International Journal of Science and Research (IJSR), India Online ISSN: 2319-7064

Effect of Dental Implant Parameters on Stress Distribution at Bone-Implant Interface

Sarthak Seth1, Parveen Kalra2
1

Post Graduate Student, PEC University of Technology, Sector 12, Chandigarh 160012, India 2 Professor, PEC University of Technology, Sector 12, Chandigarh 160012, India

Abstract: The purpose of this article is to provide a review of the achievements and advancements in dental technology brought about
by computer-aided design and the all-powerful finite element method of analysis. The scope of the review covers dental implants, jawbone surrounding the implant and the biomechanical implant and jawbone interaction. Prevailing assumptions made in the published finite element analysis, and their limitations are discussed in some detail which helps identify the gaps in research as well as future research direction.

Keywords: Dental implant; Implant-jawbone interaction; Design; Finite element analysis

1. Introduction 2. Literature Review

Since the concept of osseo integration and the idea of carrying out dental prostheses using intra-osseous implants were introduced, the clinical use of dental implants for the treatment partial or completely edentulous patients has become a common practice over the past few years. The results after using dental implants in rehabilitation of many patients were successful and long-term. Even though the implant supported prostheses has been proven as an alternative to conventional dentures, many factors have been reported which cause failure of implants. Improper oral hygiene, bone quality, medical status of the patient, width, length and design of dental implants and biomechanical factors are some criterias which cause implant failure. The success of an implant supported prostheses largely depends on biomechanical factors. Lot of stresses and strains are induced in and around implant supported prostheses system. The quantity and direction of load applied causes stress in implants and deformation of bone. Proper insertion of implants is very important as the entire load on the tooth is transferred to the bone through them. Generally, an implant is used for each missing tooth to avoid any complications. But sometimes, due to limited space available in the jaw bone the number of implants can be less than the number of tooth. Therefore, one or two implants can be inserted for partial prostheses of two or three teeth. The distance between the implants can be selected based on the geometrical condition of the jaw bone. In order to evaluate the success of dental implant procedure, stress distribution in the jaw bone due to loading is calculated using a 3D model of the bone-implant system. The finite element analysis is the most widely used technique for investigating the distribution of forces. It can provide detailed quantitative data anywhere within the 3D model. FEA is very powerful as it is versatile and can be applied to various structures having complex shapes, loads and boundary conditions. Very accurate results have been produced with the help of this method and it can be used for dental systems as well. The concept of implant dentistry and finite element method was studied in the initial stage. In the sections below, a brief review of different parameters which effect the stress distribution at the bone-implant interface is given. 2.1 Implant geometry The implant geometry is an important factor which effects the stress distribution at the bone implant interface. Investigation of stress distribution generated within the jawbone by using different types of dental implants (cylindrical, conical, stepped, screw-shaped, hollow cylindrical) by means of the finite element method has been done. Siegele and Soltesz [1] results indicate that significant variations in stress distributions in the jawbone occur due to different implant shapes. Conical implant surfaces or surfaces with geometric discontinuities results in higher stresses than smoother shapes (cylindrical, screw-shaped). Holmgren et al [2] on the other hand reported that the most desirable shape for stress distribution in the surrounding jawbone is a stepped cylindrical design. The implant length and diameter also have a significant influence on the stress distribution at the bone-implant interface. Finite element analysis of stress distribution around implants can be used to determine the optimum length and diameter of the implants. Von Mises stresses at the bone-implant interface were calculated using FEA by Himmlova et al [3] for different diameter and length of implants. Implant neck was identified as the most critical area having maximum stress distribution. The minimum stress was found for implants with a diameter ranging from of 3.6 mm to 4.2 mm. Increase in the implant length also decreased Von Mises equivalent stress values. Influence of implant length was less as compared to implant diameter. Short implants present superior failure rates. Pierrisnard et al [4] investigated the stress distribution on the implants by varying implant length and bicortical anchorage. The aim to assess the extent to which implant length and
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bicortical anchorage affect the way stress is transferred to the implant components, the implant abutment, and the surrounding bone. 2.2 Taperage A little degree of taperage is generally applied to either the entire implant or just the bottom section of the implant. Tapered implants increase the stability by compressing the jawbone during and after implantation. The tapered body also facilitates implant placement between convergent roots, in areas with labial concavities and in immediate extraction sites. Mailath et al [5] examined the stress distribution at the site where implant enters the jaw bone by comparing cylindrical and conical implant shapes. It was concluded that conical shaped implants produced a less desirable stress profile than the cylindrical shaped counterparts. The fact that the survival rate of oral implants was demonstrated to be more in goodquality bone as compared to implants inserted in soft quality bone introduced the need for tapered implants. A possible way to increase the survival rate in soft-quality bone was to use at apered implant (Astrand et a l [6]). Practical experimentation was performed by Friberg et al [7] in which they calculated the stress produced in tapered implants as compared to the straight cylindrical ones. The tapered implant design resulted in an increased stability which may be important when placing implants in jawbone. 2.3 Material properties of implant The biomechanical properties of an implant and the original tissue which is replaced are very different. It has become increasingly challenging to design and manufacture of artificial materials to be used within the human body. Titanium and bio-ceramic materials, such as hydroxyapatite have high compatibility with hard tissue and living bone and hence, are widely used as fabrication materials for dental implant. Titanium has reasonable stiffness and strength while hydroxyapatite has low stiffness, low strength and high ability to reach full integration with living bone. Different material properties have been adopted for titanium in previous analysis, where the Youngs modulus has been taken from 102.2GPa to 113.8 GPa, and the Poissons ratio, between 0.29 and 0.35, based on different material testing. In order to achieve adequate dental implantation of the biomaterial, full integration of the implant with living bone must be guaranteed. In order to prevent bone damage and increase the life of an implant, the stresses produced should be uniform and of anoptimum magnitude. Hedia and Mahmoud [8] investigated functionally graded material (FGM) to achieve the above advantages. The optimal materials of the FGM dental implant are found to be a combination of hydroxyapatite and titanium. The finite element investigations have shown that the maximum stress in the bone for the hydroxyapatite/titanium FGM implant has been reduced by about 22% and 28% respectively compared Haraldson et al [11] evaluated the mastication forces and chewing efficiency in nine patients, whom were treated with over dentures on osseo integrated implants in the mandible. The bite force was measured during gentle biting, biting as when chewing and biting with maximal effort. All subjects improved subjectively as well as clinically after treatment. The bite force during gentle biting increased on average from 17.3 N before treatment to 24.0None year after treatment. A corresponding improvement of biting as when chewing was also found; from on average 24.0 N before to 38.7 N after treatment. The maximal bite force increased from on average 74.6 N at the baseline examination to 131.5 N at the one-year follow-up. The chewing efficiency improved from the confidence interval, Ci = 4 (Median value) before treatment to Ci = 2.8 (Median value) after treatment. Which means that the middle value of the patients who experienced an improvement in chewing efficiency improved by a factor of 1.2. It is concluded that treatment with an over denture supported by osseo integrated implants in the mandible improves oral function compared to the situation before treatment. Barbier et al [12] found that the horizontal loading of a freestanding implant evoked the largest maximum stresses, although the magnitude of the applied horizontal load was five times smaller than that of the vertical load. Non-axial loading has often been related to marginal bone loss, failure of osseo integration, failure of the implant and/or the prosthetic components and if connected to natural teeth, failure of the cement seal on the natural tooth. to currently employed titanium and stainless steel dental implants. Moroi et al [9] found that the hydroxyapatite coating reduced the heat conduction to the surrounding tissue because of its low thermal conductivity. However, thermal stress was induced by thermal expansion of the hydroxyapatite and titanium core. This might influence the success of hydroxyapatite-coated implants because the biomechanical properties of ceramics are sufficiently poor leading to insufficient tensile and shear stresses in the surrounding jawbone. The biomechanical integration between living bone and ceramic are not as successful as that of pure titanium. In addition, this tendency becomes more pronounced when the hydroxyapatite-coating surface extends beyond the cortical bone. It is important to fully understand the mechanical behavior of a natural tooth, in order to improve dental implant performance within the surrounding jawbone. 2.4 Loading Masticatory forces acting on dental implants can result in undesirable stress within the surrounding jawbone which in turn can cause bone rejection to the implant, leading to eventual failure of the implant. In order to produce accurate predictions of the implant-jawbone behavior, it is essential to determine realistic loading magnitudes and directions. Richter [10] investigated the actual loads experienced by teeth during chewing. Four main types of food (rubbery confection, pieces of sausage, carrots, and crackers) were examined for their effects on the load experienced by teeth during chewing.

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International Journal of Science and Research (IJSR), India Online ISSN: 2319-7064

2.5 Implant surface structure The surface quality of an implant is a combination of physical, chemical, mechanical and morphologic factors. Wennerberg et al [13] analyzed four groups of implant surface characteristics, these included group A which was Hydroxyapatite (HA) coated used by Osteobond72, IMZ73, Micro-Vent74, Bio-Vent74, Impla-Med75and Calcitek76. Group B consisted of Titanium plasma-sprayed used by IMZ and group C which was Titanium alloy implants used in industry by Core-Vent74, Screw-Vent74. Finally group Dwas commercially pure titanium used in industry. Various aspects of surface quality have been studied, some showing the presence of surface contaminants (although the biological implications of these are unclear) and better bone fixation of rough compared to smooth surfaces. Implant surface characteristics have a dramatic effect on the speed and integrity of osseo integration and the maintenance of soft tissue and surrounding jawbone around the implant. Surface modification is initiated by factors such as stress reduction and increased surface area. Hermann et al [14] found that the rough/smooth implant surface has a significant effect on marginal bone formation as evaluated by standardized longitudinal radiography. Bone remodeling occurs rapidly during the early healing phase after implant placement for non-submerged implants and after abutment connection for submerged implants. 2.6 Material properties of jawbone The long-term clinical performance of a dental implant is dependent on the preservation of good quality bone surrounding the implant and a well-maintained interface between the biomaterial of the implant and the bone. Clinically, jawbone material properties are categorized into four types. Figure 1 shows that Types 1 and 2offer high Youngs modulus, while Types 3 and 4 have a thin cortex and low Youngs modulus with low trabecular density. Jaffin and Berman stated that 90% of 1,054 implants placed were in Types 1 to 3 bones. the implant influences the load transfer from implant to the jawbone. With the correct stress level within the jawbone, the correct amount of stress shielding will occur. Stress shielding is the mechanism that protects the jawbone from stresses that it might encounter by increasing the bone density. Wolff [15] observed that bone is reshaped in response to the forces acting and this is referred to as Wolff's law. Ideally the selection of the correct implant design, will lead to maximum bone density increase. Dechow et al [16] conducted an investigation into the use of bone plates on the mandible in four adult rhesus monkeys. At the beginning and end of the experiments, bone strain was recorded inferior to each bone plate during evoked maximal incisal clenching. After death, gross dimensions and density were measured. An ultrasonic technique was used to measure the material properties, including the elastic and shear moduli. Bone strain inferior to the plates was reduced by 34% to 53% after attachment of the thick plates. Long-term placement of bone plates, and the resulting stress shielding, were found to result in structural changes in the mandibular corpus. Most finite element analysis has only considered a small part of the jawbone surrounding the implant. It has been found common during the construction of the finite element model, of the jawbone, to apply fixed constraints to the lower region of the jawbone. Patra et al [17] modeled bone support using muscle attachment with spring constraints as opposed to fixed constraints used in previous studies. Ishigaki et al. determined the directions of displacement constraints which were applied to the jawbone, according to the angles of the closing pathways of chopping type (C-type) and grinding type (G-type) chewing patterns. Directions of displacement constraints at the bottom of the mandible simulated the calculated directions of the closing pathways for C-type and G-type chewing patterns. The magnitude of the chewing force was selected as 200N. The sum of the nodal force on the mandibularocclusal surface was 200N after displacement constraints were applied to the model. The models were restrained at the base of the maxillary first molar to avoid sliding of the entire model.

3. Conclusion
A lot of research has been done on different parameters of dental implants which affect the stress distribution at the bone-implant interface. Very minimal research to find the optimum inter-implant distance has been carried out. Also, the effect of cusp inclination on the stresses produced has not been observed to a great extent. Research on the above mentioned points can prove to be very vital in dental implant design.

Figure 1: Youngs modulus and apparent density of different type of bones. Only 3% of these fixtures were lost; of the 10% of the fixtures placed in Type 4 bone, 35% failed. The mandibular is classified into cortical, crestal and trabecular tissue, it is a porous material with a complex microstructure. The quality and quantity of bone surrounding

References
[1] Siegele, D., and Soltesz, U., 1989, Numerical investigations of the influence of implant shape on
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[2] stress distribution in the jaw bone. International Journal of Oral Maxillofacial Implants, 4(4), 333-340. Holmgren, E.P., Seckinger, R.J., Kilgren, L.M., and Mante, F., 1998, Evaluating parameters of osseo integrated dental implants using finite element analysis--a two-dimensional comparative study examining the effects of implant diameter, implant shape, and load direction. Journal of Oral Implantol, 24(2), 80-88. Himmlova, L., Dostalova, T., Kacovsky, A., and Konvickova, S., 2004, Influence of implant length and diameter on stress distribution: a finite element analysis. Journal of Prosthetic Dentistry, 91(1), 20-25. Pierrisnard, L., Renouard, F., Renault, P., and Barquins, M., 2003, Influence of implant length and bicortical anchorage on implant stress distribution. Clinical Implant Dentistry Related Research, 5(4), 254262. Mailath, G., Stoiber, B., Watzek, G., and Matejka, M., 1989, Bone resorption at the entry of osseointegrated implants--a biomechanical phenomenon. Finite element study. Journal of Oral Implantol, 24(2), 80-88. Astrand, P., Billstrom, C., Feldmann, H., Fischer, K., Henricsson, V., Johansson, B., Nystrom, E., and Sunzel, B., 2003, Tapered implants in jaws with soft bone quality: a clinical and radiographic 1-year study of the Branemark System Mark IV fixture. Clinical Implant Dentistry Related Research, 5(4), 213-218. Friberg, B., Jisander, S., Widmark, G., Lundgren, A., Ivanoff, C.J., Sennerby, L., and Thoren, C., 2003, Oneyear prospective three-center study comparing the outcome of a soft bone implant (prototype Mk IV) and the standard Branemark implant. Clinical Implant Dentistry Related Research, 5(2), 71-77. Hedia, H.S., and Mahmoud, N.A., 2004, Design optimization of functionally graded dental implant. Biomedical Material Engineering, 14(2), 133-43. Moroi, H.H., Okimoto, K., Moroi, R., and Terada, Y., 1993, Numeric approach to the biomechanical analysis of thermal effects in coated implants. International Journal of Prosthodontics, 6(6), 564-572. Richter, E.J., 1998, in vivo horizontal bending moments on implants. The International Journal of Oral & Maxillofacial Implants, 13(2), 232-244. Haraldson, T., Jemt, T., Stalblad, P.A., and Lekholm, U., 1988, Oral function in subjects with over dentures supported by osseointegrated implants. Scandinavian Journal of Dental Research, 96(3), 235-242. Barbier, L., Vander Sloten, J., Krzesinski, G., Schepers, E., and Van der Perre, G., 1998, Finite element analysis of non-axial versus axial loading of oral implants in the mandible of the dog. Journal of Oral Rehabilitation, 25(11), 847-858. Wennerberg, B., Albrektsson, A., Andersson, T., 1994, Design and surface characteristics of 13 commercially available oral implant systems. International Journal of Oral & Maxillofacial Implants, 8(6), 622-633. Hermann, J.S., School field, J.D., Nummikoski, P.V., Buser, D., Schenk, R.K., and Cochran, D.L., 2001, Crestal bone changes around titanium implants: a methodological study comparing linear radiographic with histometric measurements. International Journal of Oral Maxillofacial Implants, 16(4), 475-485. [15] Wolff, J., 1986, the law of bone remodeling. Springer, Berlin. [16] Dechow, P.C., Ellis, E., Throckmorton, G.S., 1995, Structural properties of mandibular bone following application of a bone plate. Journal of Oral Maxillofacial Surgery, 53(9), 1044-1051. [17] Patra, A.K., DePaolo, J.M., D'Souza, K.S., DeTolla, D., and Meenaghan, M.A., 1998, Guidelines for analysis and redesign of dental implants. Implant Dentistry, 7(4), 355-368.

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Author Profile
Sarthak Seth received his B.Tech degree in Mechanical Engineering from R.I.M.T Institute of Engineering & Technology in 2010 and currently pursuing M.E in Production & Industrial Engineering from PEC University of Technology. His area of interest is Finite Element Analysis. Dr. Parveen Kalra has a highest qualification of Ph.D. and is currently working as a Professor in PEC University of Technology. He has an experience of 22 years in the field of teaching and has approximately published 30 research papers. His areas of research are Finite Element Analysis, Human Engineering and Robotics.

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