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• W2976092575 abstract "Background Short implants placement is a method of choice for posterior maxilla. Their immediate loading is the most attractive treatment modality but bone overstrain may compromise bone healing and result in unsatisfactory osseointegration. According to Frost mechanostat theory, bone strains should not exceed 3000 microstrain minimum effective strain pathological (MESp) threshold. Biomechanical evaluation of strain fields is promising with numerical methods, in particular by finite element (FE) method. Aim/Hypothesis The aim of the study was to correlate maximal strains induced by short implants in Type IV bone under 120.92 N mean maximal experimental functional load with 3000 microstrain MESp threshold to predict the implants success under immediate loading. Material and Methods First principal strains in bone-implant interface were evaluated in ANSYS 15. The following implants were selected for this study- 3.3, 4.1, 4.8, 5.4 mm diameter and 4.5, 5.5, 6.5, 7.5, 8.5 mm length+ they were placed bicortically. Posterior maxilla 3D models size was 15 × 30 × 10 mm. Type IV bone quality was set with 0.5, 1.0, 1.5 mm alveolar crest sinus floor cortical bone thickness. Cancellous bone thickness was 1.5-7.5 mm. 20-node quadratic 0.05 mm SOLID 186 and CONTA 174 versus TARGE 170 FEs were chosen. The maximal number of FEs was 2,312,000. 120.92 N oblique functional load was applied to implant abutment. Materials were modelled as linearly elastic and isotropic. Elasticity moduli for cortical and cancellous bone were 13.7 and 0.69 GPa. Penalty method was selected in surface-to-surface contact with 0.01 micrometer penetration limit and 0.3 friction coefficient. Maximal first principal strains in bone for all bone-implant models were correlated with 3000 microstrain MESp threshold. Results Maximal strains were located in the crestal cortical bone. The spectrum of maximal first principal strains under 120.92 N load was from 2000 to 8700 microstrain. Wide implants (5.4 mm) were found preferable than narrow (3.3 mm) ones for three cortical bone thicknesses due to sufficient strain reduction- for 4.5, 5.5, 6.5, 7.5, 8.5 mm implant length it was 39.4, 39.9, 40.9, 41.9, 44.4% for 0.5 mm, 36.5, 36.9, 37.9, 38.5, 38.9% for 1.0 mm and 35.6, 35.5, 36.2, 35.5 and 34.5% for 1.5 mm. Besides, reduction of maximal strains due to implant length increase from 4.5 to 8.5 mm was also dependent on implant diameter- 35.8, 34.7, 39.2, 41.2% for 0.5 mm, 35.8, 36.1, 37.1, 38.3% for 1.0 mm and 35.6, 31.9, 32.2. 35.7% for 1.5 mm cortical bone thickness and 3.3, 4.1, 4.8, 5.4 mm diameter respectively. The largest (5.4◊8.5 mm) implant from the spectrum allowed 64.3, 60.8 and 58.6% maximal strain decrease relative to the smallest (3.3◊4.5 mm) implant for 0.5, 1.0 and 1.5 mm cortical bone thickness. Conclusion and Clinical Implications Maximal bone strains depend on implant diameter and length, and cortical bone thickness. Under 120.92 N functional load and 0.5…1.0 mm cortical bone, failure of 4.8 × 7.5, 4.8 × 8.5, 5.4 × 6.5, 5.4 × 7.5, 5.4 × 8.5 mm implants is highly unlikely. For other scenarios, bone strains exceed 3000 microstrain threshold and implants were at risk of failure. The cause seems to be poor stiffness of cancellous bone. Analysis of cancellous bone density should precede the planning of short implants immediate loading." @default.
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• W2976092575 date "2019-09-01" @default.
• W2976092575 modified "2023-10-17" @default.
• W2976092575 title "Are short implants indicated for immediate loading?" @default.
• W2976092575 doi "https://doi.org/10.1111/clr.121_13509" @default.
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