title: Assessing bone's adaptive capacity around dental implants: a literature review.
abstract: BACKGROUND
  Increased stress (force) on prostheses induces strain (deformation) in the peri-implant bone. Elevated stress and strain could result in the failure of implants that support prostheses. However, the survival rate of implants supporting prostheses under increased stress is high. Either the bone is stronger than expected or it adapts to increased stress. Concepts regarding bone's adaptive capacity continue to evolve and are the focus of this literature review.
  
  
  METHODS
  The authors searched the literature to find studies that addressed the bone's capacity to adjust to increased stress and strain. They assessed experimental and clinical trials in which investigators monitored healing after placement of dental implants.
  
  
  RESULTS
  The data indicate that forces greater than the bone's adaptive ability can induce loss of osseointegration, as well as osseous resorption. In contrast, it is possible that increased stress on prostheses initiates a reparative process, thereby facilitating retention of implants experiencing increased stress. Numerous lines of evidence support the concept that bone can modify itself to withstand increased mechanical forces.
  
  
  CONCLUSIONS
  The authors provide an explanation for the high success rate of prostheses and implants in bone that are exposed to increased stress and strain.
authors.affiliation: Department of Periodontology, College of Dental Medicine, Columbia University, New York City, NY, USA. ggperio@aol.com
authors.forename: Gary
authors.initials: G
authors.lastname: Greenstein
authors.forename: John
authors.initials: J
authors.lastname: Cavallaro
authors.forename: Dennis
authors.initials: D
authors.lastname: Tarnow
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D001696:Biomechanical Phenomena; D016723:Bone Remodeling / Q000502:physiology; D001842:Bone and Bones / Q000502:physiology; D015921:Dental Implants; D006801:Humans; D040542:Mechanotransduction, Cellular / Q000502:physiology; D016348:Osseointegration / Q000502:physiology*
chemical_list: D015921:Dental Implants