Comparison of initial stability of mandibular first molar repaired with different threaded implants under immediate loading

doi:10.12307/2024.538

Abstract

Abstract: BACKGROUND: The threaded conical implant has a good ability to control micro movements and is conducive to immediate loading. However, the effects of double-threaded conical cylindrical implants and conical cylindrical implants on stress distribution and initial stability of implant-bone interface after immediate loading have not been reported.
OBJECTIVE: To investigate the impact of double-threaded conical cylindrical implants and conical cylindrical implants on the biological distribution of the implant and the surrounding bone interface during immediate loading in the mandibular molar region.
METHODS: (1) Three-dimensional finite element analysis: Conical beam CT scans of the mandible and first molar of a volunteer were used to develop a basal model of the mandible. The double-threaded conical cylindrical implants and conical cylindrical implants were assembled with the mandibular models, and an immediate-load (or delayed implantation) implant model (a total of four models) for the first mandibular molar was established. Loads in four directions (100 N): axial, lingual and buccal 45°, mesial and distal, and buccal and lingual, were applied to the central fossa of each model’s crown. Three-dimensional finite element method was used to analyze the implant displacement and the stress distribution at the implant-bone interface. (2) In vitro experiment: With the assistance of the oral implant robot, the double-threaded conical cylindrical implants and conical cylindrical implants were implanted on the same artificial bone pieces, separately, and the immediate load model of immediate implant implantation (or delayed implantation) was established in vitro (a total of four groups of models). Osstell resonance frequency analyzer and SmartPeg sensor were used to measure the implant stability coefficient in four vertical directions: front, rear, left, and right measurements, evaluate the initial stability, and verify the finite element analysis results.
RESULTS AND CONCLUSION: (1) The displacement difference between double-threaded conical cylindrical implants and conical cylindrical implants was small when the immediate loading of delayed implantation was applied, but the maximum stress value of conical cylindrical implant-bone interface was greater than that of double-threaded conical cylindrical implant-bone interface. When the immediate loading of immediate implantation was applied, the maximum stress value and the maximum displacement of bone around the implant appeared when the load was applied in mesiodistal direction. The stress value of the conical cylindrical implant reached 298.84 MPa and the maximum displacement was 0.31 mm, both of which were larger than that of the double-threaded conical cylindrical implant. (2) The results of in vitro experiments showed that the stability coefficient of the double-threaded conical cylindrical implant was greater than that of the conical cylindrical implant. (3) Compared with the conical cylindrical implant, the double-threaded conical cylindrical implant has higher initial stability under immediate loading, suggesting that the use of double-threaded conical cylindrical implant should be given priority in clinical immediate loading.

Key words: implant restoration, implant, immediate loading, threaded design, three-dimensional finite element analysis, initial stability

CLC Number:

Li Xinru, Zhao Wenbo, Ji Yan, Teng Weiwei, Wang Yiming, Zhou Libo. Comparison of initial stability of mandibular first molar repaired with different threaded implants under immediate loading[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(22): 3445-3450.

Figures/Tables 5

References

[1] BRIZUELA-VELASCO A, CHAVARRI-PRADO D. The functional loading of implants increases their stability: A retrospective clinical study. Clin Implant Dent Relat Res. 2019;21(1):122-129.
[2] OSTMAN PO, HELLMAN M, SENNERBY L. Direct implant loading in the edentulous maxilla using a bone density-adapted surgical protocol and primary implant stability criteria for inclusion. Clin Implant Dent Relat Res. 2005;7 Suppl 1:S60-S69.
[3] RYU HS, NAMGUNG C, LEE JH, et al. The influence of thread geometry on implant osseointegration under immediate loading: a literature review. J Adv Prosthodont. 2014;6(6):547-554.
[4] CHEN J, CAI M, YANG J, et al. Immediate versus early or conventional loading dental implants with fixed prostheses: A systematic review and meta-analysis of randomized controlled clinical trials. J Prosthet Dent. 2019;122(6):516-536.
[5] IOANNIDOU E, DOUFEXI A. Does loading time affect implant survival? A meta-analysis of 1,266 implants. J Periodontol. 2005;76(8):1252-1258.
[6] KIM HS, CHO HA, KIM YY, et al. Implant survival and patient satisfaction in completely edentulous patients with immediate placement of implants: a retrospective study. BMC Oral Health. 2018;18(1):219.
[7] ELLIS R, CHEN S, DAVIES H, et al. Primary stability and healing outcomes of apically tapered and straight implants placed into fresh extraction sockets. A pre-clinical in vivo study. Clin Oral Implants Res. 2020;31(8):705-714.
[8] IBRAHIM A, HEITZER M, BOCK A, et al. Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study. Materials (Basel). 2020;13(19):4349.
[9] IMAI M, OGINO Y, TANAKA H, et al. Primary stability of different implant macrodesigns in a sinus floor elevation simulated model: an ex vivo study. BMC Oral Health. 2022;22(1):332.
[10] MESNARD M, RAMOS A, SIMOES JA. Influences of implant condyle geometry on bone and screw strains in a temporomandibular implant. J Craniomaxillofac Surg. 2014;42(3):194-200.
[11] 高文波,马宗民,李淑娴,等.有限元分析不同骨质下种植体长度及直径对初期稳定性的影响[J].中国组织工程研究,2022,26(6): 875-880.
[12] 施梦汝,谢伟丽,施武阁,等.柱形锥形种植体在不同种植深度的三维有限元研究[J].口腔医学,2019,39(7):577-580.
[13] 孙江伟,王俊祥,白布加甫•叶力思,等.不同光滑颈圈种植体修复时应力分布的三维有限元分析[J]. 中国组织工程研究,2023, 27(7):1004-1011.
[14] 赵楚翘,徐一驰,刘定坤,等.髓腔固位冠及桩核冠修复下颌第一磨牙大面积缺损的生物力学分析[J]. 口腔医学研究,2018,34(5): 513-517.
[15] KANG N, WU YY, GONG P, et al. A study of force distribution of loading stresses on implant-bone interface on short implant length using 3-dimensional finite element analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(5):519-523.
[16] KIM YK, LEE JH, LEE JY, et al. A randomized controlled clinical trial of two types of tapered implants on immediate loading in the posterior maxilla and mandible. Int J Oral Maxillofac Implants. 2013;28(6):1602-1611.
[17] 周宏志,张可,王学玲,等.不同形态种植体在两种骨质内以不同角度植入的应力分析[J].口腔医学研究,2022,38(2):138-143.
[18] ATIEH MA, ALSABEEHA NH, DUNCAN WJ, et al. Immediate single implant restorations in mandibular molar extraction sockets: a controlled clinical trial. Clin Oral Implants Res. 2013;24(5):484-496.
[19] GAO Y, LUO D, YUAN M, et al. Immediate implant placement in single mandibular molar with chronic periapical periodontitis. J Stomatol Oral Maxillofac Surg. 2023;124(6S):101545.
[20] RAMAKRISHNAN HS, SUNDAR P, HALDER S, et al. Graftless Immediate Dual Implant Anatomic Placement With Immediate Provisional Passive Loading and Definitive Hybrid Crown for the Restoration of Mandibular Molar: A Clinical Report. Cureus. 2023;15(5):e38654.
[21] AVILA G, GALINDO P, RIOS H, et al. Immediate implant loading: current status from available literature. Implant Dent. 2007;16(3):235-245.
[22] JIANG X, ZHOU W, WU Y, et al. Clinical Outcomes of Immediate Implant Loading with Fixed Prostheses in Edentulous Maxillae: A Systematic Review. Int J Oral Maxillofac Implants. 2021;36(3):503-519.
[23] LEVIN BP, CHU SJ, SAITO H, et al. A Novel Implant Design for Immediate Extraction Sites: Determining Primary Stability. Int J Periodontics Restorative Dent. 2021;41(3):357-364.
[24] RAGUCCI GM, ELNAYEF B, CRIADO-CAMARA E, et al. Immediate implant placement in molar extraction sockets: a systematic review and meta-analysis. Int J Implant Dent. 2020;6(1):40.
[25] UNSAL GS. Three-Dimensional Finite Element Analysis of Different Implant Configurations in Enlarged First Molar Areas. Int J Oral Maxillofac Implants. 2020;35(4):675-683.
[26] AYALI A, ALTAGAR M, OZAN O, et al. Biomechanical comparison of the All-on-4, M-4, and V-4 techniques in an atrophic maxilla: A 3D finite element analysis. Comput Biol Med. 2020;123:103880.
[27] BAVETTA G, BAVETTA G, RANDAZZO V, et al. A Retrospective Study on Insertion Torque and Implant Stability Quotient (ISQ) as Stability Parameters for Immediate Loading of Implants in Fresh Extraction Sockets. Biomed Res Int. 2019;2019:9720419.
[28] LEKHOLM U. Immediate/early loading of oral implants in compromised patients. Periodontol 2000. 2003;33:194-203.
[29] PAMMER D. Evaluation of postoperative dental implant primary stability using 3D finite element analysis. Comput Methods Biomech Biomed Engin. 2019;22(3):280-287.
[30] THANASRISUEBWONG P, PIMKHAOKHAM A, JIRAJARIYAVEJ B, et al. Influence of the Residual Ridge Widths and Implant Thread Designs on Implant Positioning Using Static Implant Guided Surgery. J Prosthodont. 2023;32(4):340-346.
[31] VALENTE ML, DE CASTRO DT, SHIMANO AC, et al. Analysis of the influence of implant shape on primary stability using the correlation of multiple methods. Clin Oral Investig. 2015;19(8):1861-1866.
[32] KARL M, IRASTORZA-LANDA A. Does implant design affect primary stability in extraction sites? Quintessence Int. 2017;48(3):219-224.
[33] LEBLEBICIOĞLU KI, KILIC K, BAL B, et al. Finite Element Analysis of the Stress Distribution Associated With Different Implant Designs for Different Bone Densities. J Prosthodont. 2022;31(7):614-622.
[34] BRUNSKI JB. Avoid pitfalls of overloading and micromotion of intraosseous implants. Dent Implantol Update. 1993;4(10):77-81.
[35] AL-SAWAI AA, LABIB H. Success of immediate loading implants compared to conventionally-loaded implants: a literature review. J Investig Clin Dent. 2016;7(3):217-224.
[36] SMITH RB, TARNOW DP. Classification of molar extraction sites for immediate dental implant placement: technical note. Int J Oral Maxillofac Implants. 2013;28(3):911-916.
[37] ATALAY S, CAKMAK G, DONMEZ MB, et al. Effect of implant location and operator on the accuracy of implant scans using a combined healing abutment-scan body system. J Dent. 2021;115:103855.