Effects of occlusal inclination and loading on mandibular bone remodeling: a finite element study.

PURPOSE: To provide a preliminary understanding of the biomechanics with respect to the effect of cusp inclination and occlusal loading on the mandibular bone remodeling.

MATERIALS AND METHODS: Three different cusp inclinations (0, 10, and 30 degrees) of a ceramic crown and different occlusal loading locations (central fossa and 1- and 2-mm offsets horizontally) were taken into account to explore the stresses and strains transferred from the crown to the surrounding dental bone through the implant. A strain energy density obtained from two-dimensional plane-strain finite element analysis was used as the mechanical stimulus to drive cancellous and cortical bone remodeling in a buccolingual mandibular section.

RESULTS: Different ceramic cusp inclinations had a significant effect on bone remodeling responses in terms of the change in the average peri-implant bone density and overall stability. The remodeling rate was relatively high in the first few months of loading and gradually decreased until reaching its equilibrium. A larger cusp inclination and horizontal offset (eg, 30 degrees and 2-mm offset) led to a higher bone remodeling rate and greater interfacial stress.

CONCLUSIONS: The dental implant superstructure design (in terms of cusp inclination and loading location) determines the load transmission pattern and thus largely affects bone remodeling activities. Although the design with a lower cusp inclination recommended in previous studies may reduce damage and fracture failure, it could, to a certain extent, compromise bone engagement and long-term stability.