D3 Bone Research Articles

An Evaluation of the Stress Distribution in Screw Retained Implants of Different Crown Implant Ratios in Different Bone Densities Under Various Loads-A FEM Study.

Studies on stress distribution around screw retained implants in different bone densities are limited. In clinical situations crowns of different heights are placed on the implants and the effect of varying crown implant ratio on the bone is not understood properly. To evaluate and compare the stress distribution in different screw retained implants for different crown-implant ratios in different bone densities under various occlusal loads using three dimensional finite element analyses. In this invitro study the stress distribution was evaluated and compared between two different crown heights (7.5mm, 10mm) retained on implants by using different screw materials (commercially pure titanium, titanium alloy) in two different densities of bone D2, D3 under various load (100N, 200N) applications by using finite element analysis. For crown height of 7.5mm, in D2 bone density when vertical load of 200N was applied, the maximum stress concentration was 1780N/cm(2), for oblique load of 100N it was 2936N/cm(2) respectively and in D3 bone density when vertical load of 200N was applied, the maximum stress concentration was 1820N/cm(2), for oblique load of 100N it was 3477N/cm(2) respectively. When the crown height is increased to 10mm, the maximum stress concentration in D2 bone was 1875N/cm(2) for vertical load, 4015N/cm(2) for oblique load and in D3 bone the maximum stress concentration was 2123N/cm(2) for vertical load and 4236N/ cm(2) for oblique load. In case of titanium screws for crown height of 7.5 mm, when vertical load was applied, stress concentration was 1603 N/cm(2) where as for titanium alloy screw it was 1820N/cm(2). In case of 10mm crown height stress concentration was 1904N/cm(2) for titanium screw and 2123N/cm(2) for titanium alloy screw. In case of oblique loading for 7.5mm crown height stress concentration was 3155N/cm(2) for titanium screw 3477N/cm(2) for titanium alloy screw. For 10mm crown height stress concentration was 4236N/cm(2) for titanium screw, 4663N/cm(2) for titanium alloy screw. Stress concentration was less and stress distribution was better in D2 bone density than in D3 bone density. Stress concentration was less and stress distribution was better in commercially pure titanium screw than in titanium alloy screw. With the increase in the height of crown (i.e., from 7.5mm to 10mm) stress concentration and stress distribution also increased.

Finite Element Analysis of Stress Distribution in Three Commonly Used Implant Systems in D2 and D4 Bone Densities

Finite Element Analysis of Stress Distribution in Three Commonly Used Implant Systems in D2 and D4 Bone Densities

Stress analysis at bone-implant interface of single- and two-implant-retained mandibular overdenture using three-dimensional finite element analysis.

The purpose of this research was to compare stress distribution on the bone between single implant-retained and two-implant-retained mandibular overdentures using three-dimensional (3D) finite element analysis. Two 3D finite element models were designed. The first model included single implant-supported mandibular overdenture placed in the midline of the mandible while the second model included two-implant-supported mandibular overdenture placed in the intra-foramen region, retained by ball attachment of the same diameter. The bone was modeled on the D2 bone depending on the classification given by Misch. A computed tomography scan of the mandible was used to model the bone by plotting the key points on the graph and generating the identical key points on the ANSYS Software (ANSYS, Inc., USA). The implant was modeled using appropriate dimensions as provided by the manufacturer. Stresses were calculated based on the von Mises criteria. Stresses produced in the hard bone (HB) and soft bone (SB) were higher in single implant-retained mandibular overdenture while stresses produced around the denture as well as implant were higher in two-implant-retained mandibular overdenture. Within the limitations of the study, it had been seen that stresses produced were the highest on HB and SB in single implant-retained mandibular overdenture while stresses produced across the denture as well as implant were the highest in two-implant-retained mandibular overdenture.

The effect of low-speed drilling without irrigation on heat generation: an experimental study.

ObjectivesIn this study we evaluated heat generation during the low-speed drilling procedure without irrigation.Materials and MethodsTen artificial bone blocks that were similar to human D1 bone were used in this study. The baseline temperature was 37.0℃. We drilled into 5 artificial bone blocks 60 times at the speed of 50 rpm without irrigation. As a control group, we drilled into an additional 5 artificial bone blocks 60 times at the speed of 1,500 rpm with irrigation. The temperature changes during diameter 2 mm drilling were measured using thermocouples.ResultsThe mean maximum temperatures during drilling were 40.9℃ in the test group and 39.7℃ in the control group. Even though a statistically significant difference existed between the two groups, the low-speed drilling did not produce overheating.ConclusionThese findings suggest that low-speed drilling without irrigation may not lead to overheating during drilling.

Three-dimensional finite-element analysis of a single implant-supported zirconia framework and its effect on stress distribution in D4 (maxilla) and D2 (mandible) bone quality

The aim of this in-silico study was to compare stress distributions in implants and zirconia frameworks of mandibular and maxillary implant-supported crowns. For comparison, vertical and oblique loading forces were used. Three-dimensional finite-element implant models of a mandibular section of bone (D2) and a maxillary section of bone (D4) with missing second molars and their zirconium-based superstructures were used. Zimmer dental implants of 13 mm in length and 4.7 mm in diameter were modelled. A load of 200 N was applied toward vertical and oblique (30° to the vertical) directions. Maximum and minimum von Mises stress values of the implants and the zirconia framework were calculated. The highest stress value was concentrated in the zirconia framework of the maxillary implant-supported model with the oblique loading force (301.17 MPa). The lowest stress value was concentrated in the mandibular implant-supported model. And the stress values in the maxilla were higher than in the mandible. The maxilla (D4) showed higher stress values than in the mandible (D2), because the trabecular bone is weaker and less resistant to deformation than the cortical bone. Stress values with oblique loading forces were higher than with vertical loading forces. Because of the high Young's modulus of zirconia (low elastic properties), zirconia frameworks showed higher stress values than the implants.

Vitamin D3 levels and bone mineral density in patients with psoriasis and/or psoriatic arthritis.

Limited data are available on the vitamin D3 status and bone mineral density (BMD) of patients with psoriasis or with psoriatic arthritis. Our study intended to explore possible correlations between vitamin D status and BMD, as well as among these parameters and the features of the underlying disorder. Seventy-two patients with psoriasis/or psoriatic arthritis (female:male ratio, 40:32; mean age, 58.5±11.6years; mean duration of follow up, 142.7±147.7months) participated in the study. We evaluated the characteristic clinical features of the underlying disease, performed bone densitometry of the lumbar spine and the hip region, measured the serum vitamin 25(OH)D3 levels of the patients, and undertook the statistical analysis of the relationships between the clinical and the laboratory parameters. The proportion of patients with a low BMD value did not exceed that seen in the general population. We found an inverse correlation between the serum level of vitamin 25(OH)D3 and body mass index, as well as between the former and the severity of skin involvement. Furthermore, the activity of psoriatic arthritis was significantly higher in patients with inadequate vitamin D3 status. In patients with psoriatic arthritis, BMD significantly exceeded the values measured in patients suffering from psoriatic skin lesions only. Our findings suggest the importance of evaluating the vitamin D3 status and screening for comorbid conditions in patients with psoriasis or psoriatic arthritis. This appears justified, in particular, due to the possible role of hypovitaminosis D3 in provoking the development of skin lesions and joint symptoms.

Finite element analysis of stress and displacement around mini-implant using different insertion angles and various direction of orthodontic force in maxilla and mandible

Objective: To determine the biomechanical effects of implant insertion angle and direction of orthodontic force on maxilla and mandible by finite element approach and factorial analysis. Materials and Methods: A three-dimensional finite element bone block models of maxilla and mandible with type D3 and D2 bone quality were constructed. Mini-implants were inserted at 30°, 60°, and 90° and orthodontic force was applied to the center of the mini-implant head at 60°, 90°, and 120° angulation. ANSYS software was used to evaluate the stress on implant, stress on bone and displacement of bone. Results: Maximum von Mises stress was observed at 30° insertion angle. The stress on implant, stress on bone and displacement of bone increased as the insertion angle decreased from 90° to 30° and was statistically significant in both maxilla and mandible. The direction of orthodontic force had no statistically significant effect on stress and displacement around mini-implant in both maxilla and mandible. The stress on bone and displacement of bone was greater in maxilla compared to that of mandible and was statistically significant. Conclusion: Placement of mini-implant perpendicular to the long axis of the tooth reduces the stress concentration around the mini-implant and its interface, thereby increasing the likelihood of implant stability. The direction of orthodontic force has no significant effect on implant stability.

The effect of cuspal inclination on stress distribution and implant displacement in different bone qualities for a single tooth implant: A finite element study

Background: The aim of the present finite element study was to analyze effect of cuspal inclination on stress distribution and implant displacement in different bone densities for a single tooth implant. Materials and Methods: A three dimensional finite element model of mandibular molar section of the D1 bone (entirely cortical) and D4 bone (1 mm cortical shell with low density trabecular core) to receive an implant was constructed. Three ceramic crowns with cusp inclinations of 0 degree, 10 degree and 30 degree were modeled. A mechanical load of 202.23 N was applied at three different regions; the central fossa and 1- and 2-mm offsets horizontally from the center to the buccal side for the varying inclinations. The finite element analysis was performed and stress levels using von Mises stresses and maximum displacement (in mm) were calculated. Results: The maximum stress concentration in cortical bone was seen around the neck of the implant. There was favorable distribution of stresses during loading at the central fossa with maximum stress being 15.10 Mpa for 0 degree, which increased to 54.09 Mpa for 10 degree and 86.19 Mpa for 30 degree inclination at 2 mm offset. Higher stresses were generated in D4 than D1 bone density under all loading conditions. Conclusion: The occlusal topography plays an important role in stress distribution and may be helpful in preventing crestal bone loss. This phenomenon is more pronounced in poor quality bone. Therefore, proper occlusal morphology becomes a critical issue in poor quality bone for implant longevity.

Effect of a Modified Stepped Osteotomy on the Primary Stability of Dental Implants in Low-Density Bone: A Cadaver Study

The aim of this study was to examine the effect of an alternative surgical technique on endosseous dental implant stability parameters in Class D4 bone. Differences between insertion torque (IT) and implant stability quotient (ISQ) produced by a conventional osteotomy versus a modified stepped osteotomy were examined. Correlations between IT, density in Hounsfield units (HU), and ISQ were also examined. Computed tomographic scans were taken of 16 cadaver heads to determine bone density at maxillary implant recipient sites, which ranged from 173.4 to 312.1 HU. Twenty-two implants were placed in sites with Misch Class D4 bone; control sites received 11 conventional osteotomies and test sites 11 modified stepped osteotomies. Maximum IT was recorded with an implant motor and confirmed with a torque driver, and ISQs were measured. Significant differences were analyzed with a Wilcoxon signed rank test, and correlations were analyzed with the Pearson test. The mean IT in the control group was 15.91 Ncm, and in the test group it was 26.82 Ncm. The modified stepped osteotomy had a significantly greater mean IT than the conventional osteotomy, but no significant difference in ISQ was found between groups. Pearson correlations showed a significant positive correlation between IT in the control and test groups. Significant correlations were found between ISQ and HU in the test group. No other significant correlations between HU, IT, and ISQ were found. Within the limits of this cadaver study, the modified stepped osteotomy resulted in significantly greater implant stability in terms of IT than the conventional osteotomy in soft bone. Significant correlations were found between the IT produced in the modified stepped osteotomy and bone density. No significant correlations were found between IT and ISQ.

Clinical assessment of bone quality of human extraction sockets after conversion with growth factors.

The study was conducted to evaluate the effect of mineralized freeze-dried bone allograft (FDBA), alone or in combination with growth factors in extraction sockets, on subjective assessment of bone quality during implant placement. Forty-one patients whose treatment plan involved extraction of anterior or premolar teeth were randomized into four groups: Group 1, collagen plug (control); Group 2, FDBA/β-tricalcium phosphate (β-TCP)/collagen plug; Group 3, FDBA/β-TCP/platelet-rich plasma (PRP)/collagen plug; Group 4, FDBA/β-TCP/recombinant human platelet-derived growth factor BB (rhPDGF-BB)/collagen plug. After 8 weeks of healing, implants were placed. The clinicians assessed bone quality according to the Misch classification. A benchtop calibration exercise test was conducted to evaluate agreement and accuracy of operators in recognizing different bone qualities. Differences were analyzed using one-way analysis of variance (ANOVA) or chi-square tests for continuous and categorical data. Pairwise comparisons were tested using least squares means (LS means). Spearman correlation coefficients were used to evaluate the relationship of bone growth with potential confounders. P < .05 was considered statistically significant. A simple (not weighted) kappa statistic was used to assess the agreement between raters. To assess accuracy in identifying bone quality, a chi-square test was used to compare the percent correct for each rater. The benchtop calibration exercise test demonstrated agreement among clinicians (0.75 and 0.92 between raters 1 and 2 and raters 1 and 3, respectively). Raters were more likely to identify the correct bone quality (P > .05). Inclusion of bone grafting is associated with a shift from D4 quality to D3 quality bone. Inclusion of PRP in bone grafting eliminates the incidence of D4 bone, establishing D3 and D2 quality bone as prevalent (56% vs. 42%, respectively). Inclusion of rhPDGF-BB and β-TCP in combination with the bone grafting has the same effect, although D2 quality is less prevalent. When compared to sockets grafted with FDBA/β-TCP/collagen plug alone, the sockets with growth factors demonstrated fewer residual bone graft particles. (1) Inclusion of bone grafting enhanced bone quality as assessed during implant placement. (2) Overall inclusion of PRP and rhPDGF-BB enhanced subjective bone quality, eliminating incidence of D4 quality in human extraction sockets. (3) The use of PRP or rhPDGF-BB may enhance healing within extraction sockets and decrease the healing time prior to dental implant placement.

Evaluation of 4 mm implants in mandibular edentulous patients with reduced bone height. Surgical preliminary results

Aim Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this short comunication was to evaluate the clinical use of implants < 10 mm in length and to determine short implant-supported prosthesis success in the atrophic jaw. Materials and methods Six women and three men were recruited for the treatment of edentulous mandibles. A total of 6 implants were inserted in each patient: two anterior implants of conventional lenght and four posterior 4 mm Titanium Zirconium (TiZr) implants. The insertion torque and bone denisty were evaluated. Results The mean insertion torque for the 4 mm implants was lower than for conventional ones, without any statistical difference. Moreover, most of the patients (88%) showed a D2 bone type. Conclusion The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

SAT0490 Vitamin D Serum Levels Correlate with Bone Mass Values in Postmenopausal Systemic Sclerosis Patients

BackgroundVitamin D is involved in both innate and adaptive immunity and in the regulation of bone turnover1. High prevalence of vitamin D deficiency has been reported in autoimmune disease including...

A correlation between bone (B), insertion torque (IT), and implant stability (S): BITS score

Although criteria for assessing bone quality have been reported, an overall score that correlates bone quality with the primary stability and secondary stability of implants is not yet available. The purpose of this article was to propose a scoring index that will establish a correlation among the bone density values from computed tomography, maximum insertion torque values, and resonance frequency analysis in different phases of implant treatment. In this study, 60 implant sites were evaluated to assess bone density (Hounsfield units), insertion torque values (Ncm), and primary stability and secondary stability (implant stability quotient values obtained by using resonance frequency analysis). On the basis of computed tomography data, the bone was classified as D1 to D4. The insertion torque was noted and classified into 2 groups, A and B. The implant stability quotient values obtained from resonance frequency analysis depicting primary stability and secondary stability were classified into 5 groups. The primary score noted was a result of the values obtained for the 3 parameters at the time of implant placement. The secondary score was obtained by considering the values of the bone density and resonance frequency analysis recorded at different time intervals. Bone densities of D2, D3, and D4 were noted, dividing the bone type into 3 groups. The maximum torque noted in the study was 40 Ncm. The difference between various insertion torque values and bone types was found to be statistically nonsignificant. Higher mean implant stability quotient values were obtained for primary and secondary stability for the D2 bone than for D3 and D4 bone. When analyzed according to the time of insertion, the mean values increased at second stage surgery in all bone types. The difference in mean values among all bone types was found to be statistically significant (P<.001). A comparison of primary and secondary implant stability quotient values in all bone types did not find any statistical significance (P=.780). A score was recorded at the time of implant placement and at the time of second stage surgery, and the prosthetic treatment was planned accordingly. The score highlights the importance of considering the association of bone quality, insertion torque values, and stability as denoted by implant stability quotient throughout treatment. Based on the variation in the score noted at recall visits, alterations in the treatment plan can be made with respect to the healing period and prosthetic design.

Peri-implant Stress Analysis of Immediate Loading and Progressive Loading Implants in Different Bone Densities (D2 and D3): A Finite Element Study

Aim: To analyze the peri-implant stress distribution in immediate loading and progressive loading implants in different bone densities (D2 and D3). Materials and methods: A 3D finite element model of a mandi­ bular section of the bone with a missing second premolar and a crown structure was used. Eighteen models were generated, eight were used for immediate loading and the remaining ten were of progressive loading. Of the eight models of immediate loading, four models each were used for D2 and D3 bone density types. Of the ten models used for progressive bone loading, five models each were used for D2 and D3 bone density types. A solid 4.2 × 10 mm screw type implant system (Replace Select RP, Nobel Biocare) was selected. The simulated crown consisted of metal coping of Nickel-Chromium alloy, porcelain and acrylic in few models. Axial and oblique loads were applied to the implant through the crown based on the loading protocols for immediate and progressive loading. Results: Maximum stress was found in the cortical bone at the neck of the implant for both type of loading protocols except when there was no bone implant contact seen at initial stages of healing in immediate loading implants. Oblique occlusal forces show a significantly higher stress level as compared to axial loading forces.

The effect of shape, length and diameter of implants on primary stability based on resonance frequency analysis.

The aim of this in vitro study was to evaluate the effect of shape, diameter and length of implants on their primary stability based on resonance frequency analysis. Replace select tapered and Branemark MK III implants were selected. Each of these two selected groups was divided into nine subgroups based on the implant length (IL) (short, medium and long) and the implant diameter (ID) (narrow platform [NP], regular platform [RP] and wide platform [WP]). Five implants were assigned to each of the nine subgroups. Implants were placed in artificial bone blocks with bone quality similar to D3 bone. Immediately after the implant placement, its primary stability was measured using Osstell Mentor equipment. T-test and Tukey's honest significant difference Post hoc were performed for data analysis. Statistical significance was defined at P < 0.05. Replace select system showed significantly higher primary stability compared to the Branemark system, when using the short implants for all three diameters (P ≤ 0.004). However, in medium length implants there were no significant differences between the two implant systems (P ≥ 0.31). In long implants, only when the NP and RP implants were used, the Replace Select system showed significantly higher primary stability compared to the Branemark system (P = 0.000). In the replace select system, long implants had a significantly higher primary stability compared to medium and short length implants (P ≤ 0.003). In the NP and RP Branemark implants, short implants showed significantly lower primary stability compared to medium and long implants (P ≤ 0.002). However, in WP Branemark implants, primary stability increased significantly with increasing the IL from short to medium and from medium to long (P = 0.000). There were also significant differences between NP and the two other wider implants in both systems (P = 0.000). The use of tapered implants is recommended, especially, when the use of short implants is necessary. The use of RP implants is also preferred to WP implants, because thicker bone wall will remain in place when applying RP implants. Furthermore, no significant difference was observed between RP and WP implants.

Regeneration of Human Bone Using Different Bone Substitute Biomaterials

The present study aimed to assess clinical and biological performances of several bone substitute biomaterials (BSBs). The evaluation was conducted at 6 months and after several years on 295 patients undergoing sinus augmentation with 13 different BSBs; the data belonging to previously published studies have been analyzed using innovative mathematical models to evaluate the bone regenerative index (Br) and the structural density index (Ds). After 6 months, compared to the Ds index of native bone, the regenerated bone showed a D3 bone type; while, after several years, the regenerated bone type was D2, with an evident increase in the density of the regenerated bone over time. Moreover, the values of Br were higher for combined biomaterials indicating a fewer amount of residual particles and marrow spaces, while the values of Ds were higher for anorganic bovine bone indicating a greater new bone formation and a lesser amount of marrow spaces. After 20 years, the bone regenerated using hydroxyapatite still had a D4 bone quality. After 6 months of healing, the regenerated bone had a composite structure resembling poor D3 bone type, and covered approximately one-third of the space filled by BSBs. None of the evaluated biomaterials seemed to be ideal.

2D FEA of evaluation of micromovements and stresses at bone-implant interface in immediately loaded tapered implants in the posterior maxilla

Aim:The aim of the study is to evaluate the influence implant length on stress distribution at bone implant interface in single immediately loaded implants when placed in D4 bone quality.Materials and Methods:A 2-dimensional finite element models were developed to simulate two types of implant designs, standard 3.75 mm–diameter tapered body implants of 6 and 10 mm lengths. The implants were placed in D4 bone quality with a cortical bone thickness of 0.5 mm. The implant design incorporated microthreads at the crestal part and the rest of the implant body incorporated Acme threads. The Acme thread form has a 29° thread angle with a thread height half of the pitch; the apex and valley are flat. A 100 N of force was applied vertically and in the oblique direction (at an angle of 45°) to the long axis of the implants. The respective material properties were assigned. Micro-movements and stresses at the bone implant interface were evaluated.Results:The results of total deformation (micro-movement) and Von mises stress were found to be lower for tapered long implant (10 mm) than short implant (6 mm) while using both vertical as well as oblique loading.Conclusion:Short implants can be successfully placed in poor bone quality under immediate loading protocol. The novel approach of the combination of microthreads at the crestal portion and acme threads for body portion of implant fixture gave promising results.

Effects of levetiracetam as a monotherapy on bone mineral density and biochemical markers of bone metabolism in patients with epilepsy

Antiepileptic drugs (AEDs) may have adverse effects on bone metabolism and bone mineral density (BMD). The aim of this study is to determine the changes of bone metabolism and BMD in epilepsy patients who are undergoing levetiracetam (LEV) monotherapy. Drug-naïve, sixty-one patients with recent onset epilepsy were recruited (24 female, 37 males; mean age: 31.0±13.1 years) in this study. We measured calcium, phosphate, bone alkaline phosphatase, parathyroid hormone, osteocalcin, insulin-like growth factor (IGF)-1, C-telopeptide, vitamin D3 levels and bone density measurements with DEXA method before and after LEV administration of mean duration 14.16±3.36 months. T score in lumbar spine (L1-L4) was significantly increased with the correction of multiple T tests using Bonferroni's test across LEV monotherapy (p=0.0401). However, no significant change was observed in other parameters for BMD and T score. Repeated measures ANOVA with Bonferroni's correction of confounders such as sex, age, and treatment duration revealed significant increase in T score in lumbar spine (p=0.0164). The level of average LEV dosage itself did not reveal any significant association with BMD and bone metabolism. We suggest that LEV monotherapy may have no harmful effect on bone strength and metabolism for 1 year.

Continuous light induces bone resorption and affects vertebral morphology in Atlantic salmon (Salmo salarL.) fed a phosphorous deficient diet

This study investigated the combined effects of photoperiod and dietary P level on bone osteoclast and osteoblast activity, and morphology, as well as plasma vitamin D status in Atlantic salmon post-smolts. The fish were reared under continuous light (LL) or 12 h light/dark (LD) per day, and fed diets with insufficient phosphorous (P) (4 g kg−1 available dietary P, LP) or sufficient P (8 g kg−1 available dietary P, HP) for 79 days in seawater. LL significantly increased plasma 25(OH)D3 level and bone tartrate resistant acid phosphatase (TRACP) activity, and decreased bone collagen XI α1 chain (col11a1) mRNA transcription. The LP diet significantly increased plasma 1,25(OH)2D3 level and bone alkaline phosphatase activity, but decreased bone TRACP activity and matrix metalloproteinase 13 (mmp13) mRNA transcription, and vertebral mineral content, stiffness and length/dorso-ventral diameter (l/d) ratio. A significant interaction between light and P was only observed on the l/d ratio, and the LP-LL group was the only group that developed vertebrae with a compressed morphology (significantly lowest l/d ratio). In practical terms, these results show that Atlantic salmon post-smolts under continuous light may need P supplemented diets to support normal bone development.

Three-dimensional numerical simulation of stress induced by different lengths of osseointegrated implants in the anterior maxilla

Lower survival rates were observed for the implant placed in the anterior maxilla. The purpose of this study was to investigate the influence of different implant lengths on the stress distribution around osseointegrated implants under a static loading condition in the anterior maxilla using a three-dimensional finite element analysis. The diameter of 4.0 mm external type implants of different lengths (8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) was used in this study. The anterior maxilla was assumed to be D3 bone quality. All the material was assumed to be homogenous, isotropic and linearly elastic. The implant–bone interface was constructed using a rigid element for simulating the osseointegrated condition. Then, 176 N of static force was applied on the middle of the palatoincisal line angle of the abutment at a 120°angle to the long axis of abutment. The von Mises stress value was measured with an interval of 0.25 mm along the bone–implant interface. Incremental increase in implant length causes a gradual reduction of maximum and average von Mises stress at the labial portion within the implant. In the bone, higher stress was concentrated within cortical bone area and more distributed at the labial cortex, while cancellous bone showed relatively low stress concentration and even distribution. An increase in implant length reduced stress gradients at the cortical peri-implant region. Implant length affects the mechanisms of load transmission to the osseointegrated implant. On the basis of this study the biomechanical stress-based performance of implants placed in the anterior maxilla improves when using longer implants.