Bone Stress Evaluation with and without Cortical Bone Using Several Dental Restorative Materials Subjected to Impact Load: A Fully 3D Transient Finite-Element Study.

Abstract

Statement of problem. Previous peri-implantitis, peri-implant bone regeneration, or immediate implant placement postextraction may be responsible for the absence of cortical bone. Single crown materials are then relevant when dynamic forces are transferred into bone tissue and, therefore, the presence (or absence) of cortical bone can affect the long-term survival of the implant. Purpose: the purpose of this study is to assess the biomechanical response of dental rehabilitation when selecting different crown materials in models with and without cortical bone. Methods: several crown materials were considered for modeling six types of crown rehabilitation: full metal (MET), metal-ceramic (MCER), metal-composite (MCOM), peek-composite (PKCOM), carbon fiber-composite (FCOM), and carbon fiber-ceramic (FCCER). An impact-load dynamic finite-element analysis was carried out on all the 3D models of crowns mentioned above to assess their mechanical behavior against dynamic excitation. Implant-crown rehabilitation models with and without cortical bone were analyzed to compare how the load-impact actions affect both type of models. Results: numerical simulation results showed important differences in bone tissue stresses. The results show that flexible restorative materials reduce the stress on the bone and would be especially recommendable in the absence of cortical bone. Conclusions: this study demonstrated that more stress is transferred to the bone when stiffer materials (metal and/or ceramic) are used in implant supported rehabilitations; conversely, more flexible materials transfer less stress to the implant connection. Also, in implant-supported rehabilitations, more stress is transferred to the bone by dynamic forces when cortical bone is absent.