Finite element analysis of bone loss around failing implants

Abstract Dental implants induce diverse forces on their surrounding bone. However, when excessive unphysiological forces are applied, resorption of the neighbouring bone may occur. The aim of this study was to assess possible causes of bone loss around failing dental implants using finite element analysis. A further aim was to assess the implications of progressive bone loss on the strains induced by dental implants. Between 2003 and 2009 a total of 3700 implant operations were performed in a private clinic. Ten patients with 16 fixtures developed severe marginal bone defects. Finite element analysis was used to assess the effective strains produced at the bone-implant interface under unidirectional axial loading. These simulations were carried out on 4 specific implant types – Camlog Plus, Astra Osseo Speed, Straumann BL and Straumann S/SP. All implant types exhibited degraded performance under circular and horizontal bone loss conditions. This is evidenced by increased distribution of pathological strain intensities (>3000 μe), in accordance with the mechanostat hypothesis, in the surrounding bone. Among the implants, the Camlog design seemed to have performed poorly, especially at the chamfer in the implant collar (>25000 μe). Implants are designed to perform under nearly ideal conditions from insertion till osseointegration. However, when the surrounding bone undergoes remodelling, implant geometries can have varied performance, which in some cases can exacerbate bone loss. The results of this study indicate the importance of evaluating implant geometries under clinically observed conditions of progressive bone loss.