A conical implant–abutment interface at the level of the marginal bone improves the distribution of stresses in the supporting bone

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Abstract
It has been hypothesized that marginal bone resorption may result from microdamage accumulation in the bone. In light of this, a dental implant should be designed such that the peak stresses arising in the bone are minimized. The load on an implant can be divided into its vertical and horizontal components. In earlier studies, it was found that the peak bone stresses resulting from vertical load components and those resulting from horizontal load components arise at the top of the marginal bone, and that they coincide spatially. These peak stresses added together produce a risk of stress-induced bone resorption. Using axisymmetric finite element analysis it was found that, with a conical implant-abutment interface at the level of the marginal bone, in combination with retention elements at the implant neck, and with suitable values of implant wall thickness and modulus of elasticity, the peak bone stresses resulting from an axial load arose further down in the bone. This meant that they were spatially separated from the peak stresses resulting from horizontal loads. If the same implant-abutment interface was located 2 mm more coronally, these benefits disappeared. This also resulted in substantially increased peak bone stresses.