Biomechanical consequences of progressive marginal bone loss around oral implants: a finite element stress analysis

The purpose of this study was to explore the biomechanical effects of progressive marginal bone loss in the peri-implant bone. Finite element model of a Ø 4.1 × 10 mm Straumann dental implant and a solid abutment was constructed as predefined eight-layers around the implant neck. The implant-abutment complex was embedded in a cylindrical bone model to analyze bone biomechanics regardless of anatomical influences. Angular and circular progressive marginal bone loss was simulated by sequential removal of each layer, resulting crater-like defects and a total of ten finite element models for analysis. Each model was subjected to a vertical and oblique static load of 100 N in separate load cases. Principal stress minimum and maximum, displacement, and equivalent of elastic strain outcomes were compared. Under vertical loading, principal stresses minimum and maximum decreased remarkably as with the increase in bone resorption. Under oblique load simulations, decrease in principal stress maximum and minimum was evident. With progressive bone loss and under oblique load simulations, displacement and equivalent of elastic strain increased considerably in trabecular bone contacting the implant neck. The presence of cortical bone contacting a load-carrying implant, even in a bone defect, improves the biomechanical performance of implants in comparison with only trabecular bone support as a sequel of progressive marginal bone loss.     

Numerical simulation of the effect of time-to-loading on peri-implant bone

PurposeTo evaluate the effect of time-to-loading on trabecular bone around single-tooth dental implants using numerical solutions based on computer models.Materials and methodsA global model with a coarse mesh carrying a Straumann dental implant (043.033S; Institut Straumann, Basel, Switzerland) was created. A region of interest in trabecular bone was defined to study a localized part of the global model with a refined mesh. Time-to-loading submodels to simulate 2 h, 4 days, 1, 4, 6 and 12 wks of trabecular bone-healing status were designed and created. Bone types were considered in the simulation by different elastic bone properties. A 100-N oblique static load was applied. Maximum and minimum principal stresses were calculated and visualized.ResultsBone types with higher elastic moduli experienced higher stress levels. Changes in the quality and quantity of bone at the bone-implant interface did not affect the overall stress distribution. Peri-implant bone with a higher elastic modulus preserved the stress increase at the implant–bone interface.DiscussionReduced bone contact may not have a prevailing effect over bone quality and quantity on stress generation at the peri-implant bone.ConclusionTime-to-loading of single-tooth implants may not differ in terms of load distributions in neighboring peri-implant bone.     

植体弹性模量变化对牙种植体和骨组织应力分布的影响

目的通过三维有限元法分析,探讨植体弹性模量变化对牙种植体和骨组织应力分布的影响,为新型牙种植系统的研究提供实验依据。方法应用螺旋CT数据,建立下颌骨和种植体模型。设定植体弹性模量分别为110、90、70、55和40 GPa,模拟咬合状态,在垂直、水平、斜向分别施加300、100、130 N静止载荷,计算并分析各组在3种载荷下植体周围骨组织和牙种植体各部分的应力。结果随着植体弹性模量的降低,水平和斜向载荷下牙种植体周围皮质骨受到的应力会随之降低,种植体的应力也呈逐渐减小趋势。结论降低牙种植体材料的弹性模量有利于载荷在种植体和周围骨组织中的传导,降低种植义齿晚期失败的风险。     

牙科即刻种植中不同螺纹形态及深度设计参数种植体的生物力学性能

目的分析牙科即刻种植中不同螺纹形态和螺纹深度种植体周围骨质应力分布情况,为种植体的设计和选择提供依据。方法利用Geomagic Studio、Solid Works和ANSYS Workbench建立下颌骨骨块、种植体及下颌磨牙简化模型,施加垂直载荷和斜向载荷,观察不同螺纹形态和螺纹深度的种植体及其周围骨组织应力分布情况。结果垂直载荷作用下,种植体、皮质骨、松质骨应力峰值变化范围分别为120. 51～129. 63 MPa、9. 94～13. 25 MPa、3. 92～8. 01 MPa,V形、矩形、支撑形、反支撑形种植体周围皮质骨在螺纹深度0. 40～0. 45 mm范围内应力变化平稳;斜向载荷作用下,种植体、皮质骨、松质骨应力峰值变化范围分别为220. 23～286. 51 MPa、33. 39～45. 08 MPa、4. 96～12. 5 MPa。螺纹深度为0. 45 mm,V形、支撑形、反支撑形种植体应力最小。结论 V形、支撑形、反支撑形螺纹种植体选择螺纹深度为0. 45 mm,矩形种植体选择螺纹深度0. 40 mm,呈现出较好的生物力学特性。     

Time-lapsed imaging of implant fixation failure in human femoral heads

The failure mechanisms of bone–implant constructs are still incompletely understood, because the role of the peri-implant bone in implant stability is unclear. We hypothesized that implant fixation failure is preceded by substantial peri-implant bone failure. A new device was developed that combines mechanical testing of large bone–implant constructs with high-resolution peripheral quantitative computed tomography, following the principles of image-guided failure assessment (IGFA). In this study, we investigated the push-in failure behavior of dynamic hip screws (DHS) implanted in human cadaveric femoral heads. For the first time the fixation failure of a clinically used implant in human trabecular bone could be experimentally visualized at the microstructural level. The ultimate force was highly correlated with the peri-implant bone volume fraction (R² = 0.85). We demonstrated that primary fixation failure of DHS implants was accompanied by trabecular bone failure in the immediate peri-implant bone region only. Such experimental data are crucial to enhance the understanding on the quality of the bone–implant interface and of the trabecular bone in the process of implant fixation failure. We believe that this newly developed device will be beneficial for the development of new implant designs, especially for use in osteoporotic bone.     

The influence of Young's modulus of loaded implants on bone remodeling: an experimental and numerical study in the goat knee

The aim of this study was to examine the influence of the Young's modulus of the implant material on the bone remodeling in a loaded condition. A combined animal experimental and computational study was set up. The animal experimental group comprised of 16 Saanen goats, each receiving one titanium implant (Young's modulus 110 GPa) and one high-density polyethylene (HDPE) implant (Young's modulus 1 GPa) in the left femoral condyle. Both types of implants received a titanium coating of 100 nm thickness. The implants protruded in the knee joint space and were directly weight bearing. The first group of eight goats was sacrificed after 6 weeks of loading and the second group of eight goats after 6 months of loading. The 16 femoral condyles with the 32 implants were prepared for microfocus computed tomography (micro-CT) scanning and histological sectioning. Three-dimensional trabecular bone parameters were calculated on the micro-CT images for the zones neck, middle, and apex of the implant. The percent of bone contact with the implant was measured on longitudinal histological sections. An axisymmetric finite element (FE) model was created to compare peri-implant bone strains and relative motion between a titanium and a HDPE implant for the experimental loading condition, and to assess the influence of different bone-implant interface (contact) conditions. From the statistical analysis of the 3D bone parameters, the difference between the titanium and HDPE implants was not significantly different (p > 0.05) between the zones (neck, middle, and apex) for both groups of goats. The implants could be considered in their entirety. After 6 weeks of loading, the PE implant presented lower connectivity and smaller marrow spaces in the circular region of 0-500 microm. In the region 500-1500 microm more bone volume was present for the PE implant. After 6 months, the PE implants showed more bone volume and thicker trabeculae than the titanium implants for the entire length of the implant. This effect was already present in the smallest region of interest, 0-500 microm. After 6 months more fibrous encapsulation was found around titanium implants. FE results demonstrated a substantial influence of the interface conditions on peri-implant strains and relative motion. For interface conditions that were representative for the early postoperative situation (involving press-fit and friction), differences in peri-implant bone strain distributions between titanium and HDPE could be related to the experimentally observed differences in amounts of bone and fibrous encapsulation. In contrast, differences in relative motion did not seem to play a role. Both the experimental and computational results suggest that implant stiffness can affect the peri-implant tissue response, which may be related to differences in peri-implant strains.     

Ⅱ类和Ⅲ类骨质植入深度对平台转换种植体周围骨应力分布影响的有限元分析

目的 比较植体不同植入深度时Ⅱ类和Ⅲ类骨质中种植体周围牙槽骨应力分布特征,指导临床选择合适的种植方案以均衡应力分布。 方法 利用Abaqus 6.13分别绘制下颌后牙区牙槽骨骨块与Straumann骨水平种植体模型以及下颌第一磨牙的牙冠简化模型。分别加载垂直向200 N、水平向20 N的载荷,观察不同植入深度下种植体周围骨皮质的最大应力和应力分布特征。 结果 当平台转换种植体上表面与骨皮质上表面相平时,可以观察到种植体周围骨组织最大von Mises应力(MVMS)位于骨皮质表面,随着种植体植入深度的增加,骨皮质内MVMS也随之移动,基本保持在种植体上表面周围的骨皮质内,并在种植体上表面位于骨皮质一半厚度时达到MVMS的最低值。 结论 Ⅱ类和Ⅲ类骨质平台转换种植体周围骨MVMS出现于种植体周围皮质骨内,皮质骨的应力集中则主要位于与颈部平台接触区,调整种植体植入深度可以改变皮质骨中应力集中位置。种植体上表面位于牙槽嵴下水平时,有利于减轻牙槽嵴顶皮质骨的应力。     

Effect of a thin HA coating on the stress/strain distribution in bone around dental implants using three-dimensional finite element analysis

Three-dimensional finite element analysis was performed for thin hydroxyapatite (HA) coated and titanium dental implants to study the effects on stress/strain distribution in the mandible with application of axial and oblique loads. The implants were of screw and cylinder types. With an axial load, the maximum equivalent bone stresses in the titanium implants were 21.5 and 29.0 MPa for the cylinder and screw types respectively, and the stress and strain distributions differed. For the cylinder type, the highest stress was located at the implant base, and for the screw type, it was located at the top edge of the first thread within the cortical bone. For the HA-coated cylinder and screw implants, the maximum equivalent bone stresses were 7.1 and 7.2 MPa respectively. The stress and strain distributions were similar, and the highest stress was located on the upper side of the cortical bone around the implant neck for both implants. Of the implants examined, the screw type HA-coated implant had the most uniform stress distribution in bone.     

TM种植体骨界面应力分布的有限元分析

背景：种植体形态是决定种植体骨界面应力分布的重要因素之一。探讨顺应人体正常颌骨解剖形态的TM种植体骨界面的应力分布特征对临床医生选择和设计种植体有指导意义。 目的：观察集中荷载作用下TM种植体及其周围骨组织应力分布的特征。 方法：通过逆向工程技术,将二维下颌骨CT图片转化为三维实体模型,并建立3种包含不同锥度的TM种植体真实下颌骨B/2类骨质的有限元模型,利用有限元技术研究两种加载方式下TM种植体骨界面应力分布特征。 结果与结论：垂直加载时,对于锥度较大的TM种植体周边密质骨承受较小的应力;斜向加载时,对于锥度较大的TM种植体周边密质骨和松质骨承受较大的应力;种植体颈部,密质骨上缘与种植体接触处和种植体底部松质骨出现明显应力集中现象,斜向荷载下种植体骨界面的应力分布显著高于垂直荷载下的应力分布。从1/2长度开始变化的TM种植体骨界面在垂直荷载下表现出较好的应力分布特征。     

The influence of surface porosity on gap-healing around intra-articular implants in the presence of migrating particles

The aim of the present study was to compare the effect of two different porous coatings on bone ongrowth and on the peri-implant migration of polyethylene (PE) particles. Porous-coated cylindrical implants with an either plasma-sprayed closed-pore coating (Pl) or titanium fiber metal open-pore coating (Fi) were inserted intra-articular in exact fit or with a 0.75 mm peri-implant gap. A weight-loaded implant device in the distal femur was used. We used a randomized paired design in eight dogs. PE particles were injected repeatedly intra-articular in the knee until the dogs were killed after 8 weeks. Fi implants had significantly more bone ongrowth 8 (0-21)% compared with Pl implants 0 (0-0)% in gap situations and reduced the number of peri-implant PE particles significantly. Among exact-fitted implants we found that peri-implant tissue around Pl implants consisted of significantly more fibrous tissue than around Fi implants. A sealing effect against the migration of PE particles was found for both Fi and Pl implants in exact fit.     

The quantitative assessment of peri-implant bone responses using histomorphometry and micro-computed tomography

In the present study, the effects of implant design and surface properties on peri-implant bone response were evaluated with both conventional histomorphometry and micro-computed tomography (micro-CT), using two geometrically different dental implants (Screw type, St; Push-in, Pi) either or not surface-modified (non-coated, CaP-coated, or CaP-coated + TGF-β1). After 12 weeks of implantation in a goat femoral condyle model, peri-implant bone response was evaluated in three different zones (inner: 0–500 μm; middle: 500–1000 μm; and outer: 1000–1500 μm) around the implant. Results indicated superiority of conventional histomorphometry over micro-CT, as the latter is hampered by deficits in the discrimination at the implant/tissue interface. Beyond this interface, both analysis techniques can be regarded as complementary. Histomorphometrical analysis showed an overall higher bone volume around St compared to Pi implants, but no effects of surface modification were observed. St implants showed lowest bone volumes in the outer zone, whereas inner zones were lowest for Pi implants. These results implicate that for Pi implants bone formation started from two different directions (contact- and distance osteogenesis). For St implants it was concluded that undersized implantation technique and loosening of bone fragments compress the zones for contact and distant osteogenesis, thereby improving bone volume at the interface significantly.     

In vivo behaviour of hydroxyapatite coatings on titanium implants: a quantitative study in the rabbit

The aim of this study was to evaluate quantitatively the behaviour of in vivo hydroxyapatite coated implants (HA) in the rabbit over time, and to compare the results with observations made on titanium plasma spray implants (TPS). Results were analysed according to the percentage of bone contact. Eighteen HA cylindrical implants (3.25 x 8 mm) and 6 TPS cylindrical implants from Steri-Oss were placed in the epiphysis of the femur in 24 white rabbits. Each rabbit received one implant. Three rabbits with one HA implant (n = 3) and 1 rabbit with one TPS implant (n = 1) were sacrificed after implantation periods of 2, 4, 6, 8, 10 and 12 months. Implants were cut along the long axis and prepared for histological and histomorphometrical evaluations. Measurements of coating thickness and percentage of bone contact were performed with scanning electron microscopy analysis on the sides of the implant, in 3 different types of bone, namely cortical, trabecular and marrow. In cortical bone, dense bone was apposed to the HA implants: from 92.3 +/- 5.5% at 2 months to 89.6 +/- 6.5% at 1 year, with no significant regression of HA thickness (P = 0.37). TPS coating showed less bone contact, but thickness was stable (P = 0.46). In trabecular zone, where bone contact was less pronounced, a significant regression of HA coatings thickness (P < 0.05) was observed. Nevertheless TPS coatings were stable (P = 0.81). Histomorphometrical results demonstrated that a highly significant regression (P < 0.0001) of HA thickness was observed in the marrow area, where the bone-to-implant contact never exceeded 7.6% from 2 to 12 months. TPS coating did not reveal any sign of resorption (P = 0.88), despite a rare bone contact. Histological analysis revealed inflammatory and giant cells, principally in the marrow area in contact with HA coating, but always in restrictive numbers. We conclude that bone contact protected the HA coating from resorption.     

Histologic and histomorphometric evaluation of early and immediately loaded implants in the dog mandible

New bone formation around US III OSSTEM implants after early and immediate loading was evaluated in this study. Three premolars and the first and second molars were first removed from the left mandible of five dogs. At 3 weeks after extraction of the teeth in the left mandible, the corresponding teeth in the right mandibles were removed. After 12 weeks of bone healing, five implants were placed in the left mandible. At 3 weeks after placement of implants in the left mandible, another five were placed in the right mandible. At the time of placing implants in the right mandible, four implants on each side were restored using a fixed provisional restoration. The anterior-most implant was not loaded and was used as controls. Periotest measurements performed immediately after implantation and after 16 weeks loading indicated implant stability for all groups tested. At 16 weeks after loading, the rate of peri-implant bone formation for the early loaded, immediately loaded (IL), and control implants were observed to be 75.00, 73.37, and 62.04%, respectively. It was thus concluded that early stability was achieved in early and IL implants using fixed provisional restoration, thereby resulting in the high rate of peri-implant bone formation.     

Bone strains around apically free versus grafted implants in the posterior maxilla of human cadavers

The objective of this study was to compare the bone strains of apically free versus grafted implants in the posterior maxilla. The experiments were undertaken in four edentulous maxillary posterior regions of fresh human cadavers, having a minimum bone height of 8 mm. In each bone fragment, two Ø 4.1 mm × 12 mm Straumann^® implants were placed, and insertion torque values (ITV) and implant stability quotients (ISQ) of the implants were quantified to determine implant anchorage. Two splinted crowns were fabricated for each experimental model. Strain gauges were bonded on the buccal and sinus floor cortical bones around apically free and grafted implants. Microstrains were recorded by a data acquisiton system and corresponding software at a sample rate of 10 KHz under central and buccally oriented lateral–axial static loads of 100 and 150 N in separate cases. The data were compared by independent T test at a significance level set at P < 0.05. Bone tissue strains on the buccal cortical areas adjacent to apically free implants were higher than those of apically grafted implants (P < 0.05). The differences ranged between 10 and 48 με under central and lateral axial loads of 100 and 150 N. The shift in load application from central to buccally oriented lateral axial mode increased strains between 60 and 201 με on buccal cortical bone around apically free and grafted implants (P < 0.05). Bone strains around anterior implants were higher than those of posterior implants. Microstrains in the sinus floor cortical bone in apically grafted models were slightly higher than apically free models. Bone tissue strains on the buccal cortical areas adjacent to apicallyfree implants are higher than those of apically grafted implants. Sinus lifting, resulting in an enhanced apical support, slightly increases strains at the sinus floor region, but leads to a decrease in bone strains around the collar of supporting implants.     

长径比差异对牙种植体-颌骨界面的应力分布影响

目的探讨不同长径比下牙种植体-颌骨界面的应力分布差异,为新型牙种植体结构的设计提供依据。方法运用Geomagic studio、SolidWorks和ANSYS Workbench软件建立下颌骨三维有限元模型,并根据种植体颈部有、无螺纹分成A、B两组进行仿真实验,对下颌磨牙分别施加不同的斜向咬合力和垂直向咬合力,对比分析牙种植体和周围骨组织的应力分布情况。结果长径比相同的情况下,同一种植体模型在斜向载荷作用下的等效应力峰值明显高于垂直载荷;在斜向和垂直两种载荷作用下,A、B组种植体模型应力主要集中于种植体颈部。斜向载荷作用下,A、B组种植体应力变化范围分别为144.74～374.67、161.52～475.38 MPa;垂直载荷作用下,A、B组种植体应力变化范围分别为101.28～187.40、110.08～210.32 MPa,A组种植体模型最大应力显著小于B组。结论临床上医生可根据长径比2.67初步选择标准种植体,同时结合患者颌骨状况进行选择。     

Detachment of titanium and fluorohydroxyapatite particles in unloaded endosseous implants

The shape, surface composition and morphology of orthopaedic and endosseous dental titanium implants are key factors to achieve post-surgical and long-term mechanical stability and enhance implant osteointegration.In this study a comparison was made between 12 titanium screws, plasma-spray-coated with titanium powders (TPS), and 12 screws with an additional coating of fluorohydroxyapatite (FHA-Ti). Screws were implanted in the femoral and tibial diaphyses of two mongrel sheep and removed with peri-implant tissues 12 weeks after surgery.The vibrational spectroscopic, ultrastructural and morphological analyses showed good osteointegration for both types of implants in host cortical bone. The portion of the FHA-Ti implants in contact with the medullary canal showed a wider area of newly formed peri-implant bone than that of the TPS implants.Morphological and EDAX analyses demonstrated the presence of small titanium debris in the bone medullary spaces near the TPS surface, presumably due to the friction between the host bone and the implant during insertion. Few traces of titanium were detected around FHA-Ti implants, even if smaller FHA debris were present.The present findings suggest that the FHA coating may act as a barrier against the detachment of titanium debris stored in the medullary spaces near the implant surface.     

The effect of surface immobilized bisphosphonates on the fixation of hydroxyapatite-coated titanium implants in ovariectomized rats

Immobilized bisphosphonates (BPs) have been introduced to improve implant fixation, however, no information could be found about the efficiency of this approach in osteoporotic bone. This study was designed to evaluate the bone response to surface immobilized BPs on implants inserted in tibiae of ovariectomized (OVX) rats. Three months after bilateral ovariectomy, 40 rats were randomly assigned into four groups for implantation of hydroxyapatite-coated titanium implants with or without immobilized BPs: (1) control group (without BP treatments); (2) pamidronate (PAM) group (1 mg/ml of PAM immersing); (3) ibandronate group (1 mg/ml of ibandronate immersing); and (4) zoledronic acid (ZOL) group (1 mg/ml of ZOL immersing). After implantation periods of 3 months, the peri-implant–bone density, trabecular microstructure, bone–implant interface and mechanical fixation of implants were evaluated by dual energy X-ray absorptiometry, micro-computed tomography, histology and push-out test. We found that three BPs triggered pronounced bone–implant integration and early bone formation around implants in OVX rats, with a rank order of ZOL > ibandronate > PAM. These results provide new evidence that immobilized BPs have positive effects on implant fixation in osteoporotic bone, in addition to their well-documented potency to inhibit implant loosening in normal bone.     

Comparison of dental implant stabilities by impact response and resonance frequencies using artificial bone

PurposeWe compared implant stability as determined by the peak frequency from the impact response with the implant stability quotient (ISQ) by resonance frequency analysis (RFA) in various artificial bone conditions. The clinical bone conditions were simulated using an artificial bone material with different cortical thicknesses and trabecular densities.Materials and methodsThe artificial bone material was solid, rigid polyurethane. The polyurethane foam of 0.8 g/cm³ density was used for the cortical bone layer, and that of 0.08, 0.16, 0.24, 0.32, and 0.48 g/cm³ densities for the trabecular bone layer. The cortical bone material of 4 different thicknesses (1.4, 1.6, 1.8, and 2.0 mm) was attached to the trabecular bone with varying density. Two types of dental implants (10 and 13 mm lengths of 4.0 mm diameter) were placed into the artificial bone blocks. An inductive sensor was used to measure the vibration caused by tapping the adapter–implant assembly. The peak frequency of the power spectrum of the impact response was used as the criterion for implant stability. The ISQ value was also measured for the same conditions.ResultsThe stability, as measured by peak frequency (SPF) and ISQ value, increased as the trabecular density and the cortical density increased in linear regression analysis. The SPF and ISQ values were highly correlated with each other when the trabecular bone density and cortical bone thickness changed (Pearson correlation = 0.90, p < 0.01). The linear regression of the SPF with the cortical bone thickness showed higher goodness of fit (R² measure) than the ISQ value with the cortical bone thickness. The SPF could differentiate implantation conditions as many as the ISQ value when the trabecular bone density and the cortical density changed. However, the ISQ value was not consistent with the general stability tendency in some conditions.ConclusionThe SPF showed better consistency and differentiability with implant stability than the ISQ value by resonance frequency analysis in the various implantation conditions.     

Effect of the difference of bone turnover on peri-titanium implant osteogenesis in ovariectomized rats

High and low bone turnover situations, both of which are typically observed as postmenopausal and senile osteoporosis, were created by ovariectomy (OVX), and then an investigation of whether or not the difference of bone turnover affected peri-titanium (Ti) implant osteogenesis in rats was conducted. Female rats were divided into four groups. The experimental and control groups underwent OVX or sham operations at 15 or 27 weeks of age, as high or low bone turnover groups, respectively. Ti implants were inserted into the tibiae at 30 weeks, then fluorochromes were injected 10 or 20 days after the implantation for histometry. The implants were retained for 30 days and then ground sections were prepared. Afterward, the cortical bone growth rate, bone contact ratio (BCR) of the implant in both the cortical bone area and medullary canal area, and the average trabecular bone thickness around the implant were evaluated. Biochemical markers of bone turnover were also measured. Biochemical measurements indicated both increasing osteocalcin production in OVX rats and decreasing tartrate-resistant acid phosphatase activity in the low-turnover group. Histometrical measurements showed decreasing cortical growth and low BCR in the medullary canal of the low-turnover group. The high-turnover group demonstrated BCR as high as that of the control group. There was no significant difference in the average trabecular bone thickness around the implant among the groups. As a result, two types of osteoporotic situations were confirmed and it was shown that the difference of bone turnover was clearly due to the diverse osteogenesis around the Ti implant.     

Interaction phenomena between oral implants and bone tissue in single and multiple implant frames under occlusal loads and misfit conditions: A numerical approach

An investigation is carried out on the effects induced in bone tissue surrounding oral implants placed in the premolar region of a mandible by using a numerical approach. In particular, a single implant and a multiple implant frame under loading are considered. The effects of accuracy in the coupling of the connecting bar and implants are evaluated. The mechanical response of the bone-oral implant system, depending on the different mechanical properties assumed for the peri-implant bone tissue during the evolutionary trend of osseointegration, is studied. A further task regard to the comparison of the mechanical state induced in the bone depending on the loading conditions considered. Effects of physiological occlusal loads are compared with ones given by framework defects arising from the specific manufacturing process, such as misfit between the implants and the connecting bar. The investigation offers the basis for an integrated clinical and biomechanical evaluation of the effects induced on peri-implant bone, depending on bone properties, implant system configuration, and the actions induced. Analyses performed show that stress states induced by the investigated type of misfit are comparable to those arising from the application of physiological loading conditions.