You are on page 1of 6

Shoichi Ishigaki Tamaki Nakano Shinichi Yamada Takashi Nakamura Fumio Takashima

Biomechanical stress in bone surrounding an implant under simulated chewing

Authors’ affiliation: Schoichi Ishigaki, Tamaki Nakano, Shinichi Yamada, Takashi Nakamura, Fumio Takashima, Osaka University Graduate School of Dentistry, Course for Integrated Oral Sciences and Stomatology, Division of Oromaxillofacial Regeneration, Department of Occlusion, TMD, and Advanced Prosthodontics Correspondence to: Shoichi Ishigaki, D.D.S., Ph.D. Department of Occlusion, TMD, and Advanced Prosthodontics Osaka University Graduate School of Dentistry 1–8, Yamadaoka, Suita Osaka 565–0871 Japan Tel: π 81 66879 2946 Fax: π 81 68792947 e-mail: ishigaki/dent.osaka-u.ac.jp,

Key words: chewing function; finite element analysis; implant. Abstract: The concept of reducing nonaxial loading of dental implants has been widely regarded as the standard procedure. The aim of this study was to reveal the biomechanical stress distribution in supporting bone around an implant and a natural tooth under chewing function. Three-dimensional finite element models of the mandibular first molar and the titanium implant both with the mandible in the molar region were constructed. The directions of displacement constraints were determined according to the angles of the closing pathways of chopping type and grinding type chewing patterns. The tooth model showed smooth stress distribution in the supporting bone with low stress concentration around the neck of the tooth. The implant model showed stress concentration in the supporting bone around the neck of the implant, especially in the buccal area. The grinding type model of the implant showed higher tensile stress concentration than the chopping type model at the lingual neck of the implant. The results of this study suggested the importance of considering occlusion under chewing function for understanding the biomechanics of oral implants.

Date:

18 February 2002
To cite this article:

Ishigaki S, Nakano T, Yamada S, Nakamura T, Takashima F. Biomechanical stress in bone surrounding an implant under simulated chewing Clin. Oral Impl. Res, 14, 2003; 97–102 Copyright C Blackwell Munksgaard 2003 ISSN 0905-7161

The osseointegrated implant-supported restoration has become one of the most effective prosthodontic modalities in complete and partially edentulous patients. Since the osseointegrated implant has direct bone contact, the occlusal force on the implant superstructure is directly transmitted to the surrounding bone structure. Overloading on the superstructure could lead to the loss of osseointegration, and it has been clinically proposed to avoid high stress concentration in the supporting bone (Lindquist et al. 1988). Therefore, it is important to reveal how the occlusion of an implant-supported restoration affects the stress distribution in the supporting bone (Weinberg & Kruger 1995). However, boneloading patterns in finite element models are very sensitive to the various parameters and the creation of patient-dependent fi-

nite element models is required (Van-Oosterwyck et al. 1998). Attempts to reduce nonaxial loading of dental implants are commonly advocated but cannot be justified from the available research, at least from the standpoint of implant and bone health. Based on the currently available scientific evidence, it cannot be ruled out as one gold standard for implantation (Taylor 2000). Various studies have been conducted to investigate the load in bone and implant interface. Among these, the material of the fixture (Takuma et al. 1990), design of the fixture (Siegele & Soltesz 1989), the material of the superstructure (Davis et al. 1988), stress-absorbing material (Holmes et al. 1994), cantilever length (van Zyl et al. 1995), and the mechanism of bone and implant interface (Riger et al. 1989) have been reported to af-

97

2003 / 97–102 .2.Ishigaki et al . The three-dimensional finite element model of the natural tooth consisted of 2214 nodes and 1766 solid elements (Fig. there has been no study of the effect of the functional occlusion of an implantsupported restoration on stress distribution in the supporting bone. For biting forces on dental implants. Todent. The aims of this study were to investigate the closing direction of the mandible during chewing movement and to reveal the differences in stress distribution in the supporting bone between an implant and a natural tooth under occlusal function. 1). there is a need to expand the knowledge related to the biomechanics of oral implants and the influencing factors (Duyck et al. 10 mm in length and 4 mm in diameter. Biomechanical stress under simulated chewing fect stress distribution in the supporting bone. mean age 26. The model of the occlusal table of the maxillary first molar was also constructed as an antagonistic tooth.. The directions of the closing pathways of the man- 98 | Clin. Tokyo. Element discretization was repeatedly examined and modified according to the distortion check in the software (ANSYS. Material and methods Construction of the 3D-FE models Three-dimensional finite element models were constructed for the mandibular first molar and the titanium implant including the mandible in the molar region. Among them. Houston. The three-dimensional finite element model of an implant Swanson Analysis Systems. Tokyo. the occlusion of an implant-supported restoration should be evaluated under simulated chewing function. the mandible was placed 0. mean age 25. These processes led to validity of the model. age 23–32 years.1. Oral Impl. 2000). Inc. Since loading is increasingly believed to be a determining factor in the treatment outcome with oral implants. Fig. The models were thus found to be sufficiently valid for stress analyses. the basic problem is to determine the in vivo loading components on implants in various situations (Brunski 1992). The models were fixed at the base of the maxillary first molar. The test food was a piece of commercial chewing gum (Free Zone. In order to place food elements between the maxillary and the mandibular occlusal surface. Fig. TX. Since the direction of the occlusal force is the main variable in stress distribution. indicating that element refinement was completed with acceptable element distortion. Japan). 10 subjects (nine males and one female. Res. Chewing movement was recorded with a jaw-tracking device (Sirognathograph Analyzing System III.0) showed chewing patterns of a grinding type (G-type). Kubota. Japan). The occlusal relationship of the maxillary and the mandibular occlusal surface consisted of tripodism at the intercuspal position.5 mm below the intercuspal position. age 24–30. Tokyo. Establishment of the loading conditions for the analyses Twenty adult volunteers with no missing teeth and no signs of temporomandibular disorders were selected.6) showed chewing patterns of a chopping type (Ctype). USA) on a personal computer (TITAN. Japan). 2). The three-dimensional finite element model of a natural tooth. However. The model of the implant consisted of 2269 nodes and 1731 solid elements (Fig. Lotte. The average of 10 chewing cycles after 5 s of mastication on the left and right side were analyzed. The implant structure was screw type titanium. while the other 10 subjects (nine male and one female. 14. A ceramo-metal crown was placed as the superstructure of the implant.

) and minimum value of the minimum compressive stress were higher in the C-type model than in the G-type model. Mechanical properties of different components of the models for the analyses Elastic modulus (Mpa) 1.3. Res. average.30 chewing (60.6æ) than G-type Fig. Directions of displacement constraints at the bottom of the mandible simulated the calculated directions of the closing pathways for C-type and G-type chewing. On the other hand.10 ¿ 104 1.7æ) (t-test. Minimum principle stress (compressive stress) was found at the furcated area. sd and maximum value of the maximum shear stress was higher in the G-type model than in the C-type model. The directions of closing pathways of the mandible during chewing movements both in chopping type and grinding type.v. Biomechanical stress under simulated chewing Table 1. There was no difference in c.49 0. The mean angle of the closing pathways in the sagittal plane was significantly greater in C-type chewing (22.40 ¿ 104 1. 99 | Clin. The average of the minimum compressive stress was higher in the G-type model than in the C-type model. The stresses in the food elements were also evaluated in order to evaluate chewing function. of the maximum shear stress between the C-type and the Gtype models (Table 2). 1993. The sum of the nodal force on the mandibular occlusal surface was 200 N after displacement constraints were applied to the model.Ishigaki et al .49 0.33 0. Stress distribution in the supporting bone paratively high maximum principle stress (tensile stress) concentration at the lingual neck of the implant in the buccolingual direction. Wein- Maximum and minimum principle stresses were analyzed in the supporting bone around an implant and a natural tooth.001) (Fig.3æ) (t-test. respectively.3æ) than G-type chewing (89.3æ) (t-test. it was divided into five areas in buccolingual and mesiodistal directions.00 ¿ 10 6.00 ¿ 10 1. P Ͻ 0. various studies have been conducted using photo elastic stress analysis (Deines et al.15 0. mathematical analytic method (Morgan & James 1995. P Ͻ 0. both in C-type and G-type. These results revealed that the closing pathway of G-type chewing is deviated toward the chewing side and anteriorly compared to that of C-type chewing.30 0. 5).30 0.30 0. No remarkable stress concentration was found in the supporting bone below the neck of the implant (Fig. C-type and G-type models showed different stress values in food elements.72 ¿ 104 9. It also showed high minimum principle stress (compressive stress) concentration at the buccal neck of the implant in the buccolingual direction. It also showed smooth stress distribution in the supporting bone in the buccolingual direction except at the furcated area.v. 1994). were calculated as the angle between the closing pathways within 0. 4). 3). Waskewics et al. The magnitude of the chewing force was selected as 200 N. The mean angle of closing pathways in the horizontal plane was significantly smaller in C-type chewing (60. P Ͻ 0. The G-type model showed a similar stress distribution to the C-type model (Fig.33 0. The implant model showed comparatively high minimum principle stress (compressive stress) concentration in the supporting bone at the mesial and distal neck of the implant in the mesiodistal direction. In order to quantitatively evaluate the stresses in the supporting bone. Minimum compressive stress and maximum shear stress in the food elements between the maxillary and the mandibular occlusal surface were also evaluated.00 ¿ 10 Component Cortical bone Cancellous bone Enamel Dentin Pulp Periodontal membrane Porcelain Gold alloy Titanium Food Poisson’s ratio 0. Oral Impl. Discussion To investigate the mechanical stress in bone surrounding an implant.2æ) than G-type chewing (1.41 ¿ 104 1. coefficient of veriation (c.37 ¿ 103 8. 14. Results Directions of closing pathways of the mandible during chewing movement The mean angle of the closing pathways in the frontal plane was significantly smaller in C-type chewing (35. The models were restrained at the base of the maxillary first molar to avoid sliding of the entire model. Stress analyses around the natural tooth and implant The natural tooth model showed smooth stress distribution in the supporting bone in the mesiodistal direction.001). 2003 / 97–102 . the G-type model showed com- Both the natural tooth model and the implant model showed almost the same stress values in food elements.07 ¿ 105 1.5 mm from centric occlusion. The mechanical properties of the components in these models were based on previous studies (Takuma et al. Stresses in food elements dible during the chewing movements.37 ¿ 104 1.001).30 0. Furthermore. However. 1990) (Table 1). but standard deviation (sd).

horizontal or oblique direction toward the occlusal surface as the loading condition.97 0.24 0. B: buccal.11 0. On the other hand. 4. Implant model Minimum value ª 4. MA: apex. During chewing movement. The load transfer from implants to surrounding bone depends on the type of loading.type: Grinding type (Unit: MPa). Hoshaw et al. Stress values in food elements of the natural tooth model and the implant model Natural tooth model Average SD C. These studies utilized force from a vertical. van Zyl et al.64 G-type ª 2.72 0. the bone–implant interface.61 1. periodontal tissue structure and the osseointegration.28 0. L: lingual. 1992. Since there is an intimate correlation between occlusion.61 1. there has been no study that has analyzed the loading condition under chewing function. Stress distribution in supporting bone around an implant is displayed in mesiodistal section and buccolingual section.94 1. Mastication induces vertical and transverse forces. Table 2.26 0. structure of the implant surface.Ishigaki et al .52 Maximum value Average ª 2.25 1.V.25 1.V. 2000). the length and diameter of the implants. However. and finite element stress analysis (Riger et al. 0. it is important to evaluate the occlusion and to control the occlusal force on the natural tooth and implant.26 0.72 C. It is obvious that the occlusion affects the periodontal tissue structure. See abbreviations in Fig. 1995).5. 1994). Quirynen et al. 0. Fig. The natural tooth model showed 100 | Clin.52 Maximum value Minimum compressive stress C-type ª 2. Further. Therefore. Oral Impl. smin: minimum principal stress. the major complications associated with dental implants have become restorative-related rather than surgery-related. occlusal force is generated by many closing muscle activities and is transmitted to the periodontal tissue.57 Average Maximum share stress C-type 0. Because implants lack the stress release associated with a periodontal ligament. DA: apex. finite element stress analysis is practicable to quantify internal stress in the model. smax: maximum principal stress. the point of application. 1997).19 C. berg & Kruger 1995).V. D: distal. and mechanical properties may easily be varied to simulate various situations.4.75 0. Overloading of the superstructure of an implant could also lead to the loss of osseointegration (Lindquist et al. in this study. Res. the superstructure and the quality and quality of the surrounding bone (Duyck et al. Biomechanical stress under simulated chewing Fig.94 G-type 1.25 0. which induce axial forces and bending moments and exert stress gradients in the implant as well as in the bone (Duyck et al.97 Average SD 0. A: apex. G. 1989.70 ª 4. the implant shape. 1997).28 0.56 SD C. impact loading to restorative materials and the crestal bone remain potentially more damaging with implant-supported restorations (Curtis et al.75 ª 2.24 0.19 C.66 0.type: Chopping type. 1988. the directions of the closing pathways of the mandible during chewing movement were investigated. Minimum value ª 4.10 SD 0. 14. direction and magnitude of loads. which was not equivalent to real loading during a chewing movement. F: furcated. tooth mobility and supporting bone resorption. Overloading on the occlusal surface of the natural tooth leads to trauma of the periodontal tissue. 2003 / 97–102 . Stress distribution in supporting bone around a natural tooth is displayed along mesiodistal section and buccolingual section. M: mesial.69 ª 4.V.24 0. Among these methods.

The C-type and G-type models showed different stress values in food elements. showed large compressive function in a part of food elements. based on grinding movement. the slight lateral component of the load in the buccolingual direction causes a stress concentration in the supporting bone at the buccal neck of the implant. Conversely. und dort vor allem buccal. Des mode `re molaire infe ´rieure et d’un implant en titane la premie ´te ´ construits tous deux dans la re ´gion molaire de la ont e ´taient de ´termandibule . while the implant model showed high stress concentration in supporting bone around the neck of the implant. Both the natural tooth model and the implant model have almost the same stress values in food elements. Oral Impl. eine Kräftekonzentration im stützenden Knochen. Although it was recommended that the posterior cusp inclination should be markedly reduced to avoid harmful lateral force (Weinberg 1998). O the C-type and G-type models showed different stress values in food elements. Le mode ´ cerˆ te concentration en stress dans l’os l’entourant du co ´cialement au niveau de la zone vestibulaire. The G-type model. Res. Le mode `le plant. Los lingual del implante especialmente en el a resultados de este estudio sugirieron la importancia de ´ n bajo funciones de masticacio ´ n para considerar la oclusio ´nica de los implantes orales. Man baute ein dreidimensionales Modell des unteren ersten Molaren und eines Titanimplantates in der Unterkiefermolarenregion auf. stress analyses could be executed under the simulated occlusal function. Biomechanical stress under simulated chewing smooth stress distribution in the supporting bone in both the mesiodistal and the buccolingual directions except at the furcated area. the results of this study suggest that the occlusal form should be used for implant-supported restorations so as to correspond to the chewing pattern of the individual patient. Die Resultate dieser Studie unterstreichen die Wichtigkeit der Okklusion während des Kauvorgangs für das Verständnis der Biomechanik von Zahnimplantaten. 2003 / 97–102 . Das 101 | Clin. El modelo de masticacio ´ n de tipo latete en el a ´ una concentracio ´ n de estre ´s tensional mas alta ral mostro ´ n de tipo vertical en el cuello que el modelo de masticacio ´rea bucal. From these results. Le vical. Implantatmodell des Knirschers zeigte sowohl lingual. La intencio ´ n de este estudio fue revedimiento esta ´nica del estre ´ n biomeca ´s en el hueso de lar la distribucio soporte alrededor de un implante y un diente natural bajo funciones masticatorias. entender la biomeca Zusammenfassung Durch supponierte Kaubewegungen ausgelöste biomechanische Kräfte im Knochen um ein Implantat. Das Implantatmodell zeigte am Zahnhals. ´sume ´ Re ´duction de la charge non-axiale des imLe concept de re ´te ´ accepte ´ comme un proplants dentaires a longtemps e ´tude a e ´te ´ d’e ´valuer la cessus standard. O the natural tooth model showed smooth stress distribution in supporting bone. Le but de cette e ´partition du stress bio-me ´canique au niveau de l’os aure tour d’un implant et d’une dent naturelle sous fonction `les finis en trois dimensions de de mastication. it was concluded that: O by determining the directions of displacement constraints using the angles of closing pathways during chewing movement. spe `le du type bruxisme de l’implant montrait une mode concentration de stress plus importante qu’au niveau du `le de mastication au niveau cervico-lingual de l’immode ´cialement dans la zone vestibulaire. This result was consistent with previous studies. Although the main component of the load was in a vertical direction during the chewing movement. especially at the buccal area. Bei einem Hackbiss und bei einem Knirscher wurden die Winkel zwischen der Richtungen der aufgezwungenen Bewegungen und der Kieferschlussbewegung aufgezeichnet. Das Ziel dieser Studie war es. The C-type model. rre los patrones de masticacio ´ una distribucio ´ n suave del El modelo de diente mostro ´s en el hueso de soporte con una baja concentracio ´n estre ´s alrededor del cuello del diente. Les re ´tude demontrent l’importance de l’occlusion pour come ´canique des implants buccaux. Das Zahnmodell zeigte ein ausgeglichenes Kräftemuster im umgebenden Knochen. dass nichtaxiale Kräfte bei Zahnimplantaten wenn immer möglich zu reduzieren oder zu vermeiden sind. the implant model showed stress concentration in the supporting bone around the neck of the implant in both the mesiodistal and the buccolingual directions. Das Implantatmodell des Knirschers zeigte lingual am Implantathals ein stärkeres Dehnkräftemuster als bei einem Hackbiss. it was suggested that the occlusion plays an important role in the stress distribution. Haraldson 1983. 14. Strub et al. prendre l’action biome Resumen El concepto de reducir la carga no axial de los implantes dentales ha sido ampliamente considerado como el proce´ndar. die Verteilung der biomechanischen Kräfte im Knochen um Implantate und natürliche Zähne während dem Kauvorgang zu untersuchen.Ishigaki et al . Las direcciones de las fuerzas de desplazala regio ´ngulos de ciemiento se determinaron de acuerdo a los a ´ n de tipo vertical y lateral. mit geringer Kräftekonzentration um den Zahnhals. Allgemein hat sich der Grundsatz durchgesetzt. spe du bruxisme de l’implant montrait une concentration en `le de mastication au stress plus importante que le mode ´sultats de cette niveau cervico-lingual de l’implant. El modelo de del estre ´ una concentracio ´ n del estre ´s en el hueso implante mostro de soporte alrededor del cuello del implante especialmen´rea bucal. based on chopping movement. In particular. where there was almost the same chewing function between the subjects with natural dentition and implant-supported restorations (Haraldson & Carlsson 1979. The absence of a periodontal membrane and the narrow neck of the implant could lead to this result. showed large shearing function produced in the whole food elements. In this study. Se construyeron tres modelos de elementos dimensionales finitos del primer molar infe´bula en rior y del implante de titanio ambos en la mandı ´ n molar. wie auch besonders ausgeprägt buccal am Implantathals ein stärkeres Dehnkräftemuster als bei einem Hackbiss. Les directions des contraintes e ´es en accord avec les angles des chemins de fermetumine `le dentaire re du type mastication et bruxisme Le mode ´partition de stress moelleuse dans l’os de montrait une re support avec moins de concentration de stress autour du `le d’implant montrait une collet de la dent. 1994). high minimum principle stress (compressive stress) was produced in the buccal area.

& Zarb. (1992) Fixture design and overload influence marginal bone loss and fixture success in the Branemark system. Haraldson. & Naert.. S. Jooste. International Journal of Prosthodontics 13: 271. M. & Brose. & Kruger. Journal of Prosthetic Dentistry 62: 440. (1995) Force and moment distributions among osseointegrated dental implant. Siegele. (1988) Bone resorption around fixtures in edentulous patients treated with mandibular fixed tissue-integrated prostheses. R.. C. L. W. Eich. International Journal of Periodontics and Restorative Dentistry 13: 549. I. & Aquilino. Res. U. International Journal of Oral and Maxillofacial Implants 10: 57. Clinical Oral Implants Research 9: 418.F. Duyck. Vander-Perre.. D. I. Holmes. Rockler. (1993) Photoelastic stress analysis of natural teeth and three osseointegrated implant designs. Haganman. Clinical Materials 10: 201.. R.. & Terblanche...D. G. Naert. (1994) Photoelastic analysis of stress distribution transmitted from a fixed prosthesis attached to osseointegrated implants. C. Implant Dentistry 7: Weinberg. (1994) Deflection of superstructure and stress concentration in the IMZ implant system. J. (1994) Mechanical loading of Branemark implants affects interfacial bone modeling and remodeling. D. Brunski. D. Oral Impl... (1997) Biomechanics of oral implants: a review of the literature. van Zyl. M. Taylor. M. G. T. Strub.. C. G.. Clinical Oral Implants Research 11: 465–475.. Journal of the California Dental Association 28: 779. & Parks. T. (1979) Chewing efficiency in patients with osseointegrated oral implant bridges. Duyck. & Maruyama.. G. Waskewics.. International Journal of Prosthodontics 7: 246. E. De-Cooman. I.L. Davis.B. Ostowisk.O... Quirynen.M. (1983) Comparisons of chewing patterns in patients with bridges supported on osseointegrated implants and subjects with natural dentitions. Curtis.M. International Journal of Oral and Maxillofacial Implants 9: 411.. J. Morgan. Hoshaw... G. Mylonas. International Journal of Oral and Maxillofacial Implants 3: 280.. Miyauchi. Weinberg. R. Puers. P.A. (1995) A comparison of implant/prosthesis loading with four clinical variables. J. M. T. S.W. F. International Journal of Oral and Maxillofacial Implants 4: 340. Adamus. 102 | Clin. J.P.E. J.B.. Puers. (1998) Reduction of implant loading with therapeutic 285. De-Cooman.A.A..R. 14.. Lievens. B. C. L. & van Steenberghe. Acta Odontologica Scandinavica 41: 208. I. Duyck. (1995) Three-dimensional finite element model of a human mandible incorporating six osseointegrated implants for stress analysis of mandibular cantilever prostheses. Journal of Prosthetic Dentistry 59: 63. L. 2003 / 97–102 .L.N. Bowles. C. (1992) Biomechanical factors affecting the bone–dental implant interface. & Soltesz.J. & Naert... D. F. M. B.. (1998) The influence of bone mechanical properties and implant fixation upon bone loading around oral implants. Van-Oosterwyck. H.A. Deines. Lindquist.A.. M. Riger.V. & Johnson. Tsutsumi... International Journal of Prosthodontics 8: 433.. (1990) The influence of materials difference on stress distribution and bone remodeling around alumina and titanium dental implants. Haraldson. S. H. R. & Puers.. (2000) Magnitude and distribution of occlusal forces on oral implants supporting fixed prostheses: an in vivo study. Rimrott.C. T. (1989) Numerical investigations of the influence of implant shape on stress distribution in the jaw bone. International Journal of Oral and Maxillofacial Implants 9: 360. J.A. S..H. T. Grundling. (2000) Occlusal considerations for implant restorations in the partially edentulous patient.T. Swedish Dental Journal 3: 191. G. Lievens. J. Takuma.C.. Journal of Osaka University Dental School 30: 96.R. Vander-Sloten. & Carlsson. J. (1988) Studies on frameworks for osseointegrated prostheses: part 2. & James. J. (1989) Finite element analysis of bone-adapted and bone-bonded endosseous implants. M. Sharma. Kinzel. D. & Cochran.. (1994) Functional state of edentulous patients with implantsupported fixed prostheses and implant-retained overdentures: Preliminary results. & Carlsson. Kurokawa. biomechanics.E.. De-Cooman. D.M. S.Ishigaki et al . F.B. A. Vander-Sloten. J. J. Takashima. Cobb. (2000) Research directions in implant prosthodontics. Biomechanical stress under simulated chewing References Brunski.D. & Weingart. D. Journal of Biomechanics 28: 1109.R. Technology and Health Care 5: 273. T. S. Beyer.C. D. G. & Kao.L. Clinical Oral Implants Research 3: 111. International Journal of Oral and Maxillofacial Implants 9: 521.Q. M. Naert.J. Van-der-Sloten. H. The effect of adding acrylic resin or porcelain to form the occlusal superstructure. Van-Oosterwyck.. Finzen.J. V. B. N. Van-Oosterwyck.E.S.