A combined three‐dimensional and axisymmetric finite element analysis was made of the effect upon the peak interfacial shear stress of providing an axially loaded mandibular dental implant with retention elements all the way up to the crest of the implant as opposed to a smooth neck. The effect of increased wall thickness of the implant and of using bi‐cortical fixation as opposed to unicortical fixation was also studied. Retention elements at the implant neck were found to bring about a major decrease in the peak interfacial shear stress. Increased wall thickness and bi‐cortical fixation also resulted in decreased peak interfacial shear stress but this effect was minor. The interpretation of this was that all these three measures increase the capacity of the implant to carry axial loads. Thus from a biomechanical viewpoint it appears to be advantageous to provide the neck of screw‐shaped implants with retention elements, for example a rough surface of suitable micro‐architecture and/or a microbhyphen;thread. It is furthermore suggested that retention elements at the implant neck will counteract marginal bone resorption in accordance with Wolff's law. This paper is a revision of: Hansson, S. (1997) Some steps to improve the capacity of dental implants to resist axial loads. In: Hansson, S., ed. Towards an optimized dental implant and implant bridge design: A bio‐mechanical approach. Thesis. Göteborg; Chalmers University of Technology.
It has been hypothesized that marginal bone resorption may result from microdamage accumulation in the bone. In light of this, a dental implant should be designed such that the peak stresses arising in the bone are minimized. The load on an implant can be divided into its vertical and horizontal components. In earlier studies, it was found that the peak bone stresses resulting from vertical load components and those resulting from horizontal load components arise at the top of the marginal bone, and that they coincide spatially. These peak stresses added together produce a risk of stress-induced bone resorption. Using axisymmetric finite element analysis it was found that, with a conical implant-abutment interface at the level of the marginal bone, in combination with retention elements at the implant neck, and with suitable values of implant wall thickness and modulus of elasticity, the peak bone stresses resulting from an axial load arose further down in the bone. This meant that they were spatially separated from the peak stresses resulting from horizontal loads. If the same implant-abutment interface was located 2 mm more coronally, these benefits disappeared. This also resulted in substantially increased peak bone stresses.
The design of the implant-abutment interface has a profound effect upon the stress state in the marginal bone when this reaches the level of this interface. The implant with the conical interface can theoretically resist a larger axial load than the implant with the flat top interface.
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