Biomechanical basis of the bone remodeling process around dental implants
According to the theory of Frost the non-physiological bone overloading may be the reason for the bone remodeling process around dental implants. Another reason can be seen in the bacterial contamination by the functionally related micro-gap occuring in the implant-abutment connection during chewing.
The basic biomechanical principles which affect the bone remodeling process around dental implants are explained in a very clear way. Using the finite element method the stresses around osseointegrated dental implants are visualized. On the basis of the bone stress distribution an explanation for the biomechanically induced bone remodeling process around dental implants is given.
A major influence on the bone stress distribution is resulting from the design of the implant-abutment connection. To illustrate the differences between different implant-abutment connections, seven types of implants are examined. The implant-abutment connections of the investigated implants are divided into three groups (flat connections, small conical connections and 45 degree conical connections). The biomechanical effect to the bone stresses of these three groups will be explained.
The microgap of the implant-abutment connection occuring during chewing is seen as responsible for the bacterial contamination around dental implants. The link between the different implant-abutment connection types, preload of the implant-abutment connection screw and the micro gap is shown. Practical advice will be given for the use of the different connection types in daily work.
Learning Objectives:
"The bone stress around an osseointegrated dental implant is distributed unphysiologically and is influenced by the type of the implant-abutment connection."