Impact of physiological and non-physiological loading scenarios and crown material on periimplant bone stress distribution: A 3D finite element study

This study numerically investigates the impact of different loading modes on the biomechanical response of an osseointegrated dental implant. While finite element modeling is commonly employed to investigate the mechanical behavior of dental implants, several models lack physiological accuracy in their loading conditions, omitting occlusal contact points that influence stress distribution in periimplant bone. Using 3D finite element modeling and analysis, stress distributions at the bone-implant interface are evaluated under both physiological loading, incorporating natural occlusal contact points, and non-physiological loading conditions, with a focus on load transmission mechanisms and the potential risk of bone overloading. Two crown materials, zirconia and lithium disilicate, are analyzed under load values of 150 N and 300 N. The physiological loading mode leads to significantly higher Von Mises stress concentrations in both cortical and trabecular periimplant regions compared to non-physiological loading. This results in different load transfer mechanisms underlining the importance of accurately modeling load application points. Crown material seems to have a minimal impact, whereas increasing the load intensity markedly increases stress levels. Notably, physiological loading reveals stress distribution at the implant apex, unlike non-physiological models. Additionally, peak values of tensile and compressive stresses at the periimplant interfaces increased under physiological conditions, with cortical bone stress rising by up to 210\%. This highlights that relying on non-physiological loading modes may inadequately capture the risk of implant failure. Overall, these results emphasize the need to consider physiological loading scenarios, particularly for assessing failure risk to better guide implant design modifications, enhancing clinical outcomes and implant longevity.