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Abstract
The attainment of a good aesthetic outcome in dental implant treatment requires inter-implant papilla reconstruction, which is very difficult to perform. Maintenance of the inter-implant bone is essential for maintenance of the inter-implant papilla. The aim of this study was to investigate the mechanical influences of the implant–abutment connection type and inter-implant distance on the inter-implant bone by using three-dimensional finite element analysis. Three computer-aided design models of two-piece implants were designed: external connection (EC), internal connection (IC), and conical connection (CC). In each model, two identical implants were placed with inter-implant distances of 3.0, 2.5, and 2.0 mm. The maximum principal stress and microgap were evaluated. The stress values of the inter-implant bone decreased in the following order: IC, EC, and CC. The microgap decreased in the following order: EC, IC, and CC. Regardless of the type of implant–abutment connection, the stress of the inter-implant bone increased as the inter-implant distance decreased. The microgap barely changed as the inter-implant distance decreased. A CC implant is a mechanically advantageous implant–abutment connection type for maintenance of the inter-implant bone. With an inter-implant distance of less than 3.0 mm, use of a CC implant might suppress absorption of the inter-implant bone.
Highlights
Dental implant treatment has recently become a popular option for restoration of missing teeth and human masticatory function [1]
Excessive occlusal force that is overloaded from the superstructure to the bone surrounding the implant through the implant–abutment connection is closely involved in bone resorption after the functional load is started [6]
In the internal connection (IC) model, tensile stress concentrates on the implant side in addition to the abutment side at the implant–abutment connection, tensile stress is applied from the apical part by the inter-implant bone, and there is greater tensile stress than in the external connection (EC) model (Figure 4)
Summary
Dental implant treatment has recently become a popular option for restoration of missing teeth and human masticatory function [1]. Various factors have been reported as causes of bone resorption around the implant; two of these factors, overloading and microgap formation, are influenced by the type of implant–abutment connection [4]. Bone resorption around the implant is caused by microfracture of the bone when a certain amount of stress is applied to the bone [5]. Excessive occlusal force that is overloaded from the superstructure to the bone surrounding the implant through the implant–abutment connection is closely involved in bone resorption after the functional load is started [6]. The application of stress within a certain range to the bone does not result in bone resorption, and may cause bone expansion [5]. No reports have described an increase in the bone mass around the implant in clinical practice, suggesting that excessive stress on the bone around the implants must be prevented
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