micro finite element analysis of dental implants under different loading conditions.

Osseointegration is paramount for the longevity of dental implants and is significantly influenced by biomechanical stimuli. The aim of the present study was to assess the micro-strain and displacement induced by loaded dental implants at different stages of osseointegration using finite element analysis (FEA). Computational models of two mandible segments with different trabecular densities were constructed using microCT data. Three different implant loading directions and two osseointegration stages were considered in the stress-strain analysis of the bone-implant assembly. The bony segments were analyzed using two approaches. The first approach was based on Mechanostat strain intervals and the second approach was based on tensile/compression yield strains. The results of this study revealed that bone surrounding dental implants is critically strained in cases when only a partial osseointegration is present and when an implant is loaded by buccolingual forces. In such cases, implants also encounter high stresses. Displacements of partially-osseointegrated implant are significantly larger than those of fully-osseointegrated implants. It can be concluded that the partial osseointegration is a potential risk in terms of implant longevity.

Finite element analysis of 6 large PMMA skull reconstructions: A multi-criteria evaluation approach.

In this study 6 pre-operative designs for PMMA based reconstructions of cranial defects were evaluated for their mechanical robustness using finite element modeling. Clinical experience and engineering principles were employed to create multiple plan options, which were subsequently computationally analyzed for mechanically relevant parameters under 50N loads: stress, strain and deformation in various components of the assembly. The factors assessed were: defect size, location and shape. The major variable in the cranioplasty assembly design was the arrangement of the fixation plates. An additional study variable introduced was the location of the 50N load within the implant area. It was found that in smaller defects, it was simpler to design a symmetric distribution of plates and under limited variability in load location it was possible to design an optimal for expected loads. However, for very large defects with complex shapes, the variability in the load locations introduces complications to the intuitive design of the optimal assembly. The study shows that it can be beneficial to incorporate multi design computational analyses to decide upon the most optimal plan for a clinical case.

A threshold of mechanical strain intensity for the direct activation of osteoblast function exists in a murine maxilla loading model.

The response to the mechanical loading of bone tissue has been extensively investigated; however, precisely how much strain intensity is necessary to promote bone formation remains unclear. Combination studies utilizing histomorphometric and numerical analyses were performed using the established murine maxilla loading model to clarify the threshold of mechanical strain needed to accelerate bone formation activity. For 7 days, 191 kPa loading stimulation for 30 min/day was applied to C57BL/6J mice. Two regions of interest, the AWAY region (away from the loading site) and the NEAR region (near the loading site), were determined. The inflammatory score increased in the NEAR region, but not in the AWAY region. A strain intensity map obtained from [Formula: see text] images was superimposed onto the images of the bone formation inhibitor, sclerostin-positive cell localization. The number of sclerostin-positive cells significantly decreased after mechanical loading of more than [Formula: see text] in the AWAY region, but not in the NEAR region. The mineral apposition rate, which shows the bone formation ability of osteoblasts, was accelerated at the site of surface strain intensity, namely around [Formula: see text], but not at the site of lower surface strain intensity, which was around [Formula: see text] in the AWAY region, thus suggesting the existence of a strain intensity threshold for promoting bone formation. Taken together, our data suggest that a threshold of mechanical strain intensity for the direct activation of osteoblast function and the reduction of sclerostin exists in a murine maxilla loading model in the non-inflammatory region.

Structural and mechanical implications of PMMA implant shape and interface geometry in cranioplasty--A finite element study.

This computational study investigates the effect of shape (defect contour curvature) and bone-implant interface (osteotomy angle) on the stress distribution within PMMA skull implants. Using finite element methodology, 15 configurations--combinations of simplified synthetic geometric shapes (circular, square, triangular, irregular) and interface angulations--were simulated under 50N static loads. Furthermore, the implant fixation devices were modelled and analysed in detail. Negative osteotomy configurations demonstrated the largest stresses in the implant (275 MPa), fixation devices (1258 MPa) and bone strains (0.04). The circular implant with zero and positive osteotomy performed well with maximum observed magnitudes of--implant stress (1.2 MPa and 1.2 MPa), fixation device stress (11.2 MPa and 2.2 MPa), bone strain (0.218e-3 and 0.750e-4). The results suggest that the preparation of defect sites is a critical procedure. Of the greatest importance is the angle at which the edges of the defect are sawed. If under an external load, the implant has no support from the interface and the stresses are transferred to the fixation devices. This can endanger their material integrity and lead to unphysiological strains in the adjacent bone, potentially compromising the bone morphology required for anchoring. These factors can ultimately weaken the stability of the entire implant assembly.

Finite element analysis of dental implant loading on atrophic and non-atrophic cancellous and cortical mandibular bone - a feasibility study.

The first aim of this study was to assess displacements and micro-strain induced on different grades of atrophic cortical and trabecular mandibular bone by axially loaded dental implants using finite element analysis (FEA). The second aim was to assess the micro-strain induced by different implant geometries and the levels of bone-to-implant contact (BIC) on the surrounding bone. Six mandibular bone segments demonstrating different grades of mandibular bone atrophy and various bone volume fractions (from 0.149 to 0.471) were imaged using a micro-CT device. The acquired bone STL models and implant (Brånemark, Straumann, Ankylos) were merged into a three-dimensional finite elements structure. The mean displacement value for all implants was 3.1 ±1.2 µm. Displacements were lower in the group with a strong BIC. The results indicated that the maximum strain values of cortical and cancellous bone increased with lower bone density. Strain distribution is the first and foremost dependent on the shape of bone and architecture of cancellous bone. The geometry of the implant, thread patterns, grade of bone atrophy and BIC all affect the displacement and micro-strain on the mandible bone. Preoperative finite element analysis could offer improved predictability in the long-term outlook of dental implant restorations.

Bilinear elastic property of the periodontal ligament for simulation using a finite element mandible model.

This study aimed to introduce a procedure for determining the bilinear elastic moduli (E1 and E2) of the periodontal ligament for a mathematical tooth model to analyse stress in the mandible. The bone and tooth morphology were scanned from a dry skull and an extracted intact tooth, respectively, and reconstructed in a three-dimensional finite element model. The model showed good agreement with previously reported in vivo premolar movement when an E1 for the first phase tooth movement of 0.05 MPa and an E2 for the second phase of 8.0 MPa with ε(12) of 0.075 were adopted. The mandible model analysis indicated that a remarkably high maximum compressive stress in the cervical cortical bone and the tensile stress in areas of masticatory muscle attachment were found. Future stress analyses using a jaw model may follow the process of determination of bilinear moduli to enhance accurate simulation with less calculation time.