Abstract
The objective of this study was to compare the bone strains of apically free versus grafted implants in the posterior maxilla. The experiments were undertaken in four edentulous maxillary posterior regions of fresh human cadavers, having a minimum bone height of 8 mm. In each bone fragment, two Ø 4.1 mm × 12 mm Straumann® implants were placed, and insertion torque values (ITV) and implant stability quotients (ISQ) of the implants were quantified to determine implant anchorage. Two splinted crowns were fabricated for each experimental model. Strain gauges were bonded on the buccal and sinus floor cortical bones around apically free and grafted implants. Microstrains were recorded by a data acquisiton system and corresponding software at a sample rate of 10 KHz under central and buccally oriented lateral–axial static loads of 100 and 150 N in separate cases. The data were compared by independent T test at a significance level set at P < 0.05. Bone tissue strains on the buccal cortical areas adjacent to apically free implants were higher than those of apically grafted implants (P < 0.05). The differences ranged between 10 and 48 με under central and lateral axial loads of 100 and 150 N. The shift in load application from central to buccally oriented lateral axial mode increased strains between 60 and 201 με on buccal cortical bone around apically free and grafted implants (P < 0.05). Bone strains around anterior implants were higher than those of posterior implants. Microstrains in the sinus floor cortical bone in apically grafted models were slightly higher than apically free models. Bone tissue strains on the buccal cortical areas adjacent to apicallyfree implants are higher than those of apically grafted implants. Sinus lifting, resulting in an enhanced apical support, slightly increases strains at the sinus floor region, but leads to a decrease in bone strains around the collar of supporting implants.
Similar content being viewed by others
References
Akca K, Cehreli MC, Iplikcioglu H (2002) Comparison of three-dimensional finite element stress analysis with in-vitro strain gauge measurements on dental implants. Int J Prosthodont 15:115–121
Akca K, Akkocaoglu M, Comert A, Tekdemir I, Cehreli MC (2005) Human ex vivo bone tissue strains around immediately-loaded implants supporting maxillary overdentures. Clin Oral Implants Res 16:715–722
Akkocaoglu M, Uysal S, Tekdemir I, Akca K, Cehreli MC (2005) Implant design and intraosseous stability of immediately-placed implants: a human cadaver study. Clin Oral Implants Res 16: 202–209
Asundi A, Kishen A (2000) A strain gauge and photoelastic analysis of in vivo strain and in vitro stress distribution in human dental supporting structures. Arch Oral Biol 45:543–550
Belser UC, Mericske-Stern R, Bernard JP, Taylor TD (2000) Prosthetic management of the partially dentate patient with fixed implant restorations. Clin Oral Implants Res 11:126–145
Bergh van den JPA, Bruggenkate ten CM, Disch FJM, Tuinzing DB (2000) Anatomical aspects of sinus floor elevations. Clin Oral Implants Res 11:256–265
Boyne P, James RA (1980) Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Maxillofac Surg 17:113–116
Bruschi GB, Scipioni A, Calesini G, Bruschi E (1998) Localized management of sinus floor with simultaneous implant placement: a clinical report. Int J Oral Maxillofac Implants 13:219–226
Cehreli MC, Iplikcioglu H, Bilir OG (2002) The influence of the location of load transfer on strains around implants supporting four unit cement-retained fixed prostheses: in vitro evaluation of axial versus off-set loading. J Oral Rehabil 4:394–400
Cehreli MC, Canay S (2002) Comparison of post-gel shrinkage strains in light- polymerized composite resins. J Prosthet Dent 88:461–466
Cehreli MC, Akca K, Tonuk E (2004) Accuracy of a manual torque application device for morse-taper implants: a technical note. Int J Oral Maxillofac Implants 19:743–748
Cehreli MC, Duyck J, DeCooman M, Puers R, Naert I (2004) Implant design and interface force transfer. A photoelastic and strain-gauge analysis. Clin Oral Implants Res 15:249–257
Cehreli MC, Comert A, Akkocaoglu M, Tekdemir I, Akca K (2006) Towards the limit of quantifying low-amplitude strains on bone and in coagulum around immediately-loaded implants in extraction sockets. Med Biol Eng Comput 44:86–94
Del Fabbro M, Testori T, Francetti L, Weinstein R (2004) Systematic review of survival rates for implants placed in the grafted maxillary sinus. Int J Periodontics Restorative Dent 24:565–577
Fanuscu M, Iida K, Caputo AA, Nishimura RD (2003) Load transfer by an implant in a sinus-grafted maxillary model. Int J Oral Maxillofac Implants 18:667–674
Fanuscu MI, Vu HV, Poncelet B (2004) Implant biomechanics in grafted sinus: a finite element analysis. J Oral Implantol 30:59–68
Ferrigno N, Laureti M, Fanali S, Grippaudo G (2002) A long-term follow-up study of non-submerged ITI implants in the treatment of totally edentulous jaws. Part I: ten-year life table analysis of a prospective multicenter study with 1286 implants. Clin Oral Implants Res 13:260–273
Geurs NC, Wang IC, Shulman LB, Jeffcoat MK (2001) Retrospective radiographic analysis of sinus graft and implant placement procedures from the academy of osseointegrated consensus conference on sinus grafts. Int J Periodontics Restorative Dent 21:517–523
Haas R, Haidvogl D, Dörtbudak O, Mailath G (2002) Freeze-dried bone for maxillary sinus augmentation in sheep. Part II: biomechanical findings. Clin Oral Implants Res13:581–586
Hatano N, Shimizu Y, Ooya K (2004) A clinical long-term radiographic evaluation of graft height changes after maxillary sinus floor augmentation with a 2:1 autogenous bone/xenograft mixture and simultaneous placement of dental implants. Clin Oral Implants Res 15:339–345
Jepsen KJ, Davy DT, Akkus O (2001) Observations of damage in bone. In: Cowin SC (ed) Bone mechanics handbook. CRP Press, Boca Raton, pp 17–1
Koca OL, Eskitascioglu G, Usumez A (2005) Three-dimensional finite-element analysis of functional stresses in different bone locations produced by implants placed in the maxillary posterior region of the sinus floor. J Prosthet Dent 93:38–44
Linde F, Sorensen HC (1993) The effect of different storage methods on the mechanical properties of trabecular bone. J Biomech 26:1249–1252
Rabkin BA, Szivek JA, Schonfeld JE, Halloran BP (2001) Long-term measurement of bone strain in vivo: the rat tibia. J Biomed Mater Res 58(B):277–281
Romeo E, Lops D, Margutti E, Ghisolfi M, Chiapasco M, Vogel G (2004) Long- term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system. Int J Oral Maxillofac Implants 19:247–259
Summers RB (1994) A new concept in maxillary implant surgery: the osteotome technique. Compend Contin Educ Dent 15:152–160
Toffler M (2004) Osteotome-mediated sinus floor elevation: a clinical report. Int J Oral Maxillofac Implants 19:266–273
Tepper G, Haas R, Zechner W, Krach W, Watzek G (2002) Three-dimensional finite element analysis of implant stability in the atrophic posterior maxilla. Clin Oral Implants Res 13:657–665
Wallace SS, Froum SJ (2003) Effect of maxillary sinus augmentation on the survival of endosseous dental implants. Ann Periodontol 8:28–343
Winter AA, Pollack AS, Odrich RB (2003) Sinus/alveolar crest tenting (SACT): a new technique for implant placement in atrophic maxillary ridges without bone grafts or membranes. Int J Periodontics Restorative Dent 23:557–565
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cehreli, M.C., Akkocaoglu, M., Comert, A. et al. Bone strains around apically free versus grafted implants in the posterior maxilla of human cadavers. Med Bio Eng Comput 45, 395–402 (2007). https://doi.org/10.1007/s11517-007-0173-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11517-007-0173-2