JHSM

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

EndNote Style
Index
Original Article
Sloped marginal configuration design of implants as an alternative innovation to the grafting operations: a three-dimensional finite element analysis
Aims: Dental implant operations often require bone grafting due to bone resorption in the buccal area, which make the treatment more complicated, increase the risk of complications, and results in extra costs and prolongation of treatment. This study aimed to evaluate the biomechanical behavior of the implants with a sloped marginal configuration design in the alveolar ridge with a level difference between the buccal and lingual bone levels using three-dimensional finite element analysis (FEA) method. Material and
Methods: Two implant models with different marginal configuration designs were used in this study. Implants were placed in the posterior edentulous mandible models in which the buccal region had a 2 mm more resorption according to lingual region which were created by imitating natural bone resorption with FEA. Bone grafting was performed on the exposed buccal surface in the conventional flat marginal configuration implant model (Model 1). In contrast, the sloped marginal configuration implants were compatible with the difference in bone level and placed directly without any additional surgical procedures (Model 2). Than three unit fixed partial dentures were designed. The design of cortical and cancellous bones, prosthetic components, implants, abutment screws and abutments covering those in the edentulous mandible models were transferred to digital three-dimensional models that were created to mimicking the real structures. The models were fixed below and behind of the mandible with zero movement. Load transfer characteristics of both models under these essential limitations were evaluated under 200N foodstuff force.
Results: The highest von Mises stress value was observed as 69.300 MPa in Model 1 and 126.870 MPa in Model 2. The maximum principal stress values were 28.236 N/mm2 and 63.449 N/mm2; the minimum principal stress values were 38.346 N/mm2 and 43.643 N/mm2 in Model 1 and Model 2, respectively. The highest von Mises stress value, maximum principal stress and minimum principal stress values were found higher in Model 2 which was created with sloped marginal configuration design of implants but all values were observed within acceptable physiological limits.
Conclusion: The sloped marginal configuration design of implants can be a non-invasive and more economical treatment alternative modality compared to conventional flat marginal configuration implants with advanced surgeries during implant placement.


1. Steigenga JT, Al-Shammari KF, Nociti FH, Misch CE, Wang H-L.Dental implant design and its relationship to long-term implantsuccess. Imp Dent 2003; 12: 306-17.
2. Buser D, Martin W, Belser UC. Optimizing esthetics for implantrestorations in the anterior maxilla: anatomic and surgicalconsiderations. Int J Oral Maxillofac Imp 2004;19: 7.
3. Ozan O, Kurtulmus-Yilmaz S. Biomechanical comparison ofdifferent implant inclinations and cantilever lengths in all-on-4treatment concept by three-dimensional finite element analysis.Int J Oral Maxillofac Imp 2018; 33: 1.
4. Pietrokovski J, Massler M. Alveolar ridge resorption followingtooth extraction. J Prosthet Dent 1967; 17: 21-7.
5. Cawood J, Howell R. A classification of the edentulous jaws. Int JOral Maxillofac Surg 1988; 17: 232-6.
6. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: aclinical and radiographic 12-month prospective study. Int J PerioRest Dent 2003; 23: 4.
7. Noelken R, Donati M, Fiorellini J, et al. Soft and hard tissuealterations around implants placed in an alveolar ridge with asloped configuration. Clin Oral Imp Res 2014; 25: 3-9.
8. Welander M, Abrahamsson I, Berglundh T. Placement of two-partimplants in sites with different buccal and lingual bone heights. JPeriodontol 2009; 80: 324-9.
9. Abrahamsson I, Welander M, Linder E, Berglundh T. Healing atimplants placed in an alveolar ridge with a sloped configuration:an experimental study in dogs. Clin Imp Dent Relat Res 2014; 16:62-9.
10. Wöhrle PS. Nobel perfect™ esthetic scalloped implant: rationalefor a new design. Clin Imp Dent Relat Res 2003; 5: 64-73.
11. Geng J-P, Tan KB, Liu G-R. Application of finite element analysisin implant dentistry: a review of the literature. J Prosthet Dent2001; 85: 585-98.
12. Alvarez-Arenal A, Gonzalez-Gonzalez I, deLlanos-Lanchares H,Brizuela-Velasco A, Ellacuria-Echebarria J. Influence of implantpositions and occlusal forces on peri-implant bone stress inmandibular two-implant overdentures: a 3-dimensional finiteelement analysis. J Oral Implantol 2017; 43: 419-28.
13. Kilic E, Doganay O. Evaluation of stress in tilted implantconcept with variable diameters in the atrophic mandible: three-dimensional finite element analysis. J Oral Implantol 2020; 46:19-26.
14. Karasan D, Güncü MB, Ersu B, Canay Ş. Biomechanicalbehavior of implants with a sloped marginal configuration. Int JProsthodontics 2018; 31: 587-90.
15. Grandin HM, Berner S, Dard M. A review of titanium zirconium(TiZr) alloys for use in endosseous dental implants. Materials2012; 5: 1348-60.
16. Akça K, Eser A, Çavuşoğlu Y, Sağırkaya E, Çehreli MC. Numericalassessment of bone remodeling around conventionally and earlyloaded titanium and titanium-zirconium alloy dental implants.Med Bio Eng Comput 2015; 53: 453-62.
17. Mosavar A, Ziaei A, Kadkhodaei M. The effect of implant threaddesign on stress distribution in anisotropic bone with differentosseointegration conditions: a finite element analysis. Int J OralMaxillofac 2015; 30: 6.
18. Inglam S, Suebnukarn S, Tharanon W, Apatananon T,Sitthiseripratip K. Influence of graft quality and marginal boneloss on implants placed in maxillary grafted sinus: a finite elementstudy. Med Bio Eng Comput 2010; 48: 681-9.
19. Toth A, Hasan I, Bourauel C, et al. The influence of implant bodyand thread design of mini dental implants on the loading ofsurrounding bone: a finite element analysis. Biomed Eng 2017;62: 393-405.
20. Soğanci G, Yazicioğlu H. Evaluation of stress distribution of minidental implant-supported overdentures in complete cleft palatemodels: a three-dimensional finite element analysis study. CleftPalate Craniofac J 2016; 53: 73-83.
21. Noelken R, Oberhansl F, Kunkel M, Wagner W. Immediatelyprovisionalized OsseoSpeed™ profile implants inserted intoextraction sockets: 3-year results. Clin Oral Imp Res 2016; 27:744-9.
22. Schiegnitz E, Noelken R, Moergel M, Berres M, Wagner W.Survival and tissue maintenance of an implant with a slopedconfigurated shoulder in the posterior mandible—a prospectivemulticenter study. Clin Oral Imp Res 2017; 28: 721-6.
23. Jaffin RA, Berman CL. The excessive loss of Branemark fixtures intype IV bone: a 5-year analysis. J Periodontol 1991; 62: 2-4.
24. Lee J-H, Frias V, Lee K-W, Wright RF. Effect of implant size andshape on implant success rates: a literature review. J Prosthet Dent2005; 94: 377-81.
25. Blanes RJ, Bernard JP, Blanes ZM, Belser UC. A 10-yearprospective study of ITI dental implants placed in the posteriorregion. II: Influence of the crown-to-implant ratio and differentprosthetic treatment modalities on crestal bone loss. Clin OralImp Res 2007; 18 :707-14.
26. Bozkaya D, Muftu S, Muftu A. Evaluation of load transfercharacteristics of five different implants in compact bone atdifferent load levels by finite elements analysis. J Prosthet Dent2004; 92: 523-30.
27. Kaleli N, Sarac D, Külünk S, Öztürk Ö. Effect of differentrestorative crown and customized abutment materials on stressdistribution in single implants and peripheral bone: A three-dimensional finite element analysis study. J Prosthet Dent 2018;119: 437-45.
28. Lian Z, Guan H, Ivanovski S, et al. Effect of bone to implantcontact percentage on bone remodelling surrounding a dentalimplant. Int J Oral Maxillofac Surg 2010; 39: 690-8.
Volume 6, Issue 2, 2023
Page : 506-512
_Footer