Biomechanical evaluation of subcrestal dental implants with different bone anchorages

Abstract

This study evaluated the biomechanical influence of apical bone anchorage on a single subcrestal dental implant using three-dimensional finite element analysis (FEA). Four different bone anchorage designs were simulated on a posterior maxillary segment using one implant with platform switching and internal Morse taper connection as follows: 2 mm subcrestal placement with (SW) or without (SO) the implant apex engaged into the cortical bone or position at bone level with anchorage only in the crestal cortical (BO) bone or with bicortical fixation (BW). Each implant received a premolar crown, and all models were loaded with 200 N to simulate centric and eccentric occlusion. The peak tensile and compressive stress and strain were calculated at the crestal cortical, trabecular, and apical cortical bone. The vertical and horizontal implant displacements were measured at the platform level. FEA indicated that subcrestal placement (SW and SO) created lower stress and strain in the crestal cortical bone compared with crestal placement (BO and BW models). The SW model exhibited lesser vertical and horizontal implant micromovement compared with the SO and BO models under eccentric loading; however, stress and strain were higher in the apical cortical bone. The BW model exhibited the lowest implant displacement. These results indicate that subcrestal placement decreases the stress in the crestal cortical bone of dental implants, regardless of apical anchorage; however, apical cortical anchorage can be effective in limiting implant displacement. Further studies are required to evaluate the effects of possible remodeling around the apex on the success of subcrestal implants.

Influence of cortical bone and implant design in the primary stability of dental implants measured by two different devices of resonance frequency analysis: An in vitro study

“…This stability can be influenced by multiple factors, such as the density of the recipient bone, the surgical technique or the design of the implant itself (3). Regarding bone density, several authors have shown that the presence of cortical bone increases the primary stability of the implant, since it provides one or several anchorages in a bone of a much greater density compared to implants fixed only in the trabecular bone, which is much less dense (4)(5)(6)(7)(8)(9)(10). However, it would be appropriate to discuss which of the two cases would produce the best osseointegration or the best biomechanical behaviour in response to the load.…”

Treatment of the Complete Edentulous Atrophic Maxilla: The Tall Tilted Pin Hole Placement Immediate Loading (TTPHIL)-ALL TILT™ Implant Option

“…2D). Torque ratchet is used for the final placement and the resistance of the implant is 41 Single-drill under preparation 42,43 Self-drilling active threaded implant for bicortical basal bone engagement 44 Tall implants to engage cortical plates (16-57 mm) [45][46][47] Tilted implants (15-65°) to have more bone implant contact 48,49 Rigid splinting with screw-retained solution for retrievability 50 Platform switching abutment with no micromovement at implant abutment junction 51 Flapless subcrestal placement (pin hole procedure) 52 Immediate prosthesis within 3 days to a week time The primary stability of the implant is, thus, checked with the torque test to determine the loading protocol ( Fig. 2E).…”

“…Apical cortical anchorage can be effective in limiting implant displacement. 63 Thus, bicortical anchorage with subcrestal placement is the advantage which TTPHIL-ALL TILT™ concept provides.…”

Comparison of Stress and Strain Distribution around Splinted and Non-splinted Teeth with Compromised Periodontium: A Three-dimensional Finite Element Analysis

“…In the latter technique, teeth with poor bone support are splinted and thus, tooth mobility is minimized. [6][7][8] Different techniques are available for splinting of mobile teeth to their adjacent teeth; 9 these techniques are divided into two groups of extracoronal and intra-coronal techniques. 10 Intra-coronal splints are not often recommended since they require tooth preparation and removal of tooth structure.…”