Abstract
The purpose of this study was to investigate the biomechanical effects of graft stiffness and progression of marginal bone loss (MBL) in the bone surrounding an implant placed in a maxillary grafted sinus based on the finite element method. The simulating model of graft stiffness as well as depth of MBL was varied to simulate nine different clinical scenarios. The results showed that the high-level strain distributions in peri-implant tissue increased with the increase in MBL depth when the stiffness of the graft was less than that of the cancellous bone (less stiffness graft models). The strain energy density (SED) value showed that a slight MBL depth (1.3 mm) with medium stiffness of grafted bone can reach the optimal load sharing due to the exhibited similar values of SED in the crestal cortical, cancellous, and grafted bone. With progression of MBL and the decrease in graft quality, maximal displacement of the implant increased considerably. Our results demonstrated that the effects of the two investigated factors (progression of MBL and graft stiffness) on the biomechanical adaptation are likely to be interrelated. The results also reveal that for clinical situations with poor grafted bone quality and progression of MBL, it is critical to consider implant stability.
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References
Acka K, Cehreli MC (2006) Biomechanical consequence of progressive marginal bone loss around oral implants: a finite element stress analysis. Med Bio Eng Comput 44:527–535
Boccaccio A, Prendergast PJ, Pappalettere C, Kelly DJ (2008) Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period. Med Bio Eng Comput 46:283–298
Carter DR, Spengler DM (1978) Mechanical properties and composition of cortical bone. Clin Orthop Relat Res 135:192–217
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 oral implants in extraction sockets. Med Bio Eng Comput 44:86–94
Cehreli MC, Akkocaoglu M, Comert A, Tekdemir I, Akca K (2007) Bone strains around apically free versus grafted implants in the posterior maxilla of human cadavers. Med Bio Eng Comput 45:395–402
Fanuscu MI, Vu HV, Poncelet B (2004) Implant biomechanics in grafted sinus: a finite element analysis. J Oral Implantol 30:59–68
Geng JP, Tan KBC, Liu GR (2001) Application of finite element analysis in implant dentistry: a review of the literature. J Prosthet Dent 85:585–598
Herzberg R, Dolev E, Schwartz D (2006) Implant marginal bone loss in maxillary sinus grafts. Int J Oral Maxillofac Implants 21:103–110
Holmgren EP, Seckinger RJ, Kilgren LM, Mante F (1998) Evaluated parameters of osseointegrated dental implants using finite element analysis—a two-dimensional comparative study examining the effects of implant diameter, implant shape and load direction. J Oral Implantol 24:80–88
Junc YC, Han CH, Lee KW (1996) A 1-year radiographic evaluation of marginal bone around dental implants. Int J Oral Maxillofac Implants 11:811–818
Kitamura E, Stegaroiu R, Nomura S, Miyakawa O (2004) Biomechanical aspects of marginal bone resorption around osseointegrated implants: considerations based on a three-dimensional finite element analysis. Clin Oral Implants Res 15:401–412
Kitamura E, Stegaroiu R, Nomura S, Miyakawa O (2005) Influence of marginal bone resorption on stress around an implant—a three-dimensional finite element analysis. J Oral Rehabil 32:279–286
Lagravere MO, Fang Y, Carey J, Toogood RW, Packota GV, Major PW (2006) Density conversion factor determining using a cone-beam computed tomography unit New Tom QR-DVT 9000. Dentomaxillofac Radiol 35:407–409
Largravere MO, Carey J, Ben-Zvi M, Packota GV, Major PW (2008) Effect of object on the density measurement and Hounsfield conversion in a New Tom 3G cone beam computed tomography unit. Dentomaxillofac Radiol 37(6):305–308
Lee S, Gantes B, Riggs M, Crigger M (2007) Bone density assessments of dental implant sites: 3. Bone quality evaluation during osteotomy and implant placement. Int J Oral Maxillofac Implants 22(2):208–212
Lekholm U, Gunne J, Henry P, Higuchi K, Linden U, Bergstrom C, van Steenberghe D (1999) Survival of the Branemark implant in partially edentulous jaws: a 10-year prospective multicenter study. Int J Oral Maxillofac Implants 14:639–645
Maiorana C, Sigurta D, Mirandola A et al (2005) Bone resorption around dental implants placed in grafted sinuses: clinical and radiologic follow-up after up to 4 years. Int J Oral Maxillofac Implants 20:261–266
Mellal A, Wiskott HWA, Botsis J et al (2004) Stimulating effect of implant loading on surrounding bone. Comparison of three numerical models and validation by in vivo data. Clin Oral Implants Res 15:239–248
Mericske-Stern R, Aerni D, Buser D, Geering AH (2001) Long-term evaluation of non submerged hollow cylinder implants. Clinical and radiographic results. Clin Oral Implant Res 12:252–259
Moy PK, Lundgren S, Holmes RE (1993) Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg 51:857–862
Oilo G, Gjerdet NR (1983) Dental casting alloys with a low content of noble metals: physical properties. Acta Odontol Scand 41:111–116
Papa F, Cortese A, Maltarello MC et al (2005) Outcome of 50 consecutive sinus lift operations. Br J Oral Maxillofac Surg 43:309–313
Prasit A, Joseph C, Bernard G, Eloy S, Matt R, Ivan D, Jason MY, Max C (2005) Bone density assessments of dental implant sites: 2. Quantitative cone-beam computerized tomography. Int J Oral Maxillofac Implants 20:416–424
Rangert B, Krogh PHJ, Langer B, Van Roekel N (1995) Bending overload and implant fracture: a retrospective clinical analysis. Int J Oral Maxillofac Implants 10:326–344
Rues S, Lenz J, Schierle HP et al (2004) Simulation of the sinus floor elevation. Proc Appl Math Mech 4:368–369
Shulman LB, Jensen OT, Block MS, Iacono VJ (1998) A consensus conference on the sinus graft. Inter J Oral Maxillofac Implants 13(Suppl):5–6
Singh GD (2008) Digital diagnostic: three-dimensional modeling. Br J Oral Maxillofac Surg 46:22–26
Spector M (1999) Basic principle of tissue engineering. In: Lynch SE, Genco RJ, Marx RE (eds) Tissue engineering: applications in maxillofacial surgery and periodontics. Quintessence, Chicago, IL
Steineman S (1996) The properties of titanium. In: Schroeder A, Sutter F, Buser D, Krekeler G (eds) Oral implantology. Basics, ITI hollow cylinder system, 2nd edn. Thieme, Stuttgart
Tepper G, Haas R, Zechner W et al (2003) Three-dimensional finite analysis of implant stability in the atrophic posterior maxilla. Clin Oral Implants Res 13:657–665
Turkyilmaz I, McGlumphy EA (2008) Influence of bone density on implant stability parameters and implant success: a retrospective clinical study. BMC Oral Health 8:32. doi:10.1186/1472-6831-8-32
Weber HP, Crohin CC, Fiorellini JP (2000) A 5-year prospective clinical and radiolographic study of non-submerged dental implant. Clin Oral Implants Res 11:144–153
Wiskott HWA, Belser UC (1999) Lack of integration of smooth titanium surfaces: a working hypothesis based on strains generated in the surrounding bone. Clin Oral Implants Res 10:429–444
Xu H, Shimizu Y, Ooya K (2005) Histomorphometric study of the stability of newly formed bone after elevation of the floor of the maxillary sinus. Br J Oral Maxillofac Surg 43:493–499
Acknowledgment
The authors would like to thank the National Metal and Materials Technology Center (MTEC), the Advanced Dental Technology Center (ADTEC), and the Faculty of Dentistry, Thammasat University, Thailand, for their support and allowing us the use of their facilities.
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Inglam, S., Suebnukarn, S., Tharanon, W. et al. Influence of graft quality and marginal bone loss on implants placed in maxillary grafted sinus: a finite element study. Med Biol Eng Comput 48, 681–689 (2010). https://doi.org/10.1007/s11517-010-0584-3
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DOI: https://doi.org/10.1007/s11517-010-0584-3