Osseointegrated Implants (osseointegrated + implant)

Distribution by Scientific Domains


Selected Abstracts


Submerged healing following surgical treatment of peri-implantitis: a case series

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2007
Ann-Marie Roos-Jansåker
Abstract Objectives: The aim was to study a regenerative surgical treatment modality for peri-implantitis employing submerged healing. Material and Methods: Twelve patients, having a minimum of one osseointegrated implant with peri-implantitis, with a progressive loss of 3 threads (1.8 mm) following the first year of healing were involved in the study. After surgical exposure of the defect, granulomatous tissue was removed and the implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®), a resorbable membrane (Osseoquest®) was placed over the grafted defect and a cover screw was connected to the fixture. The implant was then covered by flaps and submerged healing was allowed for 6 months. After 6 months the abutment was re-connected to the supra-structure. Results: A 1-year follow-up demonstrated clinical and radiographic improvements. Probing depth was reduced by 4.2 mm and a mean defect fill of 2.3 mm was obtained. Conclusion: Treatment of peri-implant defects using a bone graft substitute combined with a resorbable membrane and submerged healing results in defect fill and clinical healthier situations. [source]


Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort study

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2007
Ann-Marie Roos-Jansåker
Abstract Objectives: The aim of this prospective cohort study was to compare two regenerative surgical treatment modalities for peri-implantitis. Material and Methods: Thirty-six patients having a minimum of one osseointegrated implant, with a progressive loss of bone amounting to 3 threads (1.8 mm) following the first year of healing, combined with bleeding and/or pus on probing, were involved in this study. The patients were assigned to two different treatment strategies. After surgical exposure of the defect, granulomatous tissue was removed and the infected implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®). In 17 patients (Group 1), a resorbable membrane (Osseoquest®) was placed over the grafted defect before suturing. In 19 patients (Group 2), the graft was used alone. Results: One-year follow-up demonstrated clinical and radiographic improvements. Probing depths were reduced by 2.9 mm in Group 1 and by 3.4 mm in Group 2. Defect fill amounted to 1.5 and 1.4 mm, respectively. There was no significant difference between the groups. Conclusion: It is possible to treat peri-implant defects with a bone substitute, with or without a resorbable membrane. [source]


Studies on dentin grafts to bone defects in rabbit tibia and mandible; development of an experimental model

DENTAL TRAUMATOLOGY, Issue 1 2009
Lars Andersson
This property may possibly be used as an alternative or supplement to bone grafting to defective areas after trauma prior to treatment with osseointegrated implants. Hence, the objective of this study was to investigate if dentin can be used as a graft in bone defects in an experimental rabbit model. Materials and Methods:, Eight New Zealand White Rabbits were used to prepare bone cavities either in the angle of the mandible or tibia. Six of the eight tibial and six of the eight mandibular bone defects were filled with dentin blocks from human premolars which were extracted for orthodontic treatment. Two mandibular and two tibial bone cavities were used as controls and all the rabbits were sacrificed after 3 months. Radiographic and histological examinations were performed. Results:, There was a difference in healing pattern between the mandibular and tibial defects. In the mandible, the dentin blocks were resorbed to a larger extent and more often surrounded by fibrous tissue, probably due to the fact that the dentin blocks were mobile because of the thin mandibles and muscular activity in that area. Only some dentin blocks were ankylosed with the mandibular bone. In the tibia however, all dentin blocks were fused to bone over a large area. Osseous replacement resorption was seen. In control cavities, bone formation was seen but was never complete. No signs of inflammatory changes were seen in any fused grafts. Conclusions:, Dentin grafts have a potential to be incorporated in bone without inflammation and can be used as bone inducer and later replaced by bone. Thus, rabbit tibia served as a better model for further studies of this phenomenon when compared to the mandible. [source]


Rehabilitation by means of osseointegrated implants in oral cancer patients with about four to six years follow-up

JOURNAL OF ORAL REHABILITATION, Issue 3 2006
J. SEKINE
summary, This paper describes the reconstruction of mandibular defects in four oral cancer patients using iliac crest bone grafts and osseointegrated implants. In three patients, reconstructive surgery using a reconstruction plate and free forearm skin flap was performed following tumour and segmental mandibular resection. After 7,9 months, mandibular reconstruction with a free iliac bone graft was carried out. In one patient, reconstructive surgery was performed with vascularized iliac bone grafting with an anterolateral thigh flap at the same time as the tumour resection. Fixtures were placed in the transplanted bone, and abutments were connected 6,9 months later together with vestibuloplasty. Gingival grafts were used to replace the skin flap around abutments. All implants survived throughout the approximately 4,6 years observation time. Marginal bone loss of the graft was originally several millimetres but less than 1·5 mm. Bone loss as well as management of peri-implant soft tissue was also discussed. [source]


OC8 The short-term efficacy of osseointegrated implants in patients with non-malignant oral mucosal disease: a case series

ORAL DISEASES, Issue 2006
TA Hodgson
Purpose, The spectrum of patients who may wish or warrant osseointegrated implants is increasing, despite few reports of the impact of non-malignant oral mucosal disease upon implant placement. This report details the implant placement outcomes in three patients with pre-existing oral mucosal disease. Case reports,A: Four implants were placed in the lower anterior region of a 78-year-old female with longstanding mucous membrane pemphigoid (MMP) in 2004. The MMP had resulted in extensive cicatrisation of the upper and lower buccal and labial vestibules. One implant failed to osseointegrate, but was successfully replaced. There have been no other postplacement adverse events, despite the MMP remaining mildly active. B: A 36-years-old male with orofacial granulomatosis characterised by recurrent lip swelling and gingival enlargement, had a single implant placed in the upper canine region in 2001. Although still in situ significant peri-implant alveolar bone loss has occurred and has been stabilised by repeated debridement, local administration of topical minocycline and several courses of systemic metronidazole. C: A 53-years-old female with oral manifestations of diffuse systemic sclerosis and fibrosing alveolitis had four lower anterior mandibular implants placed in 1995 to support an 8 unit bridge. One episode of peri-implant inflammation was controlled with local debridement and topical chlorhexidine mouthrinse. The implants remain satisfactory 11 years postinsertion. Conclusion, The short-term failure of osseointegrated implant integration appears uncommon in patients with non-malignant oral mucosal disease. There remains a need to establish appropriate case selection criteria and monitor outcomes. [source]


Bilateral Bone-Anchored Hearing Aids (BAHAs): An Audiometric Evaluation,

THE LARYNGOSCOPE, Issue 1 2004
Claudia Priwin MD
Abstract Objectives Since the technique to implant bone-anchored hearing aids (BAHAs) with the use of osseointegrated implants was developed in 1977, more than 15,000 patients have been fitted with BAHAs worldwide. Although the majority have bilateral hearing loss, they are primarily fitted unilaterally. The main objective of this study was to reveal benefits and drawbacks of bilateral fitting of BAHAs in patients with symmetric or slight asymmetric bone-conduction thresholds. The possible effects were divided into three categories: hearing thresholds, directional hearing, and binaural hearing. Study Design Prospective study of 12 patients with bilateral BAHAs. Methods Baseline audiometry, directional hearing, speech reception thresholds in quiet and in noise, and binaural masking level difference were tested when BAHAs were fitted unilaterally and bilaterally. Results Eleven of the 12 patients used bilateral BAHAs on a daily basis. Tests performed in the study show a significant improvement in sound localization with bilateral BAHAs; the results with unilateral fitting were close to the chance level. Furthermore, with bilateral application, the improvement of the speech reception threshold in quiet was 5.4 dB. An improvement with bilateral fitting was also found for speech reception in noise. Conclusions Overall, the results with bilateral fitted BAHAs were better than with unilaterally fitted BAHA; the benefit is not only caused simply by bilateral stimulation but also, to some extent, by binaural hearing. Bilateral BAHAs should be considered for patients with bilateral hearing loss otherwise suitable for BAHAs. [source]


Dental implants: Maintenance, care and treatment of peri-implant infection

AUSTRALIAN DENTAL JOURNAL, Issue 4 2003
S. Chen
Abstract Osseointegration is becoming increasingly routine in the rehabilitation of partially or fully edentulous patients. However, the surrounding tissues may be subject to inflammatory conditions similar to periodontal disease and so require maintenance. This article discusses the background, aetiology, diagnosis of peri-implant diseases, and the maintenance, care and treatment of peri-implant infection in osseointegrated implants. Three case studies are presented to illustrate points in the care of implants. [source]


Oral myofunctional and vocal characteristics in subjects subjected to oral rehabilitation with osseointegrated implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2006
Karilla Matteo Sansone
Abstract Purpose: The aim of this study was to evaluate the effect of oral rehabilitation using immediately loaded fixed implant-supported mandibular prostheses, considering chewing, swallowing, speech and voice aspects. Material and methods: Fourteen patients subjected to this treatment were evaluated by a clinical examination of the stomatognathic system and perceptual evaluation of voice quality before oral rehabilitation, as well as after 1 and 4 months. Results: After oral rehabilitation, the results showed that there were no significant modifications in the aspects investigated. Conclusion: Thus, implant-supported prosthetic rehabilitation, despite providing a more satisfactory occlusal standard, did not yield changes in the functional patterns of individuals in this study. [source]


Prosthetic treatment of maxillary lateral incisor agenesis with osseointegrated implants: a 24,39-month prospective clinical study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2006
Fernando Zarone
Abstract Objectives: The present study aimed at evaluating the marginal bone resorption and the peri-implant tissue conditions around Narrow-Neck ITI implants in the implant,prosthetic treatment of the agenesis of maxillary lateral incisors. Material and methods: Thirty patients affected by monolateral or bilateral agenesis of the maxillary lateral incisors were selected. Thirty-four ITI-SLA Narrow Neck implants were inserted and loaded about 4 months after the surgical procedure. The final restorations were realized using Aureo Galvan Crowns veneered with feldspathic ceramics. The follow-up period ranged from 24 to 39 months. Both marginal bone resorption and soft tissue quality were evaluated. The data were statistically analysed using analysis of variance (ANOVA) for repeated measures, one-way ANOVA and Tukey's post hoc test (P=0.05). Results: During the 24,39-month follow-up period, no implant showed either pain and sensitivity or mobility. After 39 months of functional loading, a cumulative survival rate of 97.06% and a cumulative success rate of 94.12% were calculated. Conclusions: In case of maxillary lateral incisor agenesis, the implant,prosthetic approach has proved to be a reliable and predictable treatment for both re-establishment of function and aesthetics. Satisfactory values of marginal bone resorption over time and optimal conditions of peri-implant tissue around Narrow-Neck ITI implants were found. [source]


Impact of IL-1 genotype and smoking status on the prognosis of osseointegrated implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004
Boris Gruica
Abstract Aim: This study evaluated the impact of the IL-1 genotype and smoking status on the prognosis and development of complications of osseointegrated implants. Material and methods: The clinical charts of 180 consecutively admitted patients were analyzed with respect to the occurrence of biological complications in conjunction with oral implants. Biologic complications were defined as clinical conditions with suppuration from the peri-implant sulcus, development of a fistula or peri-implantitis with radiologic bone loss. All patients had received one or more ITI® dental implants, which had been in function for at least 8 (range: 8,15) years. This patient population had received 292 implants. From these, 51 implants in 34 patients showed late (infectious) biologic complications, and 241 implants had survived without any biologic complications at all. Results: Of the 180 patients, 53 were smokers, who were subdivided in a series of classes according to their intensity of smoking and 127 were never smokers. Sixty-four of 180 (36%) patients tested positive for the IL-1 genotype polymorphism. This prevalence corresponds to previous reports for the prevalence of European descent populations. The results for the non-smoking group indicated no significant correlation between implant complications and a positive IL-1 genotype. However, there was a clear association for heavy smokers between a positive IL-1 genotype and implant complications. 6 of 12 or half of the heavy smokers and IL-1 genotype-positive patients had either an implant failure, i.e. loss of implant, or a biologic complication during the follow-up period. Conclusions: These findings have led to the conclusion that there is a synergistic effect between a positive IL-1 genotype and smoking that puts dental implants at a significantly higher risk of developing biologic complications during function. Résumé Le but de cette étude a été d'évaluer l'impact du génotype IL-1 du tabagisme sur le pronostic et le développement de complication des implants buccaux ostéoïntégrés. Les dossiers cliniques de 180 patients ont été analysés en ce qui concerne l'arrivée de complications biologiques en association avec les implants buccaux. Des complications biologiques étaient définies en tant que conditions cliniques avec suppuration depuis le sillon paroïmplantaire, le développement d'une fistule ou d'une paroïmplantite avec perte osseuse radiologique. Tous les patients avait reçu un ou plusieurs implants buccaux ITI qui avaient été en fonction pour au moins huit années (de 8 à 15 ans). Les patients avaient reçu 292 implants. Parmi ceux-ci 51 chez 34 patients ont montré des complications biologiques tardives (infectieuses) et 241 avaient survécu sans aucune complication biologique. Des 180 patients, 53 étaient fumeurs qui ont été divisés en une série de classes suivant l'intensité du tabagisme tandis que 127 étaient non-fumeurs. Soixante-quatre des 180 patients (36%) ont été testés positifs pour le polymorphisme du génotype IL-1. Cette fréquence globale correspond au rapport précédent pour la fréquence globale des populations européennes. Les résultats pour le groupe non-fumeur indiquait qu'il n'y avait aucune relation significative entre les complications implantaires et un génotype IL-1 positif. Cependant, il y avait une association évidente pour les gros fumeurs entre le génotype IL-1 positif et des complications implantaires. Six des douze soit la moitié des gros fumeurs et des patients au génotype IL-1 positif avaient soit un échec implantaire (c.-à-d. la perte de l'implant) soit une complication biologique durant le suivi. Ces résultats ont conduit à la conclusion qu'il y a un effet synergétique entre le génotype IL-1 positif et le tabagisme mettant les implants buccaux à un risque beaucoup plus important à développer des complications biologiques durant leur mise en fonction. Zusammenfassung Ziel: Diese Studie untersuchte den Einfluss des IL-1 Genotyps und der Rauchgewohnheiten auf die Prognose und auf die Entwicklung von Komplikationen bei osseointegrierten Implantaten. Material und Methoden: Die Krankengeschichten von 180 aufgenommenen Patienten wurden auf biologische Komplikationen in Zusammenhang mit Zahni Implantaten untersucht. Biologische Komplikationen wurden definiert als klinische Zustände mit Suppuration aus dem periimplantären Sulcus, Entwicklung einer Fistel oder Periimplantitis mit radiologischem Knochenverlust. Alle Patienten waren mit einem oder mehreren ITI® Implantaten versorgt worden, welche für mindestens 8 Jahre (Bandbreite: 8,15 Jahre) in Funktion standen. Diese Patientenpopulation war mit 292 Implantaten versorgt worden. Von diesen 292 Implantaten zeigten 51 Implantate bei 34 Patienten biologische (infektiöse) komplikationen und 241 Implantate hatten ohne biologische Komplikationen überlebt. Resultate: Von den 180 Patienten waren 53 Raucher, welche in Untergruppen gemäss Schweregrad des Rauchens aufgeteilt wurden und 127 waren Nicht-Raucher. 64 der 180 Patienten (36%) zeigten ein positives Testergebnis bezüglich IL-1 Genotyp Polymorphismus. Diese Prävalenz entspricht früheren Berichten über die Prävalenz bei einer Population europäischer Abstammung. Die Resultate der Nicht-Raucher Gruppe zeigten keine signifikanten Korrelationen zwischen Implantatkomplikationen und einem positiven IL-1 Genotyp. Jedoch bestand bei den starken Rauchern eine klare Assoziation zwischen dem positiven IL-1 Genotyp und Implantatkomplikationen. 6 von 12 oder die Hälfte der starken Raucher und IL-1 Genotyp positiven Patienten zeigten entweder einen Implantat Misserfolg, z.B. Verlust des Implantats, oder eine biologische Komplikation während der Beobachtungsperiode. Schlussfolgerung: Die Ergebnisse haben zur Schlussfolgerung geführt, dass ein synergistischer Effekt zwischen einem IL-1 positiven Genotyp und Rauchen besteht, welcher Zahni Implantate einem signifikant höheren Risiko für die Entwicklung von biologischen Misserfolgen während der Funktion aussetzt. Resumen Intención: Este estudio evaluó el impacto del genotipo IL-1 y el estatus de fumador en el pronóstico y desarrollo de complicaciones de implantes orales osteointegrados. Material y métodos: Se analizaron las historias clínicas de 180 pacientes admitidos consecutivamente en lo referente a la ocurrencia de complicaciones biológicas en conjunción implantes orales. Se definieron las complicaciones orales como condiciones clínicas con supuración del surco periimplantario, desarrollo de una fístula o de periimplantitis con pérdida radiológica de hueso. Todos los pacientes recibieron uno o mas implantes orales ITI®, que levaban al menos 8 (rango 8,15) años en función. Esta población de pacientes recibió 292 implantes orales. De estos, 51 implantes de 34 pacientes mostraron (infecciones) complicaciones biológicas tardías, y 241 implantes sobrevivieron sin ninguna complicación biológica. Resultados: De los 180 pacientes, 53 eran fumadores que se subdividieron en una serie de categorías de acuerdo con su intensidad de consumo de tabaco y 127 nunca fueron fumadores. 64 de 180 (36%) dieron positivo al test del polimorfismo genético de la IL-1. Esta prevalencia corresponde con informes previos de prevalencia en poblaciones de origen europeo. Los resultados para el grupo de los no fumadores no indicó relación significativa entre complicaciones de los implantes y genotipo IL-1 positivo. Sin embargo, hubo una asociación clara para los fumadores intensos entre complicaciones de los implantes y un genotipo IL-1 positivo. 6 de 12 o la mitad de los fumadores intensos y los pacientes genotipo IL-1 positivo tuvieron o fracaso del implante i.e. pérdida del implante o una complicación biológica durante el periodo de seguimiento. Conclusiones: Estos hallazgos nos han conducido a la conclusión de que hay un efecto sinérgico entre genotipo IL-1 positivo y tabaquismo que colocan a los implantes orales en un riesgo significativamente mas alto para desarrollar complicaciones biológicas durante la función. [source]


Biomechanical aspects of marginal bone resorption around osseointegrated implants: considerations based on a three-dimensional finite element analysis

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004
Eriko Kitamura
Abstract Objectives: Although bone loss around implants is reported as a complication when it progresses uncontrolled, resorption does not always lead to implant loss, but may be the result of biomechanical adaptation to stress. To verify this hypothesis, a three-dimensional finite element analysis was performed and the influence of marginal bone resorption amount and shape on stress in the bone and implant was investigated. Material and methods: A total of nine bone models with an implant were created: a non-resorption (Base) model and eight variations, in which three different resorption depths were combined with pure vertical or conical (vertical,horizontal) resorption. Axial and buccolingual forces were applied independently to the occlusal node at the center of the superstructure. Results: Regardless of load direction, bone stresses were higher in the pure vertical resorption (A) models than in the Base model, and increased with resorption depth. However, cortical bone stress was much lower in the conical resorption models than in both the Base and A models of the same resorption depth. An opposite tendency was observed in the cancellous bone under buccolingual load. Under buccolingual load, highest stress in the implant increased linearly with the resorption depth for all the models and its location approached the void existing below the abutment screw. Conclusions: The results of this analysis suggest that a certain amount of conical resorption may be the result of biomechanical adaptation of bone to stress. However, as bone resorption progresses, the increasing stresses in the cancellous bone and implant under lateral load may result in implant failure. Résumé Bien que la perte osseuse autour des implants soit considérée comme une complication quand elle progresse de manière incontrôlée, la résoption ne se termine pas toujours par la perte de l'implant, mais peut être le résultat de l'adaptation biomécanique au stress. Pour vérifier cette hypothèse, une analyse d'éléments finis en trois dimensions a été effectuée et l'influence de l'aspect et de la quantité de résorption osseuse marginale au stress dans l'os et l'implant a été analysée. Neuf modèles osseux avec un implant ont été créés : un modèle (Base) sans résorption et huit variations dans lesquelles trois profondeurs de résorption différentes ont été combinées avec des résorptions verticales ou coniques (verticale-horizontale). Des forces axiales et vestibulo-linguales ont été appliquées de manière indépendante en occlusal au centre de la superstructure. Quelle que soit la direction de la charge, les stress osseux étaient plus importants dans la résorption verticale pure (A) que dans le modèle de base et augmentaient avec la profondeur de résorption. Cependant, le stress osseux cortical était beaucoup plus faible dans les modèles à résorption conique que dans les modèles Base et A de même profondeur de résorption. Une tendance opposée était observée dans l'os spongieux sous charge vestibulo-linguale. Sous charge vestibulo-linguale, le stress le plus important dans l'implant augmentait linéairement avec la profondeur de résorption pour tous les modèles et sa localisation approchait l'espace existant en-dessous du pilier. Les résultats de cette analyse suggèrent qu'une certaine quantité de résorption conique pourrait être le résultat d'une adaptation biomécanique au stress osseux. Cependant, quand la résorption osseuse progresse les stress s'amplifiant dans l'os spongieux et au niveau de l'implant sous une force latérale peuvent résulter en un échec implantaire. Zusammenfassung Ziel: Auch wenn ein Knochenverlust um Implantate, der unkontrolliert fortschreitet, als Komplikation beschrieben wird, führen solche Resorptionen nicht gezwungenermassen zu einem Implantatverlust. Sie könnten aber Ausdruck einer biomechanischen Adaptation auf die Belastungen sein. Um diese Hypothese zu überprüfen, führte man eine dreidimensionale "Finite-Element"-Analyse durch. Man untersuchte die Zusammenhänge von Ausmass und Form der marginalen Knochenresorption und den entstehenden Kräften im Knochen und Implantat. Material und Methode: Die Arbeitsgrundlage waren 9 Modelle mit je einem Implantat: eines diente als Kontrolle (ohne Resorptionserscheinungen), die anderen acht zeigten drei verschiedene Resortionstiefen in Kombination mit rein vertikalen oder konischen (vertiko-horizontal) Defektformen. Dann liess man, unabhängig von der Okklusionsgestaltung, axiale und buccolinguale Kräfte auf die Mitte der Suprastruktur auftreffen. Resultate: Unabhängig von der Belastungsrichtung war die Knochenbelastung bei den rein vertikalen Resorptionsmodellen (A) grösser als beim Kontrollmodell und sie nahmen mit der Tiefe der Resorption zu. Die Belastung im kortikalen Knochen war aber in den Modellen mit konischen Resorptionen viel geringer als beim Kontrollmodell und den A-Modellen mit denselben Resorptionstiefen. Eine genau umgekehrte Tendenz konnte man im spongiösen Knochen unter buccolingualer Belastung feststellen.Bei einer buccolingualen Belastung nahm die Belastungsspitze beim Implantat bei allen Modellen linear mit der Resorptionstiefe zu und der Ort dieser Belastungsspitze lag im Bereich des Leerraumes genau unterhalb der Schraube des Sekundärteils. Zusammenfassung: Die Resultate dieser Analyse lassen vermuten, dass die konische Resorption bis zu einem gewissen Ausmass das Resultat einer biomechanischen Adaptation auf die Belastung des Knochens ist. Wenn aber die Knochenresorption fortschreitet, können die zunehmenden Belastungen im spongiösen Knochen und im Implantat bei einer lateralen Belastung zum Implantatmisserfolg führen. Resumen Objetivos: Aunque la pérdida de hueso alrededor de los implantes se informa como una complicación cuando progresa incontroladamente, la reabsorción no siempre lleva a la pérdida del implante, pero puede ser el resultado de la adaptación biomecánica al estrés. Para verificar esta hipótesis, se llevó a cabo un análisis tridimensional de elementos finitos y se investigó la influencia de la cantidad de reabsorción de hueso marginal y la forma en el estrés en el hueso y el implante. Material y métodos: Se crearon un total de 9 modelos de hueso con un implante: Un modelo sin reabsorción (Base) y 8 variaciones, el las que se combinaron tres diferentes profundidades de reabsorción con reabsorciones verticales o cónicas puras (vertical,horizontal). Se aplicaron fuerzas axiales y bucolinguales independientemente al nodo oclusal en el centro de la superestructura. Resultados: A pesar de la dirección de la carga, los estreses óseos fueron más altos en los modelos de reabsorción vertical pura (A) que en los modelos Base y se incrementaron con la profundidad de reabsorción. De todos modos, el estrés cortical fue mucho menor en los modelos de reabsorción cónica que en los modelos Base y A con la misma profundidad de reabsorción. Se observó una tendencia opuesta en el hueso esponjoso bajo carga bucolingual. Bajo carga bucolingual, el estrés mas alto en el implante se incrementó linealmente con la profundidad de reabsorción para todos los modelos y su localización se aproximó al espacio existente bajo el tornillo del pilar. Conclusión: Los resultados de este análisis sugieren que cierta cantidad de reabsorción cónica puede resultar de la adaptación biomecánica del hueso al estrés. De todos modos, al progresar la reabsorción ósea, los estrés crecientes en el hueso esponjoso y en el implante bajo carga lateral puede resultar en un fracaso del implante. [source]