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Volume 27 , Issue 6
November/December 2012

Biomechanical Comparison of a Single Short and Wide Implant with Monocortical or Bicortical Engagement in the Atrophic Posterior Maxilla and a Long Implant in the Augmented Sinus

Shih-Hao Chang, DDS, MS/Chun-Li Lin, PhD/Yang-Sung Lin, MS/ Shue-Sang Hsue, PhD/Shiang-Rung Huang, MS

PMID: 23189315

Purpose: The present study investigated the biomechanical interactions of a monocortically or bicortically engaged short and wide implant in the atrophic posterior maxilla and compared them to those of a long implant in the augmented sinus under different loading conditions via a nonlinear finite element (FE) approach. Materials and Methods: Nonlinear FE models of a single implant in the posterior maxilla were constructed for the following conditions: (1) A monocortically engaged 5-mm-long, 7-mm-wide implant with an internal tripodgrip abutment connection (SIT-1), (2) a bicortically engaged 6-mm-long, 7-mm-wide implant with internal tripod-grip abutment connection (SIT-2), and (3) a 13-mm-long, 4.5-mm-wide implant with an internal-hexagon abutment connection in an augmented sinus. Simulated loads of 150 N were applied axially at the central fossa, off-axis at the buccal and palatal cusps, and toward the axis at the buccal and palatal cusps. Results: The simulated results showed that loading condition was the main factor influencing the mechanical responses. Oblique occlusal forces increased implant stress and stress/strain values for the surrounding bone. The use of a long implant decreased the implant stress but increased the bone stress/strain values relative to a short and wide implant. The SIT-1 and SIT-2 implants increased the implant stress on average by 2.94 and 2.67 fold, respectively. However, the SIT-2 implant reduced the average stress and strain in bone by 37%, and the SIT-1 implant reduced average stress by 33% and average strain by 32%. Conclusions: Placement of a short and wide implant in the atrophic posterior maxilla may be a possible alternative for reducing the strain/stress on the surrounding bone. Detrimental off-axis loads should always be minimized to prevent extraordinarily high bone strain and stress. Int J Oral Maxillofac Implants 2012;27:e102e111

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