Simulated bone remodeling around tilted dental implants in the anterior maxilla

Abstract

Dental implants have to be placed with the long axis in different angulations due to the change in bone morphology. The objective of this study was to investigate the different bone remodeling response induced by the tilted dental implants and to assess whether it could lead to bone loss and implant failure. In this study, bone remodeling due to palato-labially inclined dental implants placed in the anterior maxillary incisor region was simulated. CT-based finite element models of a maxillary bone with dental implants were created herein. Five dental implants were placed at [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text], respectively. The remodeling progression was recorded and compared. Model [Formula: see text] (palatal side) shows the highest bone density values, but the inclined implant at [Formula: see text] (labial side) leads to significant bone loss. From a biomechanical perspective, it is speculated that a palatally inclined implant is more likely to enhance the bone density in the maxillary anterior region, but labial inclination of implant could jeopardize its stability.

Biomechanical effect of inclined implants in fixed prosthesis: strain and stress analysis

“…As the present study used a simplified fixed prosthesis, the generated stress inferences in the abutment and screw would not correspond to reality, as verified during the 3D model validation 14 . Nevertheless, the literature is rather concise in emphasizing possible damage on the prosthetic screw when used in inclined implants 6,8,14,21 . Future studies evaluating fatigue life and torque maintenance of prosthetic screws in straight and angled abutments should be performed to complement the available literature data.…”

“…Despite the possibility of reducing the treatment longevity due to implant's inclination the clinician will need this arrangement several times due to anatomical accidents and bone disposition which restricts installation sites 7 . The decision to install an inclined implant can be scientifically based on several articles that evaluated inclined implants in anterior regions, with reduced occlusal load and contact on the prosthetic crown's palatine face [8][9][10] . These studies mostly express a common clinical situation and provide the dentist with an initial basis that inclined implants aggravate the strain generated around the supporting tissue, but the physiological limit is still maintained 9 .…”

Biomechanical Effects of Various Bone-Implant Interfaces on the Stability of Orthodontic Miniscrews: A Finite Element Study

“…The finite element model was meshed using 10-node solid tetrahedral elements (Figure 2(a)). Following a convergence test [7], 0.5 mm was determined to be the appropriate element mesh size for bone and tooth, and even a miniature size (0.2 mm) was selected to accommodate the small feature in the model (e.g., PDL and miniscrew). The detailed element assignment is listed in Table 1.…”

Current status of digital dental surgery

“…Therefore, it is not possible to detect bone density with this mathematical model in an automated way. 30 However, several studies have demonstrated that software assistance in the determination of implant relationships with adjacent structures can markedly optimize geometry and alleviate the chewing. 31,32 Using CAD software, a dentist can design a fixed prosthetic replacement upon the projected implant abutments, fabricated in an automated way with the CAM systems.…”