title: Biomechanical effects of offset placement of dental implants in the edentulous posterior mandible.
abstract: BACKGROUND
  Proper implant placement is very important for long-term implant stability. Recently, numerous biomechanical studies have been conducted to clarify the relationship between implant placement and peri-implant stress. The placement of multiple implants in the edentulous posterior mandible has been studied by geometric analysis, three-dimensional finite element analysis (FEA), model experimentation, etc. Offset placement is a technique that reduces peri-implant load. However, few studies have used multiple analyses to clarify the value of the offset placement under identical conditions. The present study aimed to clarify the biomechanical effects of offset placement on the peri-implant bone in edentulous posterior mandibles by comparative investigation using FEA and model experimentation with strain gauges.
  
  
  METHODS
  Three implants were embedded in an artificial mandible in the parts corresponding to the first premolar, the second premolar, and the first molar. A titanium superstructure was mounted to prepare models (experimental models). Three load points (buccal, central, and lingual) were established on the part of the superstructure corresponding to the first molar. Three types of experimental models, each with a different implant placement, were prepared. In one model, the implants were placed in a straight line; in the other two, the implants in the parts corresponding to the second premolar and the first molar were offset each by a 1-mm increment to the buccal or lingual side. Four strain gauges were applied to the peri-implant bone corresponding to the first molar. The experimental models were imaged by micro-computed tomography (CT), and FEA models were constructed from the CT data. A vertical load of 100 N was applied on the three load points in the experimental models and in the FEA models. The extent of compressed displacement and the strain in the peri-implant bone were compared between the experimental models and the FEA models.
  
  
  RESULTS
  Both experimental and FEA models suffered the least compressed displacement during central loading in all placements. The greatest stress and compressive strain was on the load side in all types of placements.
  
  
  CONCLUSIONS
  Offset placement may not necessarily be more biomechanically effective than straight placement in edentulous posterior mandibles.
authors.affiliation: Department of Geriatric Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan. y-shimura@dent.showa-u.ac.jp.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shimura
authors.affiliation: Department of Geriatric Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Geriatric Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Kitagawa
authors.affiliation: Department of Geriatric Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Omori
keywords: Amount of compressed displacement; FEA; Offset placement; Strain gauge; Stress distribution; Three-dimensional finite element analysis