The results of this analysis suggest that a certain amount of conical resorption may be the result of biomechanical adaptation of bone to stress. However, as bone resorption progresses, the increasing stresses in the cancellous bone and implant under lateral load may result in implant failure.
From a biomechanical viewpoint, to improve implant success odds in the posterior maxilla, rather than implant selection, careful preoperative evaluation of the cortical bone at the planned implant site is recommended. If this cortical bone is very thin or even lacking, implant treatment should be carried on with caution by progressive loading in the range of functional loads.
Average marginal bone resorption of about 1 mm after the first year of functional loading, which is followed by an annual loss of approximately 0.1 mm, has been reported in stable implants. However, finite element analyses on bone stress around implants have been limited to analysing the bone stress in the absence of any bone resorption. Thus, a three-dimensional finite element analysis was performed to compare the bone stresses in a non-resorption model with those in four models with bone resorption of two depths (1.3 and 2.6 mm) and types (horizontal resorption and angular defects). Axial and bucco-lingual forces were separately applied to the center of the superstructure and the maximum equivalent stress was calculated. The main tendencies of bone stress (highest stress concentration around implant neck, higher stresses under bucco-lingual than axial load, as well as in the cortical than cancellous bone) were the same in the non-resorption and resorption models. Bone stress distributions were similar in the non-resorption and horizontal resorption models, but differed from those in the angular defect models. Moreover, the changes of the bone stress values with resorption depth differed for the two resorption types. Thus, in FEA, accurate simulation of the marginal bone shape in the implant neck region is advisable.
The simplified and segmented three-dimensional finite element models of the human maxilla showed the same locations of the highest equivalent strains as the full maxilla model created from CT DICOM data. If absolute strain values are not of interest, the Simplified models could be used in strain analyses of simulated posterior maxilla for diagnostic suggestions in implant placement.
Developed herein
is a diastereoselective synthesis of CF3-substituted spiroisochromans
via C(sp3)–H bond
functionalization involving sequential transformations ([1,5]-hydride
shift/cyclization/elimination of MeOH/intramolecular Friedel–Crafts
reaction).
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