Effect of Bone Quality on Insertion Torque during Implant Placement; Finite Eelement Analysis

임플란트 식립 시 골질이 주입회전력에 미치는 영향에 관한 삼차원 유한요소 분석

  • Jeong, Jae Doug (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Cho, In-Ho (Department of Prosthodontics, College of Dentistry, Dankook University)
  • 정재덕 (단국대학교 치과대학 치과보철학교실) ;
  • 조인호 (단국대학교 치과대학 치과보철학교실)
  • Received : 2009.05.01
  • Accepted : 2009.06.25
  • Published : 2009.06.30


The aim of the study was to assess the influence of insertion torque of bone quality and to compare axial force, moment and von Mises stress using finite element analysis of plastoelastic property for bone stress and strain by dividing bone quality to its thickness of cortical bone, density of trabecular bone and existence of lower cortical bone when implant inserted to mandibular premolar region. The $Br{\aa}nemark$ MKIII. RP implant and cylindrical bone finite model were designed as cortical bone at upper border and trabecular bone below the cortical bone. 7 models were made according to thickness of cortical bone, density of trabecular bone and bicortical anchorage and von Mises stress, axial force and moment were compared by running time. Dividing the insertion time, it seemed 300msec that inferior border of implant flange impinged the upper border of bone, 550msec that implant flange placed in middle of upper border and 800msec that superior border of implant flange was at the same level as bone surface. The maximum axial force peak was at about 500msec, and maximum moment peak was at about 800msec. The correlation of von Mises stress distribution was seen at both peak level. The following findings were appeared by the study which compared the axial force by its each area. The axial force was measured highest when $Br{\aa}nemark$ MKIII implant flange inserts the cortical bone. And maximal moment was measured highest after axial force suddenly decreased when the flange impinged at upper border and the concentration of von Mises stress distribution was at the same site. When implant was placed, the axial force and moment was measured high as the cortical bone got thicker and the force concentrated at the cortical bone site. The influence of density in trabecular bone to axial force was less when cortical bone was 1.5 mm thick but it might be more affected when the thickness was 0.5 mm. The total axial force with bicortical anchorage, was similar when upper border thickness was the same. But at the lower border the axial force of bicortical model was higher than that of monocortical model. Within the limitation of this FEA study, the insertion torque was most affected by the thickness of cortical bone when it was placed the $Br{\aa}nemark$ MKIII implant in premolar region of mandible.


  1. Johansson P, Strid K-G. Assessment of bone quality from cutting resistance during implant surgery. Int J Oral Maxillofac Implants 1994;9:279-288
  2. Schulte W, Lucas D, Muhlbradt L, Scholz F, Bretschi J, Frei D. Periotest-ein neues Verfahren und Gerat zur Messung der Function des Pardontiums. Zahnartzl Mitt 1983;73:1229-1240
  3. Friberg B, Sennerby L, Roos J, Lekholm U. Identificarion of bone quality in conjunction with insertion of titanium implants. Clin Oral Implants Res 1995; 6:213-219 https://doi.org/10.1034/j.1600-0501.1995.060403.x
  4. Sullivan DO, Sennerby L, Jagger D, Meriedith N. A comparision of two methods of enhancing implant primary stability. Clinical Implant Dentistry and Related Research 2004;6:48-57 https://doi.org/10.1111/j.1708-8208.2004.tb00027.x
  5. Carter DR, Caler WE. Cycle dependent and time dependent bone fracture with repeated loading. J Biomech Eng 1983;105-166
  6. Misch CE, Qu Z, Bibez MW. Mechanical properties of trabecular bone in the human mandible. J Oral Maxillofac Surg 1999;47:700-706
  7. Petrie CS, Williams JL. Comparative elvaluation of implant design: influence of diameter, length and taper on strains in the alveolar crest. Clin Oral Implants Res 2005;16:486-494 https://doi.org/10.1111/j.1600-0501.2005.01132.x
  8. Misch CE. Density of Bone: effect on treatment plans, surgical approach, healing, and progressive loading. Int J Oral Implant 1990;6:23-31
  9. Ueda M, Matsuki M, Jacobsgon M, Tjellstr$\ddot{o}$m A. The relationship between insertion torque and removal torque analyzed in fresh temporal bone. Int J Oral Maxilofac Implants 1991;6:442-447
  10. Weinstein AM. Klawitter JJ, Anand SC, Schuessler R. Stress analysis of porous rooted dental implants. J Dent Res 1976;55:772-777 https://doi.org/10.1177/00220345760550051001
  11. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The longterm efficacy of currently used dental implant: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1:11-25
  12. Cho IH, Lee JB, Kim YJ, Lim CJ, Yeo HH, Ryu KH Hur YG, Lee JS. Upgrade Dental Implant. Myungmun Publishing Co. Inc. 2006; 40-41
  13. Beer A, Gahleitner A, Holm A, Tschabitscher M, Homolka P. Correlation of insertion torques with bone mineral density from dental quantitative CT in the mandible. Clin Oral Implants Res 2003;14: 616-620 https://doi.org/10.1034/j.1600-0501.2003.00932.x
  14. Frost HM. Mechanical adaptation. Frost's mechanostat theory. In Martin RB, Burr DB, editors. Structure, function, and adaptation of compact bone. New York, Baven Pres 1989:179-181
  15. Carl E. Misch, Dental implant prosthodontics. Gi sung Publishing Co. Inc 2005:135-137
  16. Kitamura E, Stegaroiu R, Nomura S, Miyakawa O. Biomechanical aspect of marginal bone resorption around osseointegrated implants: considerations based on a three-dimensional finite element analysis. Clin Oral Implants Res 2004;15:401-412 https://doi.org/10.1111/j.1600-0501.2004.01022.x
  17. Satoh T, Maeda Y, Komiyama Y. Biomechanical rationale for intentionally inclined implants in the posterior mandible using 3D finite element analysis. Int J Oral Maxillofac Implants 2005;20:533-539
  18. Ivanoff C-J, Sennerby L, Lekholm U. Influence of mono-and bicortical anchorage on the integration of titanium implants. Int J Oral Maxillofac Surg 1996;25:229-235 https://doi.org/10.1016/S0901-5027(96)80036-1
  19. Albrektsson T, Wennerberg A. The impact of oral implant-past and future, 1966-2024. J Can Dent Assoc 2005;71:327
  20. Carter TB, Frost DE, Tucher MR, Juniga JR. Cortical thickness in human mandibles: clinical relevance to the sagittal split ramus osteotomy. Int J Adult Orthod Orthognath Surg 1991;6:257-260
  21. Misch CE. Contemporary implant dentistry. Mosby 1993:298-303
  22. Br$\dot{a}$nemark PI. Osseointegration and its experimental background. J Prosthet Dent 1983;50:399-409 https://doi.org/10.1016/S0022-3913(83)80101-2
  23. Johansson CB, Albrektsson T. Integration of screw implants in the rabbit: A one-year follow-up of removal torque of titanium implants. Int J Oral Maxillofac Implants 1987:2;69-75
  24. Meredith N. Assessment of Implant stability as a prognotic determinant. Int J Prothodont 1998;11: 491-501