The Effects of Implant Length and Diameter Prior to and After Osseointegration

The Effects of Implant Length and Diameter Prior to and After Osseointegration: A 2-D Finite Element Analysis Basile Georgiopoulos, Konstantinos Kalioras, Christopher Provatidis, Marianthi Manda and Petros Koidis

Journal of Oral Implantology Volume 33, Number 5 October 2007

The necessity for simplification and the reduction of risk in surgical protocol when there is inadequate bone volume has led to the use of short and/or narrow implants.47,48

The present study confirms that maximum stress concentration under loading is found at the implant abutment interface.

Wide implants are preferred in cases where immediate placement, bone engagement, and initial stability are indicated,83,84 although the disadvantages of overinstrumentation and heat generation need to be taken into account.83

Narrow implants are preferred in cases where less than 5 mm of space is available or transitional implants are indicated but carry with them the handicap of lower fracture resistance.85

It has been reported that a 3.3-mm–diameter implant is about 25% more prone to fracture than a 3.75-mm implant.47
Against this must be set clinical studies evaluating potential vertical alveolar bone loss that are not in line with the biomechanical results and indicate that the pattern of marginal bone loss seems not to be significantly correlated with the diameter of the implant and its load-bearing capacity.47,57,87,88

It seems that prior to osseointegration the use of progressively longer implants is accompanied by stress reduction. However, implants with diameters of 3.75 mm and 4.5 mm have almost the same biomechanical performance.
Whereas, after osseointegration, the best biomechanical performance is achieved by the 4.5-mm–diameter implant, but no specific tendency can be observed between strain variability and increasing diameter.

As far as bone tissue was concerned, there was a tendency towards strain reduction, before and after osseointegration, when the length of the implant was increased from 10 mm up to 14 mm. This tendency was not manifested for the range of 8 to 10 mm. The effect of implant diameter on bone tissue was not clear. It appears that implants of a diameter more than 5 mm are not preferable for immediate loading. Finally, it seems that cortical bone is not influenced by the phase of osseointegration, while trabecular bone is highly affected.

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