Evaluation and Comparison of Stress in Divergent and Convergent Collar Designs of Implants With Different Bone Densities: A Finite Element Study.

Abstract

The failure and the success rate of an implant depends on biomechanical factors, esthetics and painless sterile implant surgery conditions, out of which stresses applied to the bone and its surrounding, bone-implant interface, material characteristics of the implant used and the strength of the bone and its surrounding are the important factors. This study aimed to evaluate the stress distribution of divergent collar design (DCD)and convergent collar design (CCD) implants placing them in four different densities of the bone (D1, D2, D3 and D4).The evaluation of the stress distribution of DCDand CCD was performed using the 3D finite element method (FEM), by placing them in four different bone densities.In addition to this, a comparison of the effect of DCD and CCD in terms of stressdistribution in the bone was also done. The softwareused to process the geometric characteristics of the missing first molar in the mandibular section were Ansys, version 19.2, CATIA, version 5, and Solidworks (Dassault Systèmes). Using these software, three models were designed and successfully restored using an all-ceramic crown implant. The first model was a geometric modelof the first molar mandibular bone section, the second model was a cylindrical implant (4x10mm) with a DCD and CCD, and the third model had titanium alloy (Ti-6Al-4V) properties incorporated into the implant. The D1 bone model showed the lowest stress concentration compared to D2, D3, D4. The DCD showed the lower stress and strain concentrations as compared to the CCD in the contiguous crestal bone in all the densities of the bone in both vertical and lateral or oblique loadings. The DCD with the D1 bone showed the least stress concentration around the crestal bone region. The results of this study also showed that the maximum von Mises stress was observed in the crestal region or the neck of the implant for both the convergent and divergent collar implant designs in all the four densities of the bone. Before a patient trial of a new implant design or a new implant material, finite element analysis (FEA) gives us a clear picture of what will be the patient bone response when an implant will be placed and loaded. FEA also gives us an opportunity to test a new implant material without putting a patient at risk. In this study, four different types of bone were incorporated with two different implant collar designs. Each implant assembly was subjected to vertical as well as oblique forces. The response of each bone type for the titanium alloy implant was recorded. A color-coded response for the magnitude and the location of the maximum stress received by the bone was observed.Maximum stresses were seen in the crestal region. As this is a computer-based model, dynamic loading was not possible. This study provided us with the possible outcome in patients under a static load. Further studies can be conducted invivo to record dynamic loading responses as well as long-time loading responses.