Journal of Dental Sciences (2020) 15, 466e471

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Original Article

The effect of implant neck microthread

design on stress distribution of peri-implant
bone with different level: A finite element
analysis
Zhi-Heng Jin a,by, Meng-Dong Peng a,by, Qing Li a,b*

a
The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key
Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan,
China
b
Dept. of Prosthodontics, Hospital of Stomatology, Wuhan University, Wuhan, China

Received 20 June 2019; Final revision received 2 December 2019

Available online 31 December 2019

KEYWORDS Abstract Background/purpose: Significant research has proposed that the implant with mi-
Bone resorption; crothread in the neck can significantly reduce marginal bone loss, but whether it is consistent
Dental implant; in the condition of marginal bone loss is still unknown. The objective of this study is to inves-
Finite element tigate the effect of microthread on stress distribution in peri-implant bone with different bone
analysis; level using finite element analysis.
Shear stress Materials and methods: A series of computational models of mandible segments with different
bone resorption and implant models with or without microthread in the neck was installed by
computer-aided design software. The simulated occlusal force of 150N was applied buccolin-
gually on the top center point of implant. The FEA was performed, and the von Mises stress,
principal stress and shear stress in peri-implant bone were recorded and analyzed.
Results: In all models, the T-neck group exhibits higher von Mises stress and principal stress, as
well as lower shear stress than S-neck group. Three types of stresses increase with the depth of
bone resorption developed, but the differences of shear stress between two groups of implants
were gradually decreased.
Conclusion: The micro-thread design in implant neck can reduce marginal bone loss by
decreasing shear stress in peri-implant bone, but this effect is gradually weakened with the
decline of the marginal bone level.

* Corresponding author. School and Hospital of Stomatology, Wuhan University, 237# Luo Yu Road, Wuhan, China. Fax numbers: 86027
87686110.
E-mail address: li.q@whu.edu.cn (Q. Li).
y
The Zhi-Heng Jin and Meng-Dong Peng contributed equally to this paper and they were co-first authors.

https://doi.org/10.1016/j.jds.2019.12.003
1991-7902/ª 2019 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V. This is an open access article under
the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Microthread on stress distribution of peri-implant bone 467

ª 2019 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier
B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.
org/licenses/by-nc-nd/4.0/).

Introduction Materials and methods

Compared to the traditional removable and fixed denture, The creation of a bone block model
dental implant restoration can resume masticatory function
and aesthetic requirement of missing tooth to a greater The mandibular bone of a healthy adult male was selected
extent, which has become an optimized choice in dentist- and scanned by cone beam computed tomography (CBCT)
ry.1e3 The dental implant survival rates after 5-year follow- at 300 mm resolution in School and Hospital of Stomatology,
ups is reported to be up to 98.9%.4 The superior biocom- Wuhan University. The acquired CT images were saved as
patibility and favorable biomechanics environment of DICOM format and then imported into image processing
implantebone interface are also importance for the long- software (Mimics v17, Materialise, Leuven, Belgium). The
term survival of dental implants. segmentation and reconstruction of three dimensional solid
Considering the stress is mainly concentrated on model was performed based on gray scale values of
cortical bone around implant neck under the functional different tissues. The right premolar area of the mandible
load, much focus has been paid on maintenance of mar- was selected for analysis (Fig. 1A). The final bone model
ginal bone level. Many methods have been proposed to consists of cancellous bone surrounded by a cortical bone
optimize the stress distribution around implant to reduce layer, with the cavities corresponding to different implants.
marginal bone resorption, such as changing the diameter Dimensions were indicated in Fig. 1B. The bone model was
and thread profile of implant and/or applying the plat- divided into four groups: non-resorption, 0.25 mm resorp-
form switching technique in implant-abutment joint,5e7 tion, 0.5 mm resorption, and 0.75 mm resorption respec-
which has shown to improve marginal bone preservation tively, according to bone level of the planting area.
and maintain the level of soft tissue. Nevertheless, mar-
ginal bone loss around implant is still inevitable. Adell
et al. reported that the marginal bone resorption of
Creation of implant models
1.2 mm within one year after implantation under normal
occlusal force.8 At present, many scholars followed a The cylindrical implant model with 11.5 mm in length,
success criterion, established by Albrektsson et al., 4.0 mm in diameter and a 2.5 mm pitch V-shape thread was
that the marginal bone loss should not be more than constructed by finite element software. A 4 mm high
1.5 mm in the first year and 0.2 mm annually from the abutment and implant were simplified to a single unit as the
second year.9 abutment was not considered in this paper. Two types of
Literatures on microthread design at implant neck have implant models were generated according to the different
drawn a lot of attention. Clinical and animal studies have neck configurations. S-neck group: the implant neck with a
found the implant with microthread in the neck can smooth portion. T-neck group: the implant neck with a
significantly reduce marginal bone loss. Lee et al. microthread (Fig. 1B). Except for the difference of implant
concluded the implant with microthread might have a neck structure, all implant configurations were identical
positive effect on against marginal bone loss.10 Further- between two groups.
more, an experimental study in dogs demonstrated
microthread configuration increased the degree of Finite element analysis
boneeimplant contact when compared with the non-
microthreaded implants and provided a potential contri- Eight models with four bone and two implant configurations
bution on osseointegration, as well as on the maintenance were assembled into finite element processing software
of marginal bone.11 (Abaqus2016, Dassault Systemes, Paris, France). The im-
Three-dimensional finite element analysis (FEA) has plants were embedded into the center of bone model in
been widely used for the complex mechanical investigating horizontal plane, with the neck of implant located at the
which are difficult to perform in vivo or in vitro.12e14 highest level of alveolar crest.
Presently, many scholars explored and revealed the All materials used in FEA were assumed as homogenous,
biomechanical effect of microthread on implantebone linearly elastic, and isotropic (Table 1).15,16 The bone and
interface by FEA. Unfortunately, most of studies involved implant was considered as complete osseointegration, and
FEA model without bone resorption and ignored the the interface of bone-implant was defined as the bonded
changes of marginal bone level. Thus, this study was con- contact.17 In all models, the tetrahedral solid element was
ducted to investigate the effect of the presence or absence adopted for the mesh. In order to improve the accuracy of
of microthread on stress distribution in peri-implant bone results during the simulation, a finer mesh was used along
with different bone level. the interface at the region of implant neck. An oblique
468 Z.-H. Jin et al

Figure 1 (A) Location of analysis section in a mandible (B) Dimensions of bone and implant model.

distribution on the bone around implant neck. Y-axis was

Table 1 Material properties of implant and bone.
introduced to describe the cross-section position in
Component Young’s modulus (MPa) Poisson ratio coronal-apical direction. Y-axis coordinate values corre-
Implant (Titanium) 110000 0.3 sponding to the top and bottom of implant neck were
Cortical bone 13700 0.3 marked as 0 and 2.5. The interval of every section was 0.1
Cancellous bone 950 0.3 (Fig. 2B). The penetration depth of highest compressive
stress concentrations in S-neck and T-neck model along the
Y-axis direction (vertical or coronal-apical direction) were
0.8 mm and 0.6 mm, respectively.
static force of 150 N was applied on the top center point of Figure 3A shows the similar shear stress patterns in both
abutment from buccal to lingual at 45-degree angle to the implant model, which were concentrated on the mesial and
long axis of implant. The boundary condition was deter- distal side of peri-implant bone. The positive and negative
mined that the all nodes of mesial and distal border of bone values represented different directions. The maximum
model were fixed in all directions. The von Mises stress shear stresses in T-neck group was 8.6 MPa, which was
(equivalent stress), principal stress and shear stress were lower than that of S-neck group (9.9 MPa). In addition, the
recorded. portional bone around implant neck was selected, and the
bone volume fraction associated with different stress
ranges were obtained. It could be seen that the bone vol-
Results
ume related to low stress ranges (less than 4 Mpa) in T-neck
group was more than that in S-neck group (Fig. 3B).
For all models, the values in cortical bone were far higher
than those in cancellous bone. The marginal bone was the
region of interest for analysis, and the stress distribution on The stress distribution of the two groups of
cancellous bone was ignored. implants in bone resorption model

The maximum von Mises stress, principal stress, and shear

The stress distribution of the two groups of stress enhanced while the bone resorption increased for all
implants in full-bone model model (Table 2).The shear stress distributions in all bone
model from the lingual view were shown in Fig. 4. In gen-
T-neck group displayed higher maximum of von Mises stress eral, the shear stress in T-neck group was lower than in S-
and principal stress than S-neck group. The details of stress neck group for all of the bone resorption models, but the
values were presented in Table 2. differences were gradually decreased with the depth of
Figure 2A shows the principal stress distribution in bone resorption developed (Fig. 5).
cortical bone from the mesial view. The compressive stress
(minimum principal stress) was observed in the most of the
lingual region (compressive side), and the tensile stress Discussion
(maximum principal stress) was generated at buccal region
(tensile side), as well as the lower portion of lingual region. After the implantation, occlusal forces are transmitted to
The compressive and tensile stresses were separated by an the surrounding bone through implant. Cortical bone bears
oblique line, which represented the boundary of them. The most of stress for its higher elastic modulus than cancellous
highest compressive stress concentrations in S-neck model bone, which was called stress shielding effect.18e20 It will
appeared a homogeneous band-like distribution at the top increase the risk of marginal bone resorption. Some
of lingual bone around the implant neck (black solid arrow), scholars has confirmed that a rough surface in implant neck
whereas those in T-neck model were scattered at three installed by microthread plays a crucial role in minimizing
points on the disto-lingual peri-implant bone (red solid peri-implant marginal bone loss and was considered as
arrow). Fig. 2C shows the cross-section of principal stress retentive elements.21 Moreover, it is determined that
Microthread on stress distribution of peri-implant bone 469

Table 2 The maximum value of three types of stress peri-implant bone with different level for S-neck and T-neck model under
oblique loading.
S-neck implant T-neck implant
Stress value (Mpa) Full bone 0.25-mm 0.5-mm 0.75-mm Full bone 0.25-mm 0.5-mm 0.75-mm resorption
resorption resorption resorption resorption resorption
von Mises stress 20.22 21.52 23.89 25.83 27.39 30.25 35.46 39.98
Compressive Stress 23.64 25.79 28.52 30.58 25.47 33.4 34.33 43.14
Tensile Stress 11.93 12.78 14.8 14.9 15.94 16.07 16.86 20.06
Shear stress 9.87 10.27 10.64 11.73 8.6 9.16 10.02 11.38

microthreaded in implant neck can reduce the marginal as the existence of microthreads.10,24 The oblique force
bone resorption and could be selected to maintain bone applied on the implantebone interface was divided into
level in a related meta-analysis.22 three components: the compressive and tensile stress that
The shear stress was distributed at mesiodistal side of are perpendicular to the interface and the shear stress that
peri-implant bone for both groups under oblique load, is parallel with the interface. Bone exhibits different de-
similar to prior studies.23 Additionaly, the lower peak shear gree of resistance to three types of stress components.
stress was noticed in T-neck model compared with S-neck Cortical bone is strongest to compressive loads, 30% weaker
model, which is supported with the previous reports that to tensile forces, and 65% weaker to shear forces compared
the stress pattern of implantebone interface was changed to compressive forces.25 It indicated that the shear stress

Figure 2 Principal stress distribution for two groups of implants (A) In the bucco-lingual section view. Dotted line shows the
boundary between the compressive and tensile stress. Black and red arrow shows the concentration of compressive stress,
respectively (B) Diagrammatic sketch of describing the cross-section position in coronal-apical direction by Y-axis (C) In the cross
section view. Black dotted arrow and red dotted arrow indicates that the penetration depth of highest compressive stress con-
centrations in S-neck and T-neck model along the Y-axis direction were 0.8 mm and 0.6 mm, respectively.
470 Z.-H. Jin et al

Figure 3 (A) Shear stress distributions for two groups of implants from the lingual view (B) Volume fraction of peri-implant
cortical bone related to different stress ranges for two groups of implants.

was more destructive to bone and more crucial in aspect to It is remarkable that the peak shear stress value
marginal bone loss. Without the cushion effect of peri- increased with the bone resorption. In the similar study,
odontal ligament in natural teeth, the occlusal force ap- Wolff assessed different implant geometries on the strain
plies directly on the implantebone interface after distributions under different bone conditions, including full
osseointegration and will be susceptible to cause interfacial bone, horizontal bone loss and circular bone loss. And he
failures.26 In T-neck model, the shear force at the interface mentioned the strain magnitude in bone defect model was
was transformed into the compressive force to which bone higher than in full-bone model.28 It seems to be a vicious
is the most resistant by microthread, especially the first circle that the decline of marginal bone level causes the
thread. Hence, the lower shear values were found in T-neck
model, which revealed the predicted effect of microthread
design.
The maximum shear stress of T-neck group was lower
than S-neck group in both full-bone and bone-resorption
models. But the difference was decreasing while the bone
resorption. It was speculated that the first microthread
contacted with cortical bone was below the top of implant
neck when bone resorption occurs. The function of chang-
ing pattern of load transfer and maintaining the marginal
bone level by the first microthread become weaker and
weaker in successive bone-resorption models. In a related
study, Song et al. revealed that more peri-implant bone loss
was observed in implant with microthread placed below the
top of neck compared to those with microthreads placed at
the top.27 So it minimize the difference of peak shear stress Figure 5 Peak shear stress value of peri-implant bone for
between two groups of implants in bone-resorption model. two groups of implants in a series of bone levels.

Figure 4 Shear stress distributions in full-bone and bone-resorption models for two groups of implants.
Microthread on stress distribution of peri-implant bone 471

higher stress and in turn, the increase of stress become the proposed criteria of success. Int J Oral Maxillofac Implant
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