Numeric Simulation of Time-Dependent Remodeling of Bone Around Loaded Oral Implants

Purpose: The objective of this study was to investigate the time-dependent biomechanics of marginal bone around osseointegrated dental implants within physiologic loading conditions. Materials and Methods: The remodeling of marginal bone around a 4.1-mm-diameter, 10-mm-long implant was studied by implementing the Stanford theory into axisymmetric mathematical models simulating different bone support at the implant neck: 1-mm-thick cortical bone (model 1), 0.5-mm-thick cortical bone (model 2), absence of cortical bone (model 3), and absence of cortical bone with 0.5 mm of resorption of marginal trabecular bone (model 4). The results were examined separately for all models at five time intervals: the first loading after osseointegration and 3, 6, 9, and 12 months after osseointegration. Minimum principal stress, maximum principal stress, strain energy, total equivalent strain, displacement, average elastic modulus, and bone density were evaluated. Results: In models 1 and 2, the magnitude of the stresses increased during the 1-year period. The distributions of stresses in models 3 and 4 were less variable and lower than models with cortical bone. The region of high stresses enlarged during the first 3 months and then decreased over time. There was a time-dependent increase in strain energy density around the neck of the implant in models 1 and 2. The time-dependent displacement values of implants were almost constant over time (maximum 1 µm change). The lowest implant displacement values were observed in model 1. There was a slight increase in the elastic modulus of cortical bone and a decrease in trabecular bone (maximum 1% change). Conclusion: The time-dependent increase in stresses in the marginal zone of the implants with cortical bone support was higher than that of the implants supported solely by trabecular bone in the first year of function. Higher strain energy density around the implants with cortical bone support might indicate apposition and increase in interface stiffness, whereas lower strain energy density around implants supported solely by trabecular bone could be associated with skeletal tissue loss. Palabras clave: bone density, bone remodeling, dental implants, elastic modulus, finite element analysis, strain energy, total equivalent strain