title: Bone morphological effects on post-implantation remodeling of maxillary anterior buccal bone: A clinical and biomechanical study.
abstract: OBJECTIVE
  This study combines clinical investigation with finite element (FE) analysis to explore the effects of buccal bone thickness (BBT) on the morphological changes of buccal bone induced by the loaded implant.
  
  
  METHODS
  One specific patient who had undergone an implant treatment in the anterior maxilla and experienced the buccal bone resorption on the implant was studied. Morphological changes of the bone were measured through a series of cone-beam computed tomography (CT) scans. A three-dimensional heterogeneous nonlinear FE model was constructed based on the CT images of this patient, and the in-vivo BBT changes are correlated to the FE in-silico mechanobiological stimuli; namely, von Mises equivalent stress, equivalent strain, and strain energy density. The anterior incisory bone region of this model was then varied systematically to simulate five different BBTs (0.5, 1.0, 1.5, 2.0, and 2.5mm), and the optimal BBT was inversely determined to minimize the risk of resorption.
  
  
  RESULTS
  Significant changes in BBTs were observed clinically after 6 month loading on the implant. The pattern of bone resorption fell into a strong correlation with the distribution of mechanobiological stimuli onsite. The initial BBT appeared to play a critical role in distributing mechanobiological stimuli, thereby determining subsequent variation in BBT. A minimum initial thickness of 1.5mm might be suggested to reduce bone resorption.
  
  
  CONCLUSIONS
  This study revealed that the initial BBT can significantly affect mechanobiological responses, which consequentially determines the bone remodeling process. A sufficient initial BBT is considered essential to assure a long-term stability of implant treatment.
authors.affiliation: Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. Electronic address: nobuhiro.yoda.e2@tohoku.ac.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yoda
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Australia.
authors.forename: Keke
authors.initials: K
authors.lastname: Zheng
authors.affiliation: Department of Biomaterials, Max Planck Institute of Colloids and Interface, Germany.
authors.forename: Junning
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Kuwait.
authors.forename: Michael
authors.initials: M
authors.lastname: Swain
authors.affiliation: Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Australia.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology*; D001862:Bone Resorption / Q000209:etiology*; D002610:Cheek; D054893:Cone-Beam Computed Tomography; D003757:Dental Implantation / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology* / Q000502:physiology*; D008875:Middle Aged
chemical_list: D015921:Dental Implants
keywords: Bone remodeling; Buccal bone thickness; Dental implant; Finite element analysis; Mechanobiology