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Influence of Implant Length and Associated Parameters Upon Biomechanical Forces in Finite Element Analyses

A Systematic Review

Hingsammer, Lukas, MD, DDS*; Pommer, Bernhard, DDS, PhD; Hunger, Stefan, MD, DDS; Stehrer, Rapahel, MD§; Watzek, Georg, MD, DDS, PhD; Insua, Angel, DDS, MS, PhD

doi: 10.1097/ID.0000000000000879
Meta-Analyses and Systematic Reviews
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Purpose: The aim of this systematic review is to provide an overview of finite element analyses comparing standard and short dental implants concerning biomechanical properties and to detect the most relevant parameters affecting periimplant stress concentrations.

Material and Methods: After screening the literature and assessment of studies, 36 studies were included in this review.

Results: Eighty-three percent of the studies state that short dental implants have to bear higher stress concentrations compared with standard length implants. At the same time, 44% of articles note that implant diameter can be considered a more effective design parameter than implant length to reduce stress concentrations and to avoid an overload of periimplant bone. Regardless of implant dimension, in all studies, the highest stress concentrations are found in the cortical section around the upper part of the implant.

Conclusions: Unaffected of bone quality, implant diameter is found to play a key role to minimize periimplant stress concentrations. Concerning stress reduction implant length gains increasing relevance with decreasing bone density. Furthermore, splinting of short implants constitute an appropriate tool to avoid crestal overloading.

*Resident in Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland.

Oral Surgeon, University Docent, Academy for Oral Implantology, Vienna, Austria.

Consultant, Maxillofacial Surgeon, Department of Maxillofacial Surgery, Kepler University Clinic Linz, Linz, Austria.

§Resident in Maxillofacial Surgery, Department of Maxillofacial Surgery, Kepler University Clinic Linz, Linz, Austria.

Oral Surgeon, University Professor, Academy for Oral Implantology, Vienna, Austria.

Oral Surgeon, Research Fellow, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI; University Lecturer, Oral Surgery and Oral Medicine Department, University of Santiago de Compostela, Santiago de Compostela, Spain.

Reprint requests and correspondence to: Angel Insua Brandariz, DDS, MS, PhD, Facultad de Medicina y Odontologia, C/Entrerrios s/n., Santiago de Compostela., A Coruña., España, Phone: +34 881 81 22 19, Fax: +34981582642, E-mail: ainsua@umich.edu

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