International Journal of Oral Implantology & Clinical Research

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VOLUME 7 , ISSUE 2 ( May-August, 2016 ) > List of Articles

REVIEW ARTICLE

Implant Design and Stress Distribution

Prashanth Shetty, Preeti Yadav, Mohammed Tahir, Varun Saini

Citation Information : Shetty P, Yadav P, Tahir M, Saini V. Implant Design and Stress Distribution. Int J Oral Implantol Clin Res 2016; 7 (2):34-39.

DOI: 10.5005/jp-journals-10012-1151

License: CC BY-ND 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

Implant design refers to the three-dimensional structure of the implant, with all the elements and characteristics that compose it. Dental implants are subjected to various force magnitudes and directions during function. Because implants function to transfer occlusal loads to the surrounding biologic tissues, functional design objectives should aim to manage biomechanical loads to optimize the implant-supported prosthesis function. Thus, the primary functional design objective is to manage biomechanical loads to optimize the implant-supported prosthesis function. An implant has a macroscopic body design and a microscopic component of implant design. The microscopic features are most important during initial implant healing and the initial loading period. The macroscopic implant body design is most important during early loading and mature loading periods. The product used by the implant team may increase or decrease the risk of screw loosening, crestal bone loss, implant body bone loss, peri-implantitis, esthetics of soft tissue drape, implant failure, and implant body fracture. This article shall help the learner in making a judicious informed decision regarding the different factors governing the reduction of overall stress in implant fixtures and, thus, providing a better treatment to their patients. Search strategy: A literature search was conducted using MEDLINE from 1975 to 2014 to identify studies, from simulated laboratory models, animal, to human, related to this topic using the keywords of implant biomechanics, implant macrodesign, thread pitch, thread geometry, thread depth, thread width, and implant crestal module.


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  1. Misch, CE.; Bidez, MW. A Scientific rationale for dental implant design. In: Misch CE, editor. Contemporary implant dentistry. 2nd ed. St Louis, MO: Mosby; 1999. p. 200-229.
  2. Scortecci, GM.; Bert, M.; Leclercq, P. Complications, prevention, correction and maintenance. In: Scortecci GM, Misch CE, Brenner KU, editors. Implant and restorative dentistry. New York: Martin Dunitz; 2000.
  3. Misch CE, Hoar J, Beck G, Hazen R, Misch CM. A bone quality based implant system; a preliminary report of stage I and stage II. Implant Dent 1998;7(1):35-41.
  4. Yukna RA. Optimizing clinical success with implants; maintenance and care. Compend Cont Educ Dent 1993;15(Suppl):554-561.
  5. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003 Aug;90(2):121-132.
  6. Lemons, JE.; Phillips, RW. Biomaterials for dental implants. In: Misch CE, editor. Contemporary implant dentistry. St. Louis: Mosby; 1993. p. 262.
  7. Kan JY, Rungcharassaeng K, Kim J, Lozada JL, Goodacre CJ. Factors affecting the survival of implants placed in grafted maxillary sinuses: a clinical report. J Prosthet Dent 2002 May;87(5):485-489.
  8. Steigenga J, Al-Shammari K, Misch C, Nociti FH Jr, Wang HL. Effects of implant thread geometry on percentage of osseointegration and resistance to reverse torque in the tibia of rabbits. J Periodontol 2004 Sep;75(9):1233-1241.
  9. Hansson S, Werke M. The implant thread as a retention element in cortical bone: the effect of thread size and thread profile: a finite element study. J Biomech 2003 Sep;36(9):1247-1258.
  10. Huang HL, Hsu JT, Fuh LJ, Tu MG, Ko CC, Shen YW. Bone stress and interfacial sliding analysis of implant designs on an immediately loaded maxillary implant: a non-linear finite element study. J Dent 2008 Jun;36(6):409-417.
  11. Chun HJ, Cheong SY, Han JH, Heo SJ, Chung JP, Rhyu IC, Choi YC, Baik HK, Ku Y, Kim MH. Evaluation of design parameters of osseointegrated dental implants using finite element analysis. J Oral Rehabil 2002 Jun;29(6):565-574.
  12. Strong JT, Misch CE, Bidez MW, Nalluri P. Functional surface area, thread form parameter optimization for implant body design. Compend Contin Clin Educ 1998 Special;19(3):4-9.
  13. Cowin SC. Bone mechanics. Boca Raton, FL: CRC Press; 1989. p. 313.
  14. Tada S, Stegaroiu R, Kitamura E, Miyakawa O, Kusakari H. Influence of implant design and bone quality on stress/strain distribution in bone around implants: a 3-dimensional finite element analysis. Int J Oral Maxillofac Implants 2003 May-Jun;18(3):357-368.
  15. Kitagawa T, Tanimoto Y, Nemoto K, Aida M. Influence of cortical bone quality on stress distribution in bone around dental implant. Dent Mater J 2005 Jun;24(2):219-224.
  16. Lin CL, Wang JC, Ramp LC, Liu PR. Biomechanical response of implant systems placed in the maxillary posterior region under various conditions of angulation, bone density, and loading. Int J Oral Maxillofac Implants 2008 Jan-Feb;23(1):57-64.
  17. Lin CL, Wang JC, Chang WJ. Biomechanical interactions in tooth-implant-supported fixed partial dentures with variations in the number of splinted teeth and connector type: a finite element analysis. Clin Oral Implants Res 2008 Jan;19(1):107-117.
  18. Natali AN, Pavan PG, Ruggero AL. Analysis of bone—implant interaction phenomena by using a numerical approach. Clin Oral Implants Res 2006 Feb;17(1):67-74.
  19. Kong L, Zhao Yh, Hu K, Li D, Zhou H, Wu Z, Liu B. Selection of the implant thread pitch for optimal biomechanical properties: a three-dimensional finite element analysis. Adv Eng Softw 2009 Jul;40(7):474-478.
  20. Lee CC, Lin SC, Kang MJ, Wu SW, Fu PY. Effects of implant threads on the contact area and stress distribution of marginal bone. J Dent Sci 2010 Sep;5(3):156-165.
  21. Chung SH, Heo SJ, Koak JY, Kim SK, Lee JB, Han JS, Han CH, Rhyu IC, Lee SJ. Effects of implant geometry and surface treatment on osseointegration after functional loading: a dog study. J Oral Rehabil 2008 Mar;35(3):229-236.
  22. Lan TH, Du JK, Pan CY, Lee HE, Chung WH. Biomechanical analysis of alveolar bone stress around implants with different thread designs and pitches in the mandibular molar area. Clin Oral Investig 2012 Apr;16(2):363-369.
  23. Rieger MR, Mayberry M, Brose MO. Finite element analysis of six endosseous implants. J Prosthet Dent 1990 Jun;63(6):671-676.
  24. Misch, CE. Implant body size: a biomechanical and esthetic rationale. In: Misch CE, editor. Contemporary implant dentistry. 3rd ed. St. Louis: Mosby/Elsevier; 2008. p. 169.
  25. Bozkaya D, Muftu S, Muftu A. Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite element analysis. J Prosthet Dent 2004 Dec;92(6):523-530.
  26. Schrotenboer J, Tsao YP, Kinariwala V, Wang HL. Effect of microthreads and platform switching on crestal bone stress levels: a finite element analysis. J Periodontol 2008 Nov;79(11):2166-2172.
  27. Lee JH, Frias V, Lee KW, Wright RF. Effect of implant size and shape on implant success rates: a literature review. J Prosthet Dent 2005 Oct;94(4):377-381.
  28. Misch CE, Suzuki JB, Misch-Dietsh FM, Bidez MW. A positive correlation between occlusal trauma and peri-implant bone loss: literature support. Implant Dent 2005 Jun;14(2):108-116.
  29. Misch CE. A three dimensional finite element analysis of two blade implant neck designs [master's thesis]. Pittsburgh, University of Pittsburgh; 1989.
  30. Misch CE. Early crestal bone loss etiology and its effect on treatment planning for implants, Dental Learning systems Co. Postgrad Dent 1995;2:3-17.
  31. Khon DH. Overview of factors important in implant design. J Oral Implantol 1992;18(3):204-219.
  32. Misch CE. Implant design considerations for the posterior regions of the mouth. Implant Dent 1999;8(4):376-386.
  33. Misch CE. Contemporary implant dentistry. 2nd ed. St. Louis: Elsevier; 1999. p. 54.
  34. Balshi TJ. An analysis and management of fractured implants: a clinical report. Int J Oral Maxillofac Implants 1996 Sep-Oct;11(5):660-666.
  35. Okumura N, Stegaroiu R, Kitamura E, Kurokawa K, Nomura S. Influence of maxillary cortical bone thickness, implant design and implant diameter on stress around implants: a three-dimensional finite element analysis. J Prosthodont Res 2010 Jul;54(3):133-142.
  36. Vidyasagar L, Apse P. Dental implant design and biological effects on bone-implant interface. Stomatologija, Baltic Dent Maxillofac J 2004;6(2):51-54.
  37. Sorkina N, Varssano D. Corneal collagen, crosslinking: a systematic review. Ophthalmologica 2014 Apr;232(1):10-27.
  38. Steppat, MH.; Raiskup-Wolf, F.; Sporl, E.; Hoyer, A.; Pillunat, LE. Collagen cross linking in patients with pellucid marginal degeneration. Proceedings of the ARVO Meeting, April-May 2008, Florida, USA. 2008.
  39. Kymionis GD, Karavitaki AE, Kounis GA, Portaliou DM, Yoo SH, Pallikaris IG. Management of pellucid marginal corneal degeneration with simultaneous customized photorefractive keratectomy and collagen crosslinking. J Cataract Refract Surg 2009 Jul;35(7):1298-1301.
  40. Spadea L. Corneal collagen cross-linking with riboflavin and UVA irradiation in pellucid marginal degeneration. J Refract Surg 2010 May;26(5):375-377.
  41. Hassan Z, Nemeth G, Modis L, Szalai E, Berta A. Collagen cross-linking in the treatment of pellucid marginal degeneration. Indian J Ophthalmol 2014 Mar;62(3):367-370.
  42. Stojanovic A, Zhang J, Chen X, Nitter TA, Chen S, Wang Q. Topography-guided transepithelial surface ablation followed by corneal collagen cross-linking performed in a single combined procedure for the treatment of keratoconus and pellucid marginal degeneration. J Refract Surg 2010 Feb;26(2):145-152.
  43. Koller T, Schumacher S, Fankhauser F 2nd, Seiler T. Riboflavin/ultraviolet a crosslinking of the paracentral cornea. Cornea 2013 Feb;32(2):165-168.
  44. Han DCY, Lim L. Implantation of toric intraocular lens in pellucid marginal degeneration: a case report on ocular aberrometry outcome. J Clin Exp Ophthalmol 2012 Jan;3:204.
  45. Bahar I, Bialer O. Cataract extraction and Toric intraocular lens implantation for the management of Pellucid marginal degeneration and cataract. Int J Keratoco Ectatic Corneal Dis 2012 Jan-Apr;1(1):66-67.
  46. de Vries NE, Tahzib NG, Webers CA, Hendrikse F, Nuijts RM. Use of verisyse/artisan phakic intraocular lens for the reduction of myopia in a patient with pellucid marginal degeneration. Cornea 2008 Feb;27(2):241-245.
  47. Camoriano GD, Aman-Ullah M, Purba MK, Sun J, Gimbel HV. Toric collagen copolymer phakic intraocular lens to correct myopic astigmatism in eyes with pellucid marginal degeneration. J Cataract Refract Surg 2012 Feb;38(2):256-261.
  48. Varley GA, Macsai MS, Krachmer JH. The results of penetrating keratoplasty for pellucid marginal corneal degeneration. Am J Ophthalmol 1990 Aug;110(2):149-152.
  49. Speaker MG, Arentsen JJ, Laibson PR. Long-term survival of large diameter penetrating keratoplasties for keratoconus and pellucid marginal degeneration. Acta Ophthalmol Suppl 1989;192:17-19.
  50. Jinabhai A, Radhakrishnan H, O'Donnell C. Pellucid corneal marginal degeneration: a review. Contact Lens Anterior Eye 2011 Apr;34(2):56-63.
  51. Kaushal S, Jhanji V, Sharma N, Tandon R, Titiyal JS, Vajpayee RB. “Tuck In” lamellar keratoplasty (TILK) for corneal ectasias involving corneal periphery. Br J Ophthalmol 2008 Feb;92(2):286-290.
  52. Schanzlin DJ, Sarno EM, Robin JB. Crescentic lamellar keratoplasty for pellucid marginal degeneration. Am J Ophthalmol 1983 Aug;96(2):253-254.
  53. Kremer I, Sperber LT, Laibson PR. Pellucid marginal degeneration treated by lamellar and penetrating keratoplasty. Arch Ophthalmol 1993 Feb;111(2):169-170.
  54. Rasheed K, Rabinowitz YS. Surgical treatment of advanced pellucid marginal degeneration. Ophthalmology 2000 Oct;107(10):1836-1840.
  55. Jabbarvand M, Hashemian H, Khodaparast M, Hassanpour N, Mohebbi M. Intrastromal lamellar keratoplasty in patients with pellucid marginal degeneration. J Cataract Refract Surg 2015 Jan;41(1):2-8.
  56. MacLean H, Robinson LP, Wechsler AW. Long-term results of corneal wedge excision for pellucid marginal degeneration. Eye (Lond) 1997;11(Pt 5):613-617.
  57. Javadi MA, Karimian F, Hosseinzadeh A, Noroozizadeh HM, Sa'eedifar MR, Rabie HM. Lamellar crescentic resection for pellucid marginal corneal degeneration. J Refract Surg 2004 Mar-Apr;20(2):162-165.
  58. Fronterre A, Portesani GP. Epikeratoplasty for pellucid marginal corneal degeneration. Cornea 1991 Sep;10(5):450-453.
  59. Ramez Barbara J, Barbara R, Zadok D, et al. Collagen Corneal Cross-Linking followed by Intac Implantation in a Case of Post-PRK Ectasia. Int J Keratoco Ectatic Corneal Dis 2012;1(1):68-72.
  60. Yeung SN, Ku JYF, Lichtinger A, Low SAW, Kim P, Rootman DS. Efficacy of single or paired intrastromal corneal ring segment implantation combined with collagen crosslinking in keratoconus. J Cataract Refract Surg 2013 Aug;39(8):1146-1151.
  61. Kiliç A, Kamburoglu G, Akinci A. Riboflavin injection into the corneal channel for combined collagen crosslinking and intrastromal corneal ring segment implantation. J Cataract Refract Surg 2012 May;38(5):878-883.
  62. Ferenczy PA, Dalcegio M, Koehler M, Pereira TS, Moreira H, Bugmann ML. Femtosecond-assisted intrastromal corneal ring implantation for keratoconus treatment: a comparison with crosslinking combination. Arq Bras Oftalmol 2015 Mar-Apr;78(2):76-81.
  63. Baikoff G, Joly P. Comparison of minus power anterior chamber intraocular lenses and myopic epikeratoplasty in phakic eyes. Refract Corneal Surg 1990 Jul-Aug;6(4):252-260.
  64. Baikoff G. Phakic anterior chamber intraocular lenses. Int Ophthalmol Clin 1991 Winter;31(1):75-86.
  65. Fechner PU, Worst JG. A new concave intraocular lens for the correction of myopia. Eur J Implant Refract Surg 1989 Mar;1(1):41-43.
  66. Brauweiler PH, Wehler T, Busin M. High incidence of cataract formation after implantation of a silicone posterior chamber lens in phakic, highly myopic eyes. Ophthalmology 1999 Sep;106(9):1651-1655.
  67. Zhang X, Tao X-C, Li Z-W, Zhou W-Y, Ma P, Zhang C-X, Wang Y-M, Mu G-Y. Combining corneal crosslinking and phakic toric implantable collamer lenses for the treatment of keratectasia: a case report. Exp Ther Med 2016 Sep;12(3):1495-1498.
  68. Cakir H, Utine CA. Combined kerarings and Artisan/Artiflex IOLs in keratectasia. J Refract Surg 2011 Feb;27(2):119-126.
  69. Moshirfar M, Fenzl CR, Meyer JJ, Neuffer MC, Espandar L, Mifflin MD. Simultaneous and sequential implantation of Intacs and verisyse phakic intraocular lens for refractive improvement in keratectasia. Cornea 2011 Feb;30(2):158-163.
  70. Thompson RW Jr, Price MO, Bowers PJ, Price FW Jr. Long-term graft survival after penetrating keratoplasty. Ophthalmology 2003 Jul;110(7):1396-1402.
  71. McAllum PJ, Segev F, Herzig S, Rootman DS. Deep anterior lamellar keratoplasty for post-LASIK ectasia. Cornea 2007 May;26(4):507-511.
  72. Villarrubia A, Perez-Santonja JJ, Palacin E, Rodriguez-Ausin PP, Hidalgo A. Deep anterior lamellar keratoplasty in post-laser in situ keratomileusis keratectasia. J Cataract Refract Surg 2007 May;33(5):773-778.
  73. Grewal S, Laibson PR, Cohen EJ, Rapuano CJ. Acute hydrops in the corneal ectasias: Associated factors and outcomes. Trans Am Ophthalmol Soc 1999;97:187-98.
  74. Koenig SB, Smith RW. Keratoconus and corneal hydrops associated with compulsive eye rubbing. Refract Corneal Surg 1993;9:383-84.
  75. Mashor RS, Kumar NL, Ritenour RJ, Rootman DS. Keratoconus caused by eye rubbing in patients with Tourette syndrome. Can J Ophthalmol 2011;46:83-86.
  76. Kandarakis A, Karampelas M, Soumplis V, et al. A case of bilateral self-induced keratoconus in a patient with Tourette syndrome associated with compulsive eye rubbing: Case report. BMC Ophthalmol 2011;11:28.
  77. Coyle JT. Keratoconus and eye rubbing. Am J Ophthalmol 1984;97:527-28.
  78. Gritz DC, McDonnell PJ. Keratoconus and ocular massage. Am J Ophthalmol 1988;106:757-58.
  79. Rahi A, Davies P, Ruben M, et al. Keratoconus and coexisting atopic disease. Br J Ophthalmol 1977;61:761-64.
  80. Besancon G, Baikoff G, Deneux A, et al. Preliminary note on the psychological and mental status of patients with keratoconus. Bull Soc Ophtalmol Fr 1980;80:441-43.
  81. Copeman PW. Eczema and keratoconus. Br Med J 1965;2: 977-79.
  82. Mannis MJ, Morrison TL, Zadnik K, et al. Personality trends in keratoconus. An analysis. Arch Ophthalmol 1987;105:798-800.
  83. Swartz NG, Cohen EJ, Scott DG, et al. Personality and keratoconus. CLAO J 1990;16:62-64.
  84. Gasset AR, Hinson WA, Frias JL. Keratoconus and atopic diseases. Ann Ophthalmol 1978;10:991-94.
  85. Kaya V, Karakaya M, Utine CA, et al. Evaluation of the corneal topographic characteristics of keratoconus with orbscan II in patients with and without atopy. Cornea 2007;26:945-48.
  86. Galin MA, Berger R. Atopy and keratoconus. Am J Ophthalmol 1958;45:904-06.
  87. Roth HL, Keirland RR. The natural history of atopic dermatitis. A 20-year follow-up study. Arch Dermatol 1964;89:209-14.
  88. Lowell FC, Carroll JM. A study of the occurrence of atopic traits in patients with keratoconus. J Allergy 1970;46:32-39.
  89. Nemet AY, Vinker S, Bahar I, Kaiserman I. The association of keratoconus with immune disorders. Cornea 2010;29:1261-64.
  90. Buddi R, Lin B, Atilano SR, et al. Evidence of oxidative stress in human corneal diseases. J Histochem Cytochem 2002;50: 341-51.
  91. Kenney MC, Brown DJ. The cascade hypothesis of keratoconus. Cont Lens Anterior Eye 2003;26(3):139-46.
  92. Behndig A, Karlsson K, Johansson BO, et al. Superoxide dismutase isoenzymes in the normal and diseased human cornea. Invest Ophthalmol Vis Sci 2001;42:2293-96.
  93. Podskochy A, Fagerholm P. The expression of Fas ligand protein in ultraviolet-exposed rabbit corneas. Cornea 2002;21:91-94.
  94. Newkirk KM, Chandler HL, Parent AE, et al. Ultraviolet radiation-induced corneal degeneration in 129 mice. Toxicol Pathol 2007;35:819-26.
  95. Pettenati MJ, Sweatt AJ, Lantz P, et al. The human cornea has a high incidence of acquired chromosome abnormalities. Hum Genet 1997;101:26-29.
  96. Snibson GR. Collagen cross-linking: A new treatment paradigm in corneal disease—a review. Clin Experiment Ophthalmol 2010;38:141-53.
  97. Spoerl E, Raiskup-Wolf F, Kuhlisch E, Pillunat LE. Cigarette smoking is negatively associated with keratoconus. J Refract Surg 2008;24:S737-40.
  98. Rabinowitz YS, Nesburn AB, McDonnell PJ. Videokeratography of the fellow eye in unilateral keratoconus. Ophthalmology 1993;100:181-86.
  99. Goodrich DW, Lee WH. The molecular genetics of retinoblastoma. Cancer Surv 1990;9:529-54.
  100. Moodaley LC, Woodward EG, Liu CS, Buckley RJ. Life expectancy in keratoconus. Br J Ophthalmol 1992;76:590-91.
  101. Honein MA, Dawson AL, Petersen EE, Jones AM, Lee EH, Yazdy MM, Ahmad N, Macdonald J, Evert N, Bingham A, et al. Birth defects among fetuses and infants of US women with evidence of possible Zika virus infection during pregnancy. JAMA 2017 Jan 3;317(1):59-68.
  102. Chervenak FA, Jeanty P, Cantraine F, Chitkara U, Venus I, Berkowitz RL, Hobbins JC. The diagnosis of fetal microcephaly. Am J Obstet Gynecol 1984 Jul 1;149(5):512-517.
  103. Papageorghiou AT, Thilaganathan B, Bilardo CM, Ngu A, Malinger G, Herrera M, Salomon LJ, Riley LE, Copel JA. ISUOG Interim Guidance on ultrasound for Zika virus infection in pregnancy: information for healthcare professionals. Ultrasound Obstet Gynecol 2016 Apr;47(4):530-532.
  104. Chibueze EC, Parsons AJ, Lopes KD, Yo T, Swa T, Nagata C, Horita N, Morisaki N, Balogun OO, Dagvadorj A, et al. Diagnostic accuracy of ultrasound scanning for prenatal microcephaly in the context of Zika virus infection: a systematic review and meta-analysis. Sci Rep 2017 May 23;7(1):2310.
  105. Cordeiro MT. Zika virus: laboratory diagnosis. In: Zika in focus. Springer International Publishing; 2017. pp. 59-62.
  106. Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, Kolenc M, Resman Rus K, Vesnaver Vipotnik T, Fabjan Vodušek V, et al. Zika virus associated with microcephaly. N Engl J Med 2016 Mar 10;374(10):951-958.
  107. Zare Mehrjardi M, Keshavarz E, Poretti A, Hazin AN. Neuroimaging findings of Zika virus infection: a review article. Jpn J Radiol 2016 Dec;34(12):765-770.
  108. Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol 2016 Jan;47(1):6-7.
  109. Araujo AQ, Silva MT, Araujo AP. Zika virus-associated neurological disorders: a review. Brain 2016;139(8):2122-2130.
  110. Brasil P, Pereira JP Jr, Moreira ME, Ribeiro Nogueira RM, Damasceno L, Wakimoto M, Rabello RS, Valderramos SG, Halai UA, Salles TS, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med 2016 Dec 15;375(24):2321-2334.
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