Journal of Oral Rehabilitation 2000 27; 538545

A natural tooths stress distribution in occlusion with a

dental implant
I. AKPINAR*, N. ANIL* & L. PARNAS

*Hacettepe University Faculty of Dentistry, Department of Prosthodontics,

and The Middle East Technical University, Faculty of Mechanical Engineering, Ankara, Turkey

SUMMARY

The loss of one or more teeth is normally treated with conventional fixed or removable partial dentures or with implant supported
fixed or removable dentures. This study investigated stresses formed around the implant and the
antagonist natural tooth under occlusal force in
the substitution of a missing lower first molar
with a rigid or resilient IMZ (Intra Mobil Zylinder)

implant, using the finite element stress analysis

method. The results indicate that a bite force of
143 N resulted in high compressive stresses around
the roots of a natural tooth opposing a restoration
supported by an IMZ implant with rigid type
abutment. It is speculated that these high compressive stresses may contribute to intrusion of
the tooth.

Introduction

around the implant (Steenberghe, Lekholm & Bolender, 1990).

The IMZ (Intra Mobil Zylinder) implant system differs
from other implant systems in that it incorporates a
polyoxymethylene intra-mobile component designed
to provide stress distribution (Babbush, Kirsch & Mentag, 1987; Benzing et al., 1987; Interpore International,
1987). The intra-mobile component (IME) compensates for the lack of natural movement inherent to the
tooth, the periodontal ligament and the alveolar complex (Kirsch & Mentag, 1986; Babbush et al., 1987;
Kirsch & Ackermann, 1989). The use of a resilient IME
theoretically restores the shock-absorbing capacity to
the implant complex, thus preventing stress overload.
Root intrusion of the natural tooth has been observed
in cases of natural toothrigid implant combinations
(Ismail, Meffert & Fagan, 1990; Charles, 1993). In order
to prevent this occurrence, Lill, Matejka & Rambousek
(1988) proposed the use of stress-breaking elements.
The purpose of this study is to analyse the stress
distribution under bite force in the implant, the antagonist tooth and the area surrounding them using the
finite element stress analysis method.

The functional and aesthetic demands of patients for

prosthetic reconstruction often lead to a fixed prosthesis. Therefore, the therapeutic possibilities of conventional reconstructive dentistry are very much in
demand. In the majority of cases, it is necessary to place
an implant in order to reach this goal.
The mechanical situation at the osseointegrated implant bone interface is quite different to that at the
natural tooth bone interface. While the tooth hangs on
the alveolar bone by means of the periodontal ligament, the osseointegrated implant is tightly and directly
attached to the bone (Williams, Levin & La Pointe,
1985; Chapman, 1989). That is the reason why the
implant and the neighbouring bone are exposed to
different stresses under bite forces as compared with
the natural tooth. The ratio of amount of movement of
a tooth in a heatly periodontium to that of an osseointegrated dental implant has been estimated to be
between 10 : 1 and 100 : 1 (Richter, 1989). Over the
course of time, this potential difference in movement
amount could result in gradual loss of crestal bone
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OCCLUSAL STRESS ON DENTAL IMPLANT

Materials and methods

A multipurpose finite element package ANSYS* was
used for this study.
The mathematical model was prepared in accordance
with the specifications provided by the manufacturing
company. These model geometries were then digitized
using the design program, an Intel-based 486 PC and
an 18 18 digitize tablet.
The models were preprocessed in ANSYS* to generate the meshed structure, in order to place the necessary boundary conditions and loading. The
mathematical models shown in Fig. 1 have 2743 elements and 16 606 active d.f.

In the model of the occlusion state, it was accepted

that the upper compartment, which includes the maxilla, was immobile and that vertical and lateral excursions similar to the natural tooth were provided for the
mandibular model. Three-point contact was supplied in
occlusion. A 143 N bite force was applied from the
mandible parallel to the long axis of the implant tooth
system.
It was assumed that there is a perfect connection
between the cortical bone, the trabecular bone and the
implant body. The tissues are assumed to be linearly
elastic materials with different elasticity moduli and
Poissons ratios as shown in Table 1.
The results of the analysis were adapted to be processed on the Silicon Graphics Show-Case program.

Results
Stress distribution patterns and values at the buccal and
palatal root apex of the natural tooth and at the implant
apex

Fig. 1. Mathematical models.

Table 1. Elastic material properties

Metal (gold)
Dentine
Periodontal
ligament
Cortical bone
Trabecular bone
Titanium P35
Polyoxymethylene

Elasticity modulus (kg/cm2)

Poissons ratio

2 040 800
189 800
703

033
031
045

102 400
5102
1 055 102
35 175

030
030
035
035

* Swanson Analysis System, Inc., Canonsbury, PA, U.S.A.

Friedrichsfeld AG, Mannheim, Germany.

Autodesk, Inc., San Rafael, CA, U.S.A.

Similar stress distribution patterns were observed in

the area around the natural tooth counterfacing the
rigid and resilient implants (Figs 2,3 and 6). It was
found, however, that stress values were different. The
tensile stress value defined at the buccal root apex of
the tooth, situated contrary to the resilient type implant, was higher than that at the antagonist of the
rigid type implant. As for the compressive stresses,
their values were higher for the rigid type in both the
buccal and the palatal root apices (Table 2). Similar
stress distribution contours are observed for the apices
of both implants (Figs 2, 3 and 7).
Tensile and compressive stress values in the rigid
implant apices were found to be higher than those of
the resilient type, as shown in Table 3.
Stress distribution and values at the cervical area of the
natural tooth and the implants
As shown in Figs 2 and 6, the tensile stress values
obtained for nearly all parts of the natural tooth situated contrary to the resilient type of implant were
higher in comparison with the rigid type.
In the buccal cervical only, the compressive stress
values of the tooth counterfacing the rigid implant
were found to be higher.

Mountain View, CA, U.S.A.

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I . A K P I N A R et al.

Fig. 2. Tensile stress patterns around rigid

and resilient type implants and around the
occluding tooth (N/cm2).

Tensile and compressive stress values in the area

surrounding the rigid implants were generally higher
than those of the resilient type (Figs 2, 3 and 7). Lower
tensile stress values for the rigid type were found only
in the buccal area. It is also observed that in the rigid
type, stress distribution contours formed at the implant bone interface, while the resilient type implant
system does not exhibit this behaviour.
Stresses, in particular compressive ones, are concentrated around the intra-mobile element and in the
implant body (Fig. 3, Table 3).

Strain distribution and values at the apex of the natural

tooth and the implant apices
Similar strain distributions were observed in the area
surrounding the natural tooth situated contrary to both
implant types (Figs 4, 5 and 8).
The compressive strain values in the buccal root
apex of the tooth counterfacing the rigid implant were
greater in comparison with the tooth counterfacing the
resilient implant (Figs 5 and 8, Table 2).

In the apices of both implant types, the strain values

were found to be very close to one another (Figs 4, 5
and 9, Table 3).

Strain distribution and values at the cervical area of the

natural tooth and the implants
With the exception of the palatal cervical area of the
natural tooth counterfacing the resilient implant, the
strain values determined for all parts of the tooth
counterfacing the rigid implant were determined to be
higher than the corresponding values of the tooth
counterfacing the resilient implant (Figs 4,5 and 8,
Table 2).
For both cases, it was found that in the palatal part
of the palatal root the tensile and the compressive
strain values were quite high (Figs 4, 5 and 8, Table 2).
Higher compressive strain values were found both in
the buccal and in the lingual part of the resilient
implant. However, tensile strain values were equal for
both implant types (Figs 4, 5 and 9, Table 3).

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Fig. 3. Compressive stress patterns around

rigid and resilient type implants and
around the occluding tooth (N/cm2).

Table 2. Maximum stress and strain values around molar tooth

Maximum stress (N/cm2)
Rigid

AB
AP
CB
CP

Maximum strain (x10-3)

Resilient

Rigid

Resilient

Tension

Compression

Tension

Compression

Tension

Compression

Tension

Compression

160
300
275
570

1377
2500
967
2478

224
250
388
645

1254
2478
802
2731

250
393
050
160

559
803
040
170

135
428
070
148

318
889
043
197

AB =Apex, buccal root; AP = apex, palatal root; CB = buccal side of buccal root, cervical third; CP = palatal side of
palatal root, cervical third.
Table 3. Maximum Stress and Strain Values around Implant
Maximum strain (103)

Maximum stress (N/cm2)

Rigid

A
CB
CL

Resilient

Rigid

Resilient

Tension

Compression

Tension

Compression

Tension

Compression

Tension

Compression

030
400
400

4162
4162
3300

025
450
200

4105
4000
3046

306
070
070

750
067
050

308
070
070

759
078
070

A= Apex; CB =cervical, buccal side; CL = cervical, lingual side.

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I . A K P I N A R et al.

Fig. 4. Tensile strain patterns around rigid

and resilient type implants and around the
occluding tooth ( 10 3).

Fig. 5. Compressive strain patterns

around rigid and resilient type implants
and around the occluding tooth
(10 3).

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OCCLUSAL STRESS ON DENTAL IMPLANT

Fig. 6. Maximum stress distribution

around tooth counterfacing resilient
and rigid type implants.

Discussion
In this study, stresses formed in an implant substituting
a lower molar tooth and its antagonist, as well as in the
area surrounding them, were investigated. This area
was particularly chosen because the incidence of a
missing first molar is high and because it has the most
important role in chewing (Ranget & Sullivan, 1993).
In creating the mathematical model, the upper first
molar, which has more than one root, was chosen. It
was supposed that the difference in the shape and
length of each root would cause a difference in the
stress and strain values (Wheeler, 1974). As our analysis was two dimensional, only one buccal root and the
palatal root were designed in the mathematical model.
In this model, the cylindrical type implant recommended for one missing tooth was used (Rieger et al.,
1989). As the importance of ensuring a perfect occlusion is well known, three-point contact was provided
in the mathematical model. The most important
biomechanical characteristic demanded from a successful osseointegrated implant is its resistance to chewing
force (Brunski & Hipp, 1984).
Although the extent of the force necessary to cause
failure of the implant is not known, it is supposed to be
much greater than the maximum bite force recorded
clinically (Brunski & Hipp, 1984; Skalak, 1985). In our
study, a bite force of 143 N was applied as near as
possible to the long axis of the implant tooth system
and parallel to it (Wimmer, 1987; Bragger, Hammerle
& Weber, 1990). The use of rigid and resilient IMZ
implants has been the subject of a number of studies

(Babbush et al., 1987; Lill et al., 1988; Chapman, 1989;

McGlumphy, Campagni & Peterson, 1989; Ow & Ho,
1992; Charles, 1993). While some claimed that resilient implants provided advantages in stress transfer
(Babbush et al., 1987; Benzing et al., 1987),
McGlumphy et al. (1989) acknowledged that rigid and
resilient internal elements do not take part in the stress
distribution. The results of our study, however, appear
to be contrary to the latter. The compressive stress
values in the apices of both implants were higher than
the tensile stress values. While the stresses that could
influence the success of the implant arise in the cervi-

Fig. 7. Maximum stress distribution around resilient and rigid

type implants.

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I . A K P I N A R et al.

Fig. 8. Maximum strain distribution

around the tooth counterfacing resilient
and rigid type implants.

cal part of the rigid type implant, they arise around the
intra-mobile element within the implant in the resilient implant. Besides, the deformation of titanium as
compared with that of bone is so negligible that it may
not be taken into account (Haraldson, 1980). That is
why the implant reacts as a rigid body when force is
applied. Bone, however, undergoes a certain deformation (McGlumphy et al., 1989). The loads meet at the
implant bone interface (Chapman, 1989). If these
stresses override the limit of tolerability, the result
would be a failure. For this reason, the changeability of
the resilient intra-mobile element may be of use for the
prolongation of the implants life. Besides, the high
strain values in the palatal cervical part of the tooth
suggest that with time the tooth may be pushed towards the palatal.
The high compressive stresses around the buccal root
of the natural tooth counterfacing the rigid type implant lead to the conclusion that these stresses may
cause intrusion of the tooth. It may be assumed that a
considerably long period of use could impair the carefully designed tooth implant occlusal contact and consequently also affect the life of the implant.
It can be concluded from the results of this study
that the success of an implant supported reconstruction
is not only dependent on the implant itself or its
connections with neighbouring teeth. The influence of
an implant supported reconstruction on antagonist
teeth may also be important for the success of
treatment.

Clinical implications
Occlusal stresses generated around a resilient or rigid
type implant and an antagonist tooth are important for
the selection of the proper implant type.
A rigid type implant may be the source of intrusive
stresses around the antagonist tooth. Besides, there is a
concentration of stresses in the boneimplant interface. Therefore, a rigid type implant should not be
preferred.

Fig. 9. Maximum strain distribution around resilient and rigid

type implants.

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OCCLUSAL STRESS ON DENTAL IMPLANT

In the resilient implant, stresses are concentrated in
the intra-mobile element. This peculiarity and the
changeability of the intra-mobile element make the use
of this implant type more advantageous.

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Correspondence: Dr Nesrin Anil, Hacettepe University, Faculty of

Dentistry, Department of Prosthodontics, 06100 Ankara, Turkey.
E-mail: anesrin@yahoo.com

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