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Presentation 1543 Topic 15. Dental biomechanics

BIOMECHANICAL ANALYSIS OF SMALL DIAMETER AND SHORT DENTAL IMPLANTS

Christoph Bourauel (1), Maria Aitlahrach (1), Ludger Keilig (1), Susanne Reimann (1), Friedhelm Heinemann (2), Istabrak Hasan (1)

1. Department of Prosthetic Dentistry, Preclinical Education and Material Science, Oral Technology, University of Bonn, Germany; 2. Dep. of Prosthodontics, University of Greifswald, Germany.

Introduction
In recent years, Mini and Short dental implants became more and more popular as treatment alternatives in clinical cases with critical bony situations. So-called Minis have a reduced diameter of about 2.5 mm and are designed to be inserted in the anterior region of the maxilla or mandible. Extremely short implants, called Shorties, have a length of 5 to 7 mm and are commonly used in the posterior region after severe bone atrophy. A profound scientific analysis of the mechanical and biomechanical impact of the reduced diameter and length of these implants has not been published yet. A combined experimental and numerical study was performed in order to determine whether ultimate dimensions with respect to length and diameter can be defined for dental implants.

Figure 1: von Mises stress distribution of selected Mini implants. Obviously, the ultimate strength is exceeded in most cases.

Results
Measured implant deflections of 0.5 mm (Minis) up to 1.2 (Shorties) at the implant abutment have been registered. These extreme deflections are either due to the reduced diameter of the Mini implants or to the extremely long abutment of the Shorties. A good correlation could be determined between calculated and measured implant deflections. High von Mises stresses of up to 1,150MPa are combined with these deflections in the Mini implants (Figure 1). These partly exceeded the ultimate strength of the material (titanium Grade 4 or 5). Implant diameter and geometry had a pronounced effect on stresses in the cortical plate (up to 266MPa). Strains in spongy and stresses in cortical bone around Short implants increased markedly compared to standard implants.

Methods
21 commercially available mini (13) and short (8) implants have been analysed with respect to material behaviour and load transfer to the alveolar bone using a specialised biomechanical set-up [Keilig, 2004] and finite element (FE) analysis. The implants were inserted into bovine rib segments and loaded with forces up to 100N. Following CT scanning and geometry reconstruction, FE models of Minis and Shorties have been inserted in idealised bone segments. Minis were analysed in the anterior mandibular jaw region at a force of 150N under immediate loading conditions using the contact analysis option in MSC.Marc/Mentat. Shorties were inserted in posterior bone segments and analysed in the osseointegrated state at an occlusal force of 300N. Force/deflection characteristics of the experimental specimens were compared with the results of the FE simulations. Load transfer to the bone, i.e. stresses in the cortical and strains in the cancellous bone, as well as von Mises stresses in the implants were analysed to characterise the implant biomechanical behaviour.

Discussion
An increased risk of bone damage or implant failure may be assumed in critical clinical situations when using Mini or Short dental implants. Clinical application of especially Short implants shall be reconsidered. Controlled, long-term clinical studies are essential to prove the clinical success rates of Minis and Shorties.

References
Keilig et al, Biomed Tech, 49:208-215, 2004.

Journal of Biomechanics 45(S1)

ESB2012: 18th Congress of the European Society of Biomechanics