THE CREST MODULE

DESIGN:
A 3D FINITE ELEMENT
ANALYSIS
Cristiana Costa, MS,a Nuno Peixinho, PhD,b Joo Pedro Silva,
PhD,c and Sandra Carvalho, PhDd

THE JOURNAL OF PROSTHETIC DENTISTRY

2015;113:541-547

INTRODUCTION

CONTENT
S

MATERIALS AND METHODS

RESULTS
DISCUSSION
CRITICAL ANALYSIS
CONCLUSION

INTRODUC
TION

Osseointegration
Stress management
Microbial protection
Surgical insertion method

 The crest module is a region of

highly concentrated mechanical
stress, where bone reabsorption
usually occurs due to overload,
absence of stimulation, or
microbial contamination, all
factors that lead to treatment
failure.

MATERIAL AND METHODS

1. Seven (3D) solid models of a
mandibular section and a
dental implant were built with
3D computer-aided design
software (SolidWorks 2013;
Dassault Systmes SA)
2. Before undergoing numerical
nite element (FE) stress
analysis with software (Ansys
Workbench 15.0; Ansys
Inc)
3. Each 3D solid mandibular
models included 2 layers of

Nobel Biocare (Brnemark Mk III, Mk IV,

NobelActive; M6, M2, M4)
Astra Tech Implant System (OsseoSpeed TX;M1,
M5).
1. M1, cylindrical
2. M2, divergent with a
maximum diameter
equal to the implant
body diameter
3. M3, cup shaped
4. M4, convergent

5. M5, extended
divergent;
6. M6, divergent with a
maximum diameter
superior to the implant
body diameter;
7. M7, divergent, similar
to M5, but with a
greater thread length.

 In the FE models, isotropic, homogeneous, and linear

elastic materials were used.
Regarding the mandibular cross section used in FE
models, the bone properties were dened as being of type
2 according to the Lekholm and Zarb classication.

The top surface of the implant

models was subjected to a 30degree oblique force of 250 N,
which represents the average
value of maximum occlusal load.

Sahin S, Cehreli MC, Yalin E. The inuence of functional forces on the

biomechanics
of implant-supported prostheses-a review.

 The mesh elements of the FE

models were tetrahedrons,
with 10 nodes each, rened
in the BIC regions
From the convergence study
carried out during the
validation test of the FE
models, the mesh renement
parameters were dened.
Regarding the global mesh
controls, a minimum and a
maximum size of 0.1 and 0.5
mm were set, while in the
crest module at the boneimplant interface a 0.3 mm
mesh was applied

According to these validation

tests, osseointegrated dental
implants under a buccolingual
force of 20 N experienced lateral
displacements of 15.49 mm as
reported by Sekine et al.
They measured the buccolingual
mobility of osseointegrated dental
implants with elastic strain
meters, endosteal implant
movement ranged from 12 to 66
mm in the buccolingual direction.

Sekine H, Komiyama Y, Hotta H, Yoshida K. Mobility characteristics and tactile

sensitivity
of osseointegrated xture-supporting systems.

After the validation tests of FE models:

Maximum principal elastic strain,
Minimum principal elastic strain,

RESULTS

Maximum shear elastic strain were

evaluated .
The highest values of maximum principal
stress and strain obtained were 49.22 mpa
and 2850 microstrain in M4
The lowest were 23.85 mpa and 1499.6
microstrain in M5

DISCUSS
ION

The intent in applying a 30-degree oblique

force of 250 N was to bring the FE models as
close as possible to the actual occlusal
loading conditions and combined stress
effect in the cortical bone crest.

 The crest module design parameters of surface area and

platform diameter are important geometric indicators in
predicting the level of success of dental implant
treatments based on primary stability, osseointegration
potential, and microbial protection capacity.
M2 showed the highest peak values of minimum principal
stress/strain and maximum shear stress/strain because of
its great divergent angle (14 degrees) compared to other
divergent designs.
M4, with its convergent crest module design, produced
higher values of minimum principal stress/strain than the
cup shape (M3) or the divergent design (M7), which were
expected to have higher levels.

 M5 and M7 also showed better shear stress distribution .

Therefore, as a result of the strain peaks and their
distribution in the cortical bone region of models M5 and M7,
it is expected that they would show less bone loss in the rst
years after treatment compared to the other tested
specimens.
With its high platform diameter and its coronal divergent
design, M5 is capable of compressing the cortical bone crest
by improving its initial stability, sealing the socket bone area,
and providing a barrier for the attack of microbial organisms

Study is limited to type 2 bone.

CRITICAL
ANALYSIS

CONCLUS
ION

This study demonstrates that crest

module design inuences the distribution
and concentration levels of stress and
strain along the adjacent cortical bone.
Extended divergent collar designs were
found to be the most advantageous,
especially in the reduction of cortical
bone critical stresses, of tensile and
shear.
Geometrical shape of the extended
divergent collar design promotes the
reshaping and strengthening of the
cortical bone crest.

REFERE
NCES

Flemming I. Loss of osseointegration caused by

occlusal load of oral implants. A clinical and
radiographic study in monkeys. Clin Oral
Implants Res 1996;7: 143-52.
Bozkaya D, Muftu S, Muftu A. Evaluation of load
transfer characteristics of ve different
implants in compact bone at different load
levels by nite elements analysis. J Prosthet
Dent 2004;92:523-30.
Boldt J, Knapp W, Proff P, Rottner K, Richter EJ.
Measurement of tooth and implant mobility
under physiological loading conditions. Ann
Anat 2012;194: 185-9.
Sekine H, Komiyama Y, Hotta H, Yoshida K.
Mobility characteristics and tactile sensitivity of