d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689

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journal homepage: www.intl.elsevierhealth.com/journals/dema

Differences in the biomechanical behaviors of

natural teeth and dental implants

Hao-Hueng Chang a,b , Chun-Liang Yeh a , Yin-Lin Wang a,b ,

Yi-Chao Huang c , Shang-Jye Tsai a,d , Yu-Ting Li a ,
Ju-Hsuan Yang a , Chun-Pin Lin a,b,∗
a Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
b Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
c Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
d Department of Dentistry, Cardinal Tien Hospital Yonghe Branch, New Taipei, Taiwan

a r t i c l e i n f o a b s t r a c t

Article history: Objective. The lack of a PDL, which acts as an energy absorber, is a contributor to implants’
Received 17 November 2019 early failure; however, these discrepancies are not well understood because of limited in vivo
Received in revised form research. This study investigated the discrepancy in biomechanical behaviors between nat-
17 December 2020 ural teeth and dental implants by detecting micro-movements in vivo.
Accepted 18 January 2021 Methods. We designed a device that could measure precisely mechanical behaviors such as
creep, stress relaxation, and hysteresis by using load–control displacement on teeth and
implants. We also compared energy dissipation between natural teeth and dental implants
Keywords: by subtracting the area of the hysteresis loop of natural teeth from that of dental implants.
Biomechanics Results. Biphasic curves with an initial phase of rapid response and a subsequent phase of
Natural teeth slow response were confirmed in creep and stress relaxation curves for the load–time rela-
Dental implants tionship in natural teeth. By contrast, the behavior of creep or stress relaxation was less
Periodontal ligament prominent when the dental implants were tested. We observed that the periodontal liga-
Creep ment under an axial intrusive load of 300 g in a loading rate 3 g/s could dissipate the energy of
Stress relaxation 7.35 ± 1.18 × 10−2 mJ, approximately 50 times that of the dental implants (1.47 ± 1.22 × 10−3 )
Hysteresis with statistically significant (p < 0.05).
Energy dissipation Significance. We confirmed natural teeth could achieve greater energy dissipation compared
to dental implants, which owe to that natural teeth exhibited fluid and viscoelastic proper-
ties.
© 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

place in the jawbone with a rich microvascular network. The

1. Introduction PDL primarily plays a support role by attaching the tooth to
the surrounding alveolar bone proper. Previous research has
The periodontal ligament (PDL) is the fibrous connective tis-
indicated a close relationship between the PDL and the behav-
sue layer covering the cementum of a tooth, holding it in
ior of teeth under loading stress [1]. Moreover, many in vitro

∗
Corresponding author at: School of Dentistry, National Taiwan University and National Taiwan University Hospital, No. 1 Chang-Te
Street, Taipei 10048, Taiwan.
E-mail address: chunpinlin@gmail.com (C.-P. Lin).
https://doi.org/10.1016/j.dental.2021.01.003
0109-5641/© 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.
 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689
and in vivo studies have verified the importance of fluid in
tissues, pressure in blood vessels, elastic behavior of the alve-
olar bone, and viscoelastic properties of connective tissue to
the periodontal support mechanism. Both loads on teeth and
the displacement of teeth in the human jaw were recorded
by using experimental devices [1]. A manual intrusive load
was applied gradually to increase the force at various rates
until the expected peak force was reached. After the force was
relieved, the teeth returned to their baseline position in two
phases. In the first phase, the teeth rapidly returned toward
their baseline position almost linear with time for nearly the
same amount of time it took to reach the peak force. The sec-
ond recovery phase was slower, with displacement and time
exhibiting a logarithmic relationship [1].
Picton expanded on Parfitt’s research and published his
results for human teeth by detecting subsequent tooth move-
ment of the first premolars of the upper jaw while chewing
with the first molars of the lower jaw [2,3]. Their load–tooth
displacement curve for tooth displacement was similar to the
findings in Parfitt’s study. However, the relationship between
intrusive force and displacement is not just a logarithmic
relationship. Picton also investigates the axial mobility and
changes in rest position over 3-h periods—all displayed reduc-
tions in mobility when no loads were applied. The consistent
finding of substantial reductions in mobility with or without
extrusion accounts for changes in blood vessels, biophysical
properties, and ground substance. The results of early exper-
iments revealed a nonlinear relationship between intrusive
force and tooth movement, which indicated that the periodon-
tal membrane might have viscoelastic properties [4]. Wills
et al. analyzed displacement-time curves following stress
relaxation in monkeys [5]. They analyzed displacement–time
curves associated with the instantaneous removal of axial
intrusive loads on incisors. They proposed that the three
stages of dental recovery can be understood using an expo-
nential curve fitting technique. Initially, a simple short-term
recoil of tissues and return of blood takes place over 1 or 2 min.
Subsequently, in the medium-term following a series of load-
ings, there is a passive recovery of the tooth position. It may be
due to the re-polymerization of the ground substance. Finally,
in the longer-term (over a few hours), there is a considerable
biochemical turnover of the components of the collagen fiber
meshwork. This turnover, particularly the changes in the fluid
content, would also have a controlling effect on the position of
the tooth within its socket. However, understanding how these
different systems interact to support the teeth is still a chal-
lenging task. Because the current hypothesis does not provide
a complete description of the role played by the PDL in chew-
ing, tooth growth, and tooth movement, future research on
the periodontal mechanism should integrate mathematical,
biological, and mechanical perspectives and offer a complete
description of the PDL mechanism.
Implants have been widely used for more than 50 years and
engineered for osteointegration, leading to their success and
wide acceptance among patients. However, bone loss due to
stress concentration leads to mechanical failure in the long
term. This problem may result from differences in the biome-
chanical behaviors of natural teeth and dental implants.
Differences in biomechanics between natural teeth and
implants have rarely been compared due to a lack of devices
683
and research methods. The aim of the study is to design a
sensitive device to deliver controlled loads and detect dis-
placement changes under different loads on teeth or implants,
then confirmed the hypothesis concerning obvious differ-
ences that exist in biomechanical behaviors between natural
teeth and implants. This device can be therefore used to
understand and compare the in vivo PDL behaviors of natu-
ral teeth and implants, including creep, stress relaxation, and
area of the hysteresis loop.
2. Experimental section
This study’s primary aim was to design and manufacture a
new device to measure slight microscale displacements of
teeth and implants in vivo. When fixed to the lower dentition
of a beagle, the developed device applies an axial intrusive
force to a single tooth or an implant while recording the con-
current forces and displacement to determine the mechanical
behavior difference between nature tooth and dental implant.
2.1. The architecture of the intraoral detection device
The intraoral device consists of load and displacement sen-
sor components (Fig. 1). The axial load was provided by a
small stepper motor (model, PK513PA-H100S) with a precision
measuring screw (model, M148-104-13) capable of applying a
uniaxial variable force to achieve displacement control. The
force was measured using a miniature cantilever force sensor
(model, UH-40N; resolution, 0.01N load cell). Signal acquisi-
tion was achieved using a static/dynamic stress measurement
and data acquisition system (model, LS-1020-16B/LS-AI-16-4;
force display accuracy, 0.05N; displacement display accuracy,
0.5 ␮m) for force and displacement measurement for fur-
ther signal processing. Moreover, a dedicated signal controller
(model, LS-A0-12-4) was employed as a feedback control force
to confirm the requisite displacement control.
Two linear variable differential transformers (LVDTs;
model, TF101F; resolution, 0.06 ␮m) were used to measure dis-
placement. LVDT1 was placed on either a targeted natural
tooth or an implant, and LVDT2 was placed on another natural
tooth as a control reference.
An autopolymerized acrylic appliance that covered the
occlusal surfaces of the dentition was fabricated for each bea-
gle. This occlusal appliance was cemented with the measuring
device to the dentition. A natural tooth was selected from
the first lateral incisors on one side of the mandible to serve
as the target tooth. A dental implant (␸ 3.3 mm Straumann,
Basel, Switzerland) was inserted and allowed to heal for three
months on the contralateral side of the mandible. An adja-
cent central incisor served as the reference tooth to reduce
the long arm’s influence of deformity during the detection of
micromovement.
In order to determine the effect of the PDL on the displace-
ment of the target tooth during loading, a reference tooth was
used as a baseline to calculate the discrepancy between the
target tooth and reference tooth. The device was fixed to the
appliance, which was mounted on a tooth other than the tar-
get tooth (or implant) or the reference tooth. The loading rod
was placed on the edge of the target tooth. The two sensors
684 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689

Fig. 1 – Overview of the new load–displacement measurement device for natural teeth and implants. (a)The device was
secured in an acrylic appliance cemented on teeth, and (b) The device setup for detection on a natural tooth or an implant in
a beagle, and (c) The beam is actuated by a stepper motor to apply a vertical load on a tooth or implant. Two LVDTs are used
to measure the displacement of a tooth (or an implant), one for the target tooth (or implant) and another as a reference. The
precise displacement of the object tooth is indexed by subtracting the reference from the object.

were adjusted such that one of the sensors rested gently on
the surface of the loading rod, and the other touched the ref-
erence tooth without imposing any stress on the tooth. The
discrepancy between the target tooth (or implant) and the
reference tooth was equivalent to the axial displacement of
LVDT1 and LVDT2, and the actual displacement of the tar-
get tooth while loading was thus determined. Beagles (N = 3)
with the target tooth on one side and the implant on the other
side were used in this study. All experimental procedures were
approved by the Institutional Animal Care and Use Commit-
tee (IACUC NO. 20100147) of the Medical College of National
Taiwan University. This study conforms to ARRIVE (Animal
Research: Reporting of in vivo Experiments) guidelines (please
see Supplemental Information).
which was maintained at a constant load, and displacement
recorded for up to 120 s.
2.4. Stress relaxation test
The amount of received force was observed by maintaining a
stable amount of displacement for a specific period. We set
the displacement rate as 1.5 ␮m/s until the intrusive axial dis-
placement of 40 ␮m was met and held in the position for 120 s.
The experiment was also performed to maintain the intru-
sive axial displacement of 60 or 80 ␮m for 120 to ascertain the
force–time relationship. Three measurements were made on
each tooth/implant to confirm.
2.5. Hysteresis loop and energy dissipation

2.2. Determining the displacement–load relationship
between natural teeth and dental implants
The displacement of natural teeth under an axial force is
approximately 200 ␮m [6]. Our device owns the load resolution
of 0.05 N and displacement resolution of 0.5 ␮m. The variation
in the displacement of natural teeth approximately within ten
␮m, in contrast to that of implants, which is negligible, indi-
cating that the displacement-measuring device can provide
an adequate measurement at the micrometer level.
We set the loading rate as 3 g/s and the non-loading dis-
placement rate as 1.5 ␮m/s for the hysteresis tests. Using the
load–displacement relationship, we assessed the hysteresis
loop and calculated the energy dissipation by using Microsoft
Excel (Microsoft Excel 2016, Microsoft Inc, USA). The analysis
results for variables are presented as the mean and standard
deviation (mean ± SD). Differences in the measured properties
among the groups were evaluated using a one-way analysis of
variance with 95% confidence intervals. A p value of less than
.05 indicated statistical significance.

2.3. Creep test 3. Results

The creep test was conducted to measure the displacement 3.1. Creep test results of natural teeth
of the dog’s natural teeth under different axial loads (100, 200,
300, and 500 g). The force was gradually increased at a con- In the creep test, a constant force was maintained for 120 s
stant incremental rate (3 g/s) until it reached an assumed load, so that the behavior of the object being measured could be
 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689 685

Fig. 2 – Detection of the biomechanical properties of natural beagle teeth. (a) Displacement–time relationship of natural dog
teeth in the creep test, (b) load–time curves of the stress relaxation test, and (c) load–displacement relationship of natural
dog teeth in the hysteresis test, and (d) energy dissipation of natural teeth in the hysteresis test. (For interpretation of the
references to colour in the text, the reader is referred to the web version of this article).

observed. Fig. 2a presents the displacement–time relationship
under four force conditions (100, 200, 300, and 500 g), indi-
cating that the final displacement values gradually increased
with force. The displacement–time diagram clearly shows the
creep phenomenon in a natural dog tooth. We determined
the relationship between the displacement and time under
a controlled load. When the load was up to 100 g, the dis-
placement was always 75 microns, regardless of the final
load value. In this test, when the load reached 100 g, the dis-
placement remained at approximately 75 ␮m regardless of the
load–control displacement, whether it was at 100, 200, 300,
or 500 g. All curves for the load–time relationship showed an
initial phase with a steep slope, followed by a gradual plateau.
3.2. Stress relaxation of natural teeth
In the stress relaxation test, a fixed displacement was main-
tained for 120 s so that the behavior of the object being
measured could be observed. Fig. 2b illustrates the force–time
relationship under three displacement conditions. After var-
ious fixed displacement values (40, 60, and 80 ␮m) were
maintained for 120 s each time, the force gradually decreased
with an increase in the time. The blue curve showed stress
relaxation when the natural tooth displacement was main-
tained at 40 ␮m. In the beginning, the rate of relaxation
under a load was higher; subsequently, the rate of relax-
ation decreased gradually. Under load application wherein the
displacement was maintained at 40 ␮m for 30 s following max-
imum loading, the condition of the stress relaxation curve
presented as a steep relaxation phase with a rapid logarith-
mic decline (y = −7.85ln(x) + 49.05)) and a flat relaxation phase
with a slow logarithmic decline (y = −5.120ln(x) + 37.97). A sim-
ilar graph pattern was observed when the displacement was
maintained at 60 and 80 ␮m under load control. When the
displacement was maintained at 60 ␮m for 45 s following max-
imum loading, the condition of the stress relaxation curve
presented as a steep relaxation phase with a rapid logarith-
mic decline(y = −23.95ln(x) + 147.62) and a flat relaxation phase
with a slow logarithmic decline (y = −15.72ln(x) + 112.97) When
the displacement was maintained at 80 ␮m for 60 s following
maximum loading, the stress relaxation was observed as a
curve with a steep relaxation phase and a rapid logarithmic
decline y = −33.51ln(x) + 227.38 (−33.51) and a flat relaxation
phase with a slow logarithmic decline y = −19.96ln(x) + 160.84
(−19.96). The force-time diagram clearly shows the stress
relaxation phenomenon in a natural dog tooth.s
3.3. Hysteresis loop of natural teeth
The load–displacement relationship of natural dog teeth in the
hysteresis test is shown in Fig. 2c. The results suggested that
as the applied load increased, the inner area of the hystere-
sis loop increased, signifying greater energy absorption by the
PDL under a heavier load. The energy dissipation of the natu-
ral teeth in the hysteresis test is shown in Fig. 2d. The energy
dissipation levels of the natural dog teeth at 100, 200, 300, and
500 g were 1.97 × 10−2 , 4.52 × 10−2 , 7.35 × 10−2 , and 13.94 × 10−2
mJ, respectively. The increase in energy absorbed with load is
to be expected.
3.4. Creep of dental implants
The effect of load on the displacement–time relationship in
the creep test is presented in Fig. 3a. In general, the dis-
placement of the implant was less than 10 ␮m. Hence, a
sawtooth wave is evident in these displacement-time curves,
which was considered to be the device’s inherent noise, which
can be determined by making measurements on non-loaded
686 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689

Fig. 3 – Detection of the biomechanical properties of dental implants in beagles. (a) Displacement–time curves of the creep
test, (b) load–time curves of the stress relaxation test, (c) load–displacement curves of the hysteresis test, and (d) energy
dissipation of dental implants in the hysteresis test. (For interpretation of the references to colour in the text, the reader is
referred to the web version of this article).

objects. We determined the relationship between force and
displacement under different loads applied for more than
160 s. When the load was up to 100 g, the displacement
was always 75 microns, regardless of the final load value.
All displacement–time relationship curves showed an initial
phase involving a steep slope, followed by a subsequent phase
involving a shallow slope. Some displacement peaks at 30−40 s
may be caused by involuntary movements of the dogs, such as
breathing.
3.5. Stress relaxation of dental implants
In Fig. 3b, the blue curve shows stress relaxation when the
natural tooth displacement was maintained at 8 ␮m. Once the
controlled displacement reached 8 ␮m, the rate of relaxation
decreased marginally. Similar stress relaxation curves were
also noted when the load control displacement increased to
and maintained at 9 and 10 ␮m.
3.6. Hysteresis loop of dental implants
The load–displacement relationship of the implants in the
hysteresis test is shown in Fig. 3c. The results suggest that
as the applied load increased, the inner area of the hys-
teresis loop increased, indicating greater energy absorption.
The energy dissipation of implants in the hysteresis test was
considerably lower because of limited viscoelastic displace-
ment, as illustrated in Fig. 3d. The energy dissipation levels
of the natural dog teeth at 100, 200, and 300 g were 8.2 × 10−4 ,
1.34 × 10−3 , and 1.47 × 10−3 mJ, respectively.
3.7. The discrepancy in biomechanics between natural
teeth and dental implants
Fig. 4a shows the relationship between stress and displace-
ment for implants and natural teeth with the loading rate
as 3 g/s in the creep test. Although, presumably, not all the
displacement of natural teeth was due to creep, some could
be due to the PDL’s nonlinear elastic response. The implants
exhibited almost no creep with a displacement of approxi-
mately four ␮m under a load of 100 g. However, the natural
teeth exhibited creep and displacement of approximately
60 ␮m under a load of 100 g. When a force of 200 g was applied,
the observed implant displacement was approximately 5 ␮m,
whereas the observed natural tooth displacement was approx-
imately 86 ␮m. When a force of 500 g was applied, the observed
implant displacement was approximately 13 ␮m, whereas
the observed natural tooth displacement was approximately
127 ␮m. The force–displacement relationship followed a lin-
ear equation for the implants and a quadratic equation for
the natural teeth. Fig. 4b shows the energy dissipation for the
natural teeth and implants in the hysteresis test. After energy
conversion, the energy dissipation of the hysteresis loop under
a load of 100 g was 1.97 ± 1.05 × 10−2 mJ for the natural teeth
and 8.2 ± 7.52 × 10−4 mJ for the implants with statically signif-
icant difference (p = 0.011). Under a load of 200 g, the energy
dissipation of the hysteresis loop was 4.52 ± 0.92 × 10−2 mJ for
the natural teeth and 1.34 ± 0.93 × 10−3 mJ for the implants
with statically significant difference (p = 0.023). The hys-
teresis loop’s energy dissipation under a load of 300 g was
7.35 ± 1.18 × 10−2 for the natural teeth and 1.47 ± 1.22 × 10−3
mJ for the implants with statically significant difference
(p = 0.036).
 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689 687

Fig. 4 – The discrepancy in biomechanics between natural teeth and dental implants. (a) Load–displacement curves of
natural teeth and implants. The load was increased from 0 to 500 g. (b) Energy dissipation of natural teeth and implants
during the hysteresis test.

yet practical model, we could test and prove our hypothe-

4. Discussion sis.
Our study found that the natural teeth exhibited creep
In this study, we used a new device to detect creep, stress
behavior because all the curves with different load had an ini-
relaxation, and hysteresis for both dental implants and nat-
tial phase with a steep slope in the displacement–time graphs,
ural teeth. We confirmed the notion that the PDL shows
followed by a gradual plateau. In other words, after an axial
viscoelastic behavior. Furthermore, we found and confirmed
force was delivered to the natural teeth, causing them to ini-
discrepancies between natural teeth and dental implants. This
tially sink rapidly with the root toward the bottom of the
is to be expected as implants have no PDL.
socket, displacement appeared to slow down under a constant
The literature contains well-researched hypotheses con-
load. According to the microenvironment of the tooth and
cerning the behavior of the PDL, including simple elastic
the surrounding supporting tissue, the resistance to shrink-
theory and more complicated theories. However, these
ing might have increased due to the stretching of the PDL
hypotheses have yet to be evaluated and confirmed in vivo. We
and extrusion of fluid in the PDL space. The PDL serves as a
agree with the concepts proposed by Parfitt, and we attempted
shock absorber through mechanisms that provide resistance
to prove that the PDL possesses a viscoelastic property in its
to light and heavy forces. Light forces are cushioned by the
function as a cushion in the alveolus during the tooth con-
intravascular fluid, which is forced out of blood vessels. Mod-
tact in chewing. We agree with Parfitt’s viewpoint that using
erate forces are absorbed by the extravascular tissue fluid,
only collagen fibers to explain the complicated mechanism of
which is forced out of the PDL space into adjacent narrow
periodontal support is insufficient. He emphasized that teeth
spaces, while heavy forces are absorbed by principal fibers.
cannot be supported only by the tension of the elastic fiber
Parfitt has shown that, initially, tooth displacement increases
bundle. Parfitt stated that teeth are supported by the fluid
rapidly when the load is approximately 100 g, and displace-
associated with vascular and interstitial fluid systems in the
ment gradually decreases logarithmically when a greater load
PDL.
is applied [1,8]. Our experimental results reveal that, in the
The limitations of studies investigate the biomechanics of
beginning, a small force produced a large displacement, but
periodontal ligament may be the complexity of force delivery
as the force increased, the displacement increased at a lower
systems and anatomic relationship between the root and sup-
rate. We found that the relationship between force and dis-
porting tissue. The results of previous studies have shown that
placement followed a quadratic equation. In contrast to our
the relationship between intrusive force and tooth mobility is
findings, Willis et al. considered the force–displacement rela-
“non-Hook” and that the PDL can possess a viscoelastic prop-
tionship to be logarithmic [5], which was not considered by
erty. In addition to discussing the stress–strain relationship
Parfitt, who considered the relationship to be quadratic with
of the PDL, Moxham and Berkovitz discussed the viscoelastic
some discontinuous phases in between.
properties of the PDL, including creep, stress relaxation, and
We found that the PDL exhibits stress relaxation charac-
hysteresis, to describe PDL support theory [7]. Yet, few related
teristics. By observing stress relaxation, we found that when
studies have been conducted, particularly on the stress relax-
a tooth under load maintained a steady position, while as
ation and hysteresis phenomena. Although the basic modes
the force gradually decreased, it mimicked a tooth under an
of displacement are consistent, a literature review revealed
axial load with a steady displacement. This is due to the
inconsistent displacement data results from different exper-
adaption of the PDL caused by extracellular fluid redistribu-
iments when compared. We used a simple single-root model
tion and the viscoelastic property of the ground substance
to demonstrate the viscoelastic behavior, and with this simple
in the periodontium. In our relaxation experiments, relax-
688 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689
ation also occurred within 2 min of our relaxation time. Dorow
and Komatsu et al. have performed stress relaxation experi-
ments using PDL and alveolar bone specimens of rabbit teeth;
the relationship between stress relaxation and time revealed
three exponential decay terms. Their findings indicated that
the PDL’s relaxation reaction might require several minutes
to more than an hour to reach equilibrium [9,10]. However,
their experiments involved an in vitro specimen composed of
teeth, the alveolar bone, and the PDL; therefore, their results
cannot represent the entire mechanical behavior of the PDL.
Similar in vitro results have been obtained in a human study
[11], a mouse study [12], and pig studies [13,14]. The aforemen-
tioned in vitro experiments could reveal only a small part of
the PDL behavior. The contribution of fiber, liquid, blood, and
overall PDL composition remains unclear. No in vivo study has
been conducted on tooth stress relaxation, and our study is the
first to identify the stress relaxation phenomenon in a bea-
gle tooth model. When the teeth were released from the load,
they gradually and slowly returned to their original positions.
The hysteresis analysis results indicate that the relationships
between load and displacement during the tooth depression
and recovery phases were considerably different. The energy
dissipation in the area could be calculated between the initial
and return phases.
In this study, we used the aforementioned device to exam-
ine natural teeth and dental implants. Fig. 4 shows the
discrepancy in biomechanics between the natural teeth and
dental implants, demonstrating that as the applied force
increased, the inner area of the hysteresis loop increased,
consequently signifying an increase in the energy absorbed
by the PDL. Based on the findings of the creep test for the
natural teeth, as the applied load increased, the resulting
creep increased; however, no significant creep was found
in the dental implants. The near-complete lack of creep
performance limits energy dissipation in resorbing force or
impact on implants during mastication. In the stress relax-
ation test, two relaxation phases in the natural dog teeth
were noted, suggesting that the PDL of a natural tooth serves
as a stress absorber. However, this phenomenon was not
observed in dental implants. We found that the periodon-
tium under an axial load of 300 g could dissipate the energy of
7.35 ± 1.18 × 10−2 mJ, approximately 50 times that of the dental
implants (1.47 ± 1.22 × 10-3 ). Hysteresis is used to describe the
stress–strain relationship during delayed or drawn-out recov-
ery. The hysteresis curve represents the behavior of the PDL
during stress load and the release of an external force. The
hysteresis loop can be used to indicate the PDL uptake and
the release of required energy. When a tooth is subjected to
an external force, the PDL can quickly absorb and then release
stored strain energy gradually based on the PDL’s viscoelas-
tic properties. If strain energy is not released, then excessive
strain energy may cause the breakage of surrounding tissues
[13–16]. Our experimental results reveal that the hysteresis of
the PDL was substantially larger than that of the implants.
Occlusal loading on a natural tooth may be absorbed
or transmitted to surrounding alveolar bone by periodon-
tium, owing to energy dissipation. This study describes an
innovative design and a practical method in comparing the
biomechanical behaviors of a tooth and an implant in vivo.
Biomechanical phenomena, including creep, stress relaxation,
and hysteresis, occurred in natural teeth and dental implants.
However, the degree of such phenomena was determined to
be considerably lower for a dental implant than that of a nat-
ural tooth. And our findings support that PDL can absorb the
energy impact on the tooth through the energy dissipation of
the periodontium’s viscoelastic property.
In clinical practice, long-term implant prosthodontic fail-
ure may be due to mechanical complications; improper
loading design leads to bone resorption, peri-implantitis, or
implant fracture. A dental implant in the clinical application
usually considers a light occlusal contact scheme with its den-
tal antagonists. Be cautious of the dental implant’s mechanical
failure was emphasized since it has small energy dissipation
than a natural tooth. Improving energy dissipation in dental
implants while chewing is a necessary feature in the design
of future implants. Many authors have attempted to develop
such implants, but they may require original or biomechanical
parameters as a reference for abutment fixtures to mimic the
biomechanical behavior of natural teeth. The role of the PDL in
biomechanics has always been a subject of considerable con-
cern in the literature. Our method and device may be adapted
and expanded for humans to establish a database of parame-
ters related to the mechanics of the PDL; such a database can
be applied in finite element analysis for dental and implant-
related research. Our method provides an easy approach to
determine the load and displacement of a natural tooth. This
method can be used to determine parameters for further finite
element construction.
5. Conclusions
We successfully designed and constructed a precise and
sensitive device that could detect natural teeth and den-
tal implants’ micromovement under different loads. We
confirmed that natural teeth’ periodontium possesses the
viscoelastic properties of creep, stress relaxation, and hys-
teresis, thus achieving greater energy dissipation than dental
implants.
Author contributions
The manuscript was written through the contributions of all
authors. All authors have given approval to the final version
of the manuscript.
Study conception and design: Hao-Hueng Chang, Shang-
Jye Tsai, Chun-Pin Lin.
Acquisition of data: Yin-Lin Wang, Yi-Chao Huang, Shang-
Jye Tsai, Yu-Ting Li, Ju-Hsuan Yang.
Analysis and interpretation of data: Hao-Hueng Chang,
Chun-Liang Yeh.
Drafting of the manuscript: Hao-Hueng Chang, Chun-Liang
Yeh.
Acknowledgements
The authors gratefully acknowledge the grant supports
from the National Taiwan University Hospital (107CGN09 &
109CGN07).
 d e n t a l m a t e r i a l s 3 7 ( 2 0 2 1 ) 682–689 689

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