The Prosthetic Influence and Biomechanics on Peri-Implant Strain: a Systematic Literature Review of Finite Element Studies

Abstract

ObjectivesTo systematically review risks of mechanical impact on peri-implant strain and prosthetic influence on stability across finite element studies.Material and MethodsAn online literature search was performed on MEDLINE and EMBASE databases published between 2011 and 2016. Following keywords tiered screening and selection of the title, abstract and full-text were performed. Studies of finite element analysis (FEA) were considered for inclusion that were written in English and revealed stress concentrations or strain at peri-implant bone level.ResultsThere were included 20 FEA studies in total. Data were organized according to the following topics: bone layers, type of bone, osseointegration level, bone level, design of implant, diameter and length of implant, implant-abutment connection, type of supra-construction, loading axis, measurement units. The stress or strain at implant-bone contact was measured over all studies and numerical values estimated. Risks of overloading were accented as non-axial loading, misfits, cantilevers and the stability of peri-implant bone was related with the usage of platform switch connection of abutment.ConclusionsPeri-implant area could be affected by non-axial loading, cantilever prosthetic elements, crown/implant ratio, type of implant-abutment connection, misfits, properties of restoration materials and antagonistic tooth. The heterogeneity of finite element analysis studies limits systematization of data. Results of these studies are comparable with other findings of in vitro, in vivo, prospective and retrospective studies.

Manufacturing of Metal Frameworks for Full‐Arch Dental Restoration on Implants: A Comparison between Milling and a Novel Hybrid Technology

“…As the manufacturing error was isolated from all other variables, such as the impression‐making and CAD phases, the data give an idea of the influence of a particular type of manufacturing technology on the trueness of the digital workflow used to make full‐arch framework prostheses. The effect of the 3 manufacturing approaches on the framework precision is of paramount importance, to achieve the least misfit possible at the interface of implant platform with the framework . The results of this study showed 3D mean position errors ranging from 8 to 35 µm, similar to previous studies that reported 10 to 51 µm inaccuracy values .…”

“…Nonetheless, the 3D errors recorded for both the SLM/m hybrid (8‐22 µm) and milled technologies (20‐35 µm) confirmed that the trueness levels observed here were well within the clinically acceptable limit in terms of dimensional gap, thus attesting to the clinical applicability of all of the manufacturing technologies . The clinical implication of this finding is related to the abovementioned concept of the misfit of the framework at the PFIs that may generate high stresses during clinical screw tightening …”

“…Previous studies provided insufficient evidence about the correlation of the misfit at the interface of the implant platform with the framework and biomechanical problems such as screw‐related complications, or the misfit influence of negative effects on initial osseointegration or peri‐implant bone stability over time. The degree of tolerable misfit remains a matter of debate; however, the problem of achieving the least misfit possible is still the aim of digital manufacturing efforts.…”

Site‐level risk predictors of peri‐implantitis: A retrospective analysis

“…Another significant finding was the association between restorations that were asymmetrical mesio-distally with respect to the fixture and peri-implantitis. While there is evidence in the literature to support association between peri-implantitis and cantilevered prosthesis (Koyano & Esaki, 2015;Maminskas, Puisys, Kuoppala, Raustia, & Juodzbalys, 2016), we believe that this is the first time offset crowns have been identified as putative predictors of periimplantitis. Structurally, asymmetrical crowns can create areas of increased plaque retention due to altered emergence profiles (Katafuchi et al, 2018), while functionally they cause aberrant occlusal load.…”

The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group I - Peri-Implantitis Aetiology, Risk Factors and Pathogenesis

“…The Prosthetic Influence and Biomechanics on Peri-Implant Strain: a Systematic Literature Review of Finite Element Studies (Maminskas et al [3]) …”