Role of initial density distribution in simulations of bone remodeling around dental implants

Purpose: In this paper, the effect of initial density distribution upon the predicted density via numerical simulations of bone remodeling was evaluated. The main purpose was to correlate the numerical results with clinical data according to which the initial bone quantity is an essential factor for long term survival of dental implants. Methods: Two-strain energy density-based bone remodeling theories were employed, one which accounts for overload resorption and the second one, which does not. The remodeling parameters were derived from the mechanostat theory. Bone remodeling around an osseointegrated dental implant was simulated based on finite element method using a generic mandible plane model. A variable time step was introduced to increase the speed of the remodeling simulations by keeping the truncation errors small. The simulations were performed for several initial density distributions correlated with values from clinical classifications of bone quality. For each density value, the occlusal load was defined in two ways so that to consider normal and overload mastication forces, respectively. Results: The results showed that the initial density distribution influences the predictions of bone remodeling simulations. For the analyzed model, the remodeling algorithm predicted overload resorption only in the case of low initial density, which can be associated with low bone quality, which, from clinical perspective, may probably lead to implant loss. Conclusions: The paper demonstrated that when simulating bone remodeling around dental implants using finite element method, it is important to account for initial density distribution in correlation with the bone quantity.