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Biomechanical Analysis of Bone Tissue After

Insertion of Dental Implants Using Meshless

Methods: Stress Analysis and Osseointegration

,†
†
,‡
M.M.A. Peyroteo* , H.I.G. Gomes , Jorge Belinha* ,
Renato M. Natal Jorge †
†
*Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Porto, Portugal Faculty of
‡
Engineering of University of Porto (FEUP), Porto, Portugal School of Engineering of Polytechnic of (ISEP),
Porto, Portugal

20.1 INTRODUCTION

Edentulism is the designation used for partial or total absence of teeth. Loss of teeth can be influenced by several
factors, mainly related to oral health. Some examples include unhealthy eating habits, poor oral hygiene, smoking, and
alcoholism. Consequently, several problems arise, such as functional limitations (i.e., mastication difficulties) or psy-
chological and social stigmas [1]. Moreover a set of pathologies can be developed and ultimately cause edentulism. The
major pathologies are dental caries and periodontitis, which affect about 3053 million and 743 million people world-
wide in 2010, respectively [2]. Overall, edentulism affected about 158 million people worldwide in 2010, which corre-
sponded to 2.3% of the world’s population. In the future the socioeconomic impact of edentulism will tend to increase
due to the aging of the population.
Nowadays, there are several solutions available, such as removable dental prosthesis, fixed partial dentures (i.e.,
dental bridges), and dental implants. Functional rehabilitation can be achieved with the placement of a removable
dental prosthesis, since it is capable of returning the masticatory, phonetic, and aesthetic functions to a partially eden-
tulous patient. However, this solution presents several drawbacks, such as difficulties and discomfort during masti-
cation, damages to the remaining surrounding natural tissues and teeth, displacement of the teeth abutment, and bone
loss in the edentulous regions [3, 4]. Fixed partial dentures are also not an ideal solution, since dental bridges are usu-
ally fixed to the teeth with dental cement, which over time deteriorates. Consequently a bacterial infection can affect
the remaining teeth and increase the risk of tooth loss. The placement of dental implants is currently a valid treatment
that has a high success rate [5]. Its use has increased exponentially in recent years, with >5 million implants inserted
per year in the United States of America, which is equivalent to €800 billion [6]. A dental implant is a biocompatible
device placed on the maxilla or mandible bone to provide support for a prosthetic reconstruction. It consists of four
components—crown, screw, abutment, and implant. All these components require rigorous control of design and con-
struction to ensure that mastication forces are properly transferred to the bone [7]. Different types of implants of dis-
tinct materials can be classified according to their size, shape, design, and surface of the threads. Testing implants with
different characteristics is an effective approach to find the ideal combination of features that allows primary stability
and osseointegration [8]. Immediately after implant’s placement the implant should remain fixed to withstand
the functional loads on teeth. This is accomplished through osseointegration in which the bone and the surface
of the implant interact to form a direct bond. Branemark et al. [9–11] were the first to observe this phenomenon with
the bone and a titanium implant. Osseointegration usually occurs in the periimplant region within the first 3–6months
after surgery. During this period the implant becomes increasingly more stable through bone remodeling. After a

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