Int. J. Oral Maxillofac. Surg.

2012; 41: 1090–1096

doi:10.1016/j.ijom.2011.12.026, available online at http://www.sciencedirect.com

Research Paper
Dental Implants

Finite element analysis of D. Kurniawan, F. M. Nor,

H. Y. Lee, J. Y. Lim
Department of Mechanical, Robotics, and

bone–implant biomechanics: Energy Engineering, Dongguk University,

Republic of Korea

refinement through featuring

various osseointegration
conditions
D. Kurniawan, F. M. Nor, H. Y. Lee, J. Y. Lim: Finite element analysis of bone–
implant biomechanics: refinement through featuring various osseointegration
conditions. Int. J. Oral Maxillofac. Surg. 2012; 41: 1090–1096. # 2011 International
Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights
reserved.

Abstract. A refinement technique is proposed for developing finite element models

capable of simulating peri-implant bone conditions for bone types II, III, and IV at
various degrees of osseointegration. The refined models feature a transition region
between bone (cortical and cancellous) and implant and designate it partially to fully
osseointegrated by assigning corresponding fractions of the bulk bone’s elastic
properties to this region. Bone is assumed to be transversely isotropic. The refined
technique is implemented in a case study, in which osseointegrated (25–100%) peri-
implant bone, type II, III, or IV with an implant attached, is loaded with a 100 MPa
occlusal load. The biomechanics of this peri-implant bone was simulated and analysed.
Results showed that the less dense bone must support higher stress and strain,
especially at the cortical region. Higher degree of osseointegration induced higher
Keywords: finite element analysis; osseointe-
stress but lower strain. Both the bone type and the osseointegration condition
gration; bone type; bone density; transversely
significantly affected the stress–strain relation. For minimum stress and strain, denser isotropic; stress and strain; bone overload.
and more osseointegrated peri-implant bone is desirable. When bone failure criteria
were set, based on the yield strength and strain of the bone, a higher degree of Accepted for publication 19 December 2011
osseointegration was needed for the less dense peri-implant bone to be considered safe. Available online 18 January 2012

The success of dental implants depends on
factors involving biological and biome-
chanics as well as clinical practice.1,2
An implant functions as a load bearing
structure, so an implant must withstand
and transfer external load acting on it to
the peri-implant bone. From this view, the
biomechanics of the corresponding peri-
implant bone is key in the evaluation of the
implant’s reliability and efficiency.3 For
satisfactory performance, an implant
needs to withstand the loads and the bone
tissue must support the transferred loads
without failure.2
Osseointegration of an implant to its
respective peri-implant bone determines
the stability and long term success of the
implant. Osseointegrated implant activates

0901-5027/0901090 + 07 $36.00/0 # 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

adequate support from properly remodelled
and maintained peri-implant bone.1 Quan-
titative clinical assessments revealed that
osseointegration does not occur fully.
Within the peri-implant bone, certain areas
show no bone-to-implant contact, so
osseointegration never reaches 100%.
Therefore, the effects of a partially osseoin-
tegrated peri-implant bone on the perfor-
mance of the implant need to be
investigated.
The finite element method is generally
considered to be an acceptable tool to
simulate the biomechanics of a peri-
implant bone.4 After generating the
implant and bone models, assigning mate-
rial properties, and applying loads and
boundary conditions, stress and strain
can be calculated based on the preset
governing equations and their subset algo-
rithms. Model parameters can be simpli-
fied because the finite element method is
inherently an approximation tool. A com-
mon simplification in simulating peri-
implant bone biomechanics is the assump-
tion of full osseointegration or no osseoin-
tegration. Considering the clinical reality
of osseointegration mentioned above, a
refinement technique capable of represent-
ing partial osseointegration is needed.
Through the refinement, the numerical
analysis is expected to represent the phy-
sical reality of an implantation better.
Previous work aiming to refine the
numerical simulation of bone–implant
interaction for various osseointegration
conditions is lacking. Amongst the few
references, the approach reported by Papa-
vasiliou et al.5 suggests that the osseointe-
grated portion of the bone must be assigned
the properties of cortical and cancellous
bones whereas the non-osseointegrated
portion should be assigned the properties
of connective tissue with very low stiffness.
The arrangements of partial osseointegra-
tion conditions (25–100%) were proposed
to be locally alternating, coronal only, api-
cal only, facial only or lingual only.5
Another approach2 proposed a transition
region between the implant and the bulk
structure of peri-implant bones, to represent
the conditions of bones during the healing
process. A similar technique was applied by
van Staden et al.6 by applying a blood and
bone interface filling around implant
threads when simulating the implant inser-
tion process. The latter two approaches
indicate that peri-implant bone contains
an area which does not have the same
properties as the bulk counterpart, although
partial osseointegration is not mentioned
specifically.
In this study, a refinement technique
is proposed, expected to represent peri-
FEA of partially osseointegrated bone
implant bone conditions better. Adopting
the approaches that introduce a bone–
implant transition region, this technique
assigns a fraction of the bone properties
to the transition region to represent partial
osseointegration. The refined technique is
proposed for application to various bone
types and for bones which do not perfectly
integrate to an implant even after the heal-
ing period and when the crown is fixed on
top of the implant. Whilst acknowledging
the anisotropy of bones, the bone is
approximated as a transversely isotropic
material. A case study is given to show
that the refined technique is implementable.
From this study, the stress and strain in a
peri-implant bone induced by occlusal load
are simulated, and the influence of the
degree of osseointegration is analysed.
Materials and methods
Geometric model
The first step of the numerical analysis is
to draw three-dimensional geometric
models of the jaw bone and the prescribed
implant. A detailed model of a patient’s
jaw bone can be generated using computed
axial tomography (CT scan) for conver-
sion into a computer aided drawing (CAD)
Image.7,8 In place of using CT data, a jaw
bone model can also be generated based
on the Lekholm and Zarb9 classification
for bone types II, III, and IV. The general
guideline is to have a thick cortical bone
for bone type II and a thin one for bone
types III and IV.
Within the jaw bone, a transition region
is introduced. The transition region is the
jaw bone section adjacent to the implant; it
lies beyond the outermost geometry of the
implant (usually up to 0.5 mm from the
implant’s inner diameter and proportion-
ally towards its apical region). The transi-
tion region covers both cortical and
cancellous bones, consisting of implant–
cortical and implant–cancellous transition
region portions.
A detailed implant model can be
obtained from the manufacturer, gener-
ated by using a coordinate measuring
machine,2 or it can be generated arbitra-
rily, as in the case of new implant designs.
Material properties
A set of material elastic properties are
assigned to the jaw bone models. Ideally,
the properties should represent the
anisotropy of bone. Bone is considered
anisotropic because it shows different
mechanical properties when measured in
different directions (in the same sample).
1091
Approximation may be applicable however
because the elastic moduli of a cortical
bone in buccolingual and infero-superior
directions are not significantly differ-
ent10,11 and those of a cancellous bone in
buccolingual and messiodistal directions
are similar.11,12 Thus, bone can be assumed
to be transversely isotropic. With this
approximation assumption, only five inde-
pendent elastic properties instead of nine
for an orthotropic material (independence
in all three directions but symmetry about
each perpendicular axis) or the full 21 for
anisotropic materials need to be derived
from the generalized Hooke’s law. By defi-
nition, this approximation of transverse
isotropy better represents the reality of a
bone’s anisotropy than the commonly
applied assumption of isotropy (only two
independent elastic properties required:
Poisson’s ratio and Young’s modulus). In
an isotropic material, the properties are
considered uniform in all directions, which
is not the case for the mandible. Nonethe-
less, this assumption is often assigned to
jaw bone models for simplicity.
With respect to the bone type, the
assigned elastic properties may apply to
bone type II, III, or IV. Following the
definition,9 the properties should represent
high density cancellous bone, low density
cancellous bone, and cortical bone.
The properties assigned to the bone–
implant transition region are acquired
from the properties of bulk cortical and
cancellous bones. Various degrees of
osseointegration are featured in this tran-
sition region. The assumption of perfect
osseointegration applies when the transi-
tion region has 100% bulk properties.
Partial osseointegration is represented by
fractional values of the bulk’s elastic and
shear moduli at constant Poisson’s ratio.
Case study
As an example of the above refinement
technique, a case study of mandibular
peri-implant bones of types II, III, and
IV loaded with 380 N occlusal load is
analysed. Each bone type is analysed for
conditions of 25%, 50%, 75%, and full
osseointegration.
The jaw bone is modelled arbitrarily
(Fig. 1a) and intended to resemble an
edentulous posterior mandible. The thick-
ness of the cortical layer is adjusted
according to the Lekholm and Zarb9 bone
specification, in which a thick cortical
bone (as in bone type II) is modelled as
having 2 mm thickness whilst a thin cor-
tical bone (for bone types III and IV) is
modelled as having 1 mm thickness
(Table 1).
1092 Kurniawan et al.

Fig. 1. (a) The modelled bone with dental implant attached, shown with the applied load (P) and boundary conditions; (b) the modelled dental
implant; and (c) transition regions. Also shown is the global coordinate system used in the analysis.

For the material properties of transver- material axes correspond to the global
sely isotropic peri-implant bone of type II, coordinate system shown in Fig. 1. E is
III, or IV, the elastic property values for the Young’s modulus, G the shear mod-
high density cancellous bone, low density ulus, and nij the Poisson’s ratio for strain in
cancellous bone, and cortical bone are the j direction when the bone is loaded in
used (Table 2). These are based on the the i direction.
work of O’Mahony et al.11 which includes For optimal precision and computation
cortical and cancellous bones and is time, adaptive meshing technique is used
further refined by Petrie and Williams13 to discretize the jaw bone with localized
who divided cancellous bones into high fine meshes. For high precision, the bone
and low density types. These values are areas adjacent to the implant are finely
used for the bulk cortical and cancellous meshed by adjusting the mesh seeds to be
bone properties and for the100% osseoin- very dense. These areas cover the bone–
tegrated transition region. Partial osseoin- implant transition regions and some part of
tegration of 25%, 50%, and 75% are the bulk bone regions, which are vital to
assigned to the transition region for each obtain precise results. Other bulk regions
bone type. The properties of the bones to of the jaw bone are kept roughly meshed to
be analysed are given in Table 1. The save computation time.
Table 1. Bone types according to cortical bone thickness and cancellous bone density.
Bone type Cortical bone thickness Cancellous bone density
II 2 mm High density
III 1 mm High density
IV 1 mm Low density
The contact type between the implant
and bones is ‘bonded’ or ‘merged’, in
which the implant’s outer elements and
the transition region elements share com-
mon nodes. Bonded or merged contact is
typical in commonly used techniques. The
distinctive feature of the proposed
approach is that the contact occurs
between implant and transition regions;
thus, overall, perfect osseointegration is
not necessarily assumed.
The implant is arbitrarily modelled as
shown in Fig. 1b, with length 10 mm and
diameter 3.8 mm. The implant is assumed
to be solid with its abutment attached and
is modelled as a single system. The assem-
bly aims to submerge the implant 10 mm
into the jaw bone. The titanium implant
(and its abutment) is assumed to have
stiffness of 110 GPa and Poisson’s ratio
of 0.35.
Regarding the external load, occlusal
load is subjected to the implant through
the crown. This occlusal load may induce
compression, tension, shear, and bending
moments to the peri-implant bones. For

Table 2. Material properties for the transversely isotropic bone, taking into account the degree of osseointegration.
High density cancellous bone Low density cancellous bone Cortical bone
Properties
25% 50% 75% 100% 25% 50% 75% 100% 25% 50% 75% 100%
Ex (MPa) 287 574 861 1148 57.5 115 172.5 230 3150 6300 9450 12,600
Ey (MPa) 52.5 105 157.5 210 10.5 21 31.5 42 3150 6300 9450 12,600
Ez (MPa) 287 574 861 1148 57.5 115 172.5 230 4850 9700 14,550 19,400
nxy 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.3 0.3 0.3 0.3
nxz 0.32 0.32 0.32 0.32 0.32 0.32 0.32 0.32 0.253 0.253 0.253 0.253
nyz 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.253 0.253 0.253 0.253
Gxy (MPa) 17 34 51 68 3.5 7 10.5 14 1212.5 2425 3637.5 4850
Gxz (MPa) 108.5 217 325.5 434 21.75 43.5 65.2 87 1425 2850 4275 5700
Gyz (MPa) 17 34 51 68 3.5 7 10.5 14 1425 2850 4275 5700
 FEA of partially osseointegrated bone 1093

Fig. 2. Stress distribution of bone type II at (a) 25%, (b) 50%, (c) 75%, and (d) 100% osseointegration.

simplification, the crown was not included bone, as intended. Figure 2 shows the are listed in Table 3. In accordance with
in the analysis. There are several ways to stress distribution for the type II bone at the non isotropic behaviour of bone, the
apply loads to finite element models to various degrees of osseointegration. Stress stress refers to von Mises stress, and the
represent occlusal loading on an implant, distribution is almost the same for all strain refers to equivalent strain, which
for example concentrated load (vertical, degrees of osseointegration but the highest accounts for stresses and strains in all
transversal, or their combination/oblique) stress occurred for 100% osseointegration, directions.
and pressure. Regarding the range of load of around 70 MPa at the crestal implant– The areas with the highest stress and
magnitude, Woodmansey et al.14 reported cortical transition region. In cancellous strain are mostly located in the close vici-
that maximum bite force is around 500 N bone, stress is almost nonexistent within nity. The stress induced in the less dense
for patients with normal occlusion and the thread region. Similar stress distribu- bone is higher than that induced in a
having an implant supported prosthesis tion occurs for bone types III and IV, with denser bone at the same loading. Simi-
in the area of the mandibular molars. stress magnitude increasing with higher larly, the strain caused by the load is also
The occlusal load in the current case study degree of osseointegration. higher in the less dense bone.
was arbitrarily presumed to be a pressure The results for maximum stress and From Table 3, it also appears that for the
(P) of 100 MPa on top of the abutment strain at cortical and cancellous bones same bone type, the stress is higher with
(Fig. 1a). Considering the area of the
loaded abutment, the pressure is equiva- Table 3. Maximum stress and maximum strain induced at peri-implant bone due to the load.
lent to a vertical concentrated force of
Bone Highest stress Highest strain
380 N. The boundary condition was set type Osseointegration (%)
with the ends of the mandible portion to be Cortical Cancellous Cortical Cancellous
fully constrained. (MPa) (MPa) (%) (%)
All drawings and linear static simula-
II 25 66.03 4.58 1.41 2.00
tions were conducted on commercial finite 50 68.80 5.91 0.81 1.24
element software ABAQUS v. 6.9 (Das- 75 70.15 6.61 0.57 0.90
sault Systemes S.A.). Statistical analysis 100 71.13 7.16 0.44 0.66
on the results obtained was calculated
using Design Expert (Stat-Ease, Inc.) soft- III 25 77.10 5.67 2.35 0.71
50 94.84 6.26 1.52 0.36
ware. 75 106.31 6.45 1.15 0.23
100 114.96 6.74 0.94 0.60
Results IV 25 131.52 3.00 1.92 15.03
The developed finite element models pro- 50 142.09 3.36 3.23 1.66
75 200.54 3.48 2.23 1.08
vided the magnitudes and distributions of 100 208.97 4.28 1.79 1.15
the stress and strain throughout the jaw
1094 Kurniawan et al.

Table 4. ANOVA for stress and strain at cortical bone.

Source Sum of squares Degree of freedom Mean square F value Prob > F
Maximum stress (von Mises)
Model 26,975.41 5 5395.08 64.42 <0.05
Bone type 3117.60 1 3117.60 37.23 <0.05
Degree of osseointegration 21,951.45 2 10,975.72 131.06 <0.05
Bone type  degree of osseointegration 1906.36 2 953.18 11.38 <0.05
Maximum strain (equivalent)
Model 5.81 3 1.94 9.72 <0.05
Bone type 4.42 2 2.21 11.09 <0.05
Degree of osseointegration 1.39 1 1.39 6.98 <0.05

higher degree of osseointegration. For
bone type II, the difference in stress mag-
nitude according to the degree of osseoin-
tegration is not so high, less than 8%
difference between the bone with 25%
osseointegration and the bone with
100% osseointegration. For bone type
III, the stress in the bone with 100%
osseointegration is 50% higher than the
stress in the bone with only 25% osseoin-
tegration. For bone type IV, the largest
difference in stress magnitude reaches
almost 60%.
Statistical analysis was used to quantify
the effects of bone type and degree of
osseointegration on the induced stress
and strain and determine their signifi-
cance. A response surface design invol-
ving bone type as a categorical variable
and degree of osseointegration as a numer-
ical variable was constructed. The catego-
rical variable has three levels (II, III, and
IV), whilst the numerical variable has four
levels (25, 50, 75, and 100%). Maximum
stress and strain were the responses. Ana-
lysis of variance (ANOVA) of the stress
and strain was utilized to determine the
significance of each variable. A confi-
dence interval of 95% was applied, with
probabilistic value, Prob > F, of maxi-
mum 5% set to be the criterion for the
variables to be considered significant.
Evaluation of the design showed that a
Fig. 3. Desirability, in resulting minimum stress and strain at cortical bone.
linear regression model is sufficient to
represent the variables and response rela-
tion and, thus, is used for further analysis.
For the model with stress as the response, a
check on sequential model sum of squares
(for determining the highest order poly-
nomial where additional terms are signifi-
cant and the model is not aliased)
suggested the use of a two factor interac-
tion model, whilst for the model with
strain as the response, a linear model is
suggested. ANOVA on the models and the
terms for stress and strain was conducted
(Table 4). Both stress and strain models
and all their terms were significant.
The statistical models can perform opti-
mization to determine the desirability
level (0–1, with 1 as the most desirable)
of bone type and degree of osseointegra-
tion. The desirability level was set at the
corresponding criteria because the stress
and strain induced in a peri-implant bone
is preferred to be minimal. As shown in
Fig. 3, a denser bone and a higher degree
of osseointegration are more likely to
result in less stress and strain.
Discussion
The proposed refinement technique for
simulating the biomechanics of peri-
implant bone for various degrees of
osseointegration was shown to be valid.
The common assumption in finite element
models of peri-implant bone biomecha-
nics is perfect osseointegration. This sim-
plification is applied by assigning a perfect
bond as the contact type through shared
nodes between the contacting elements of
the implant and the bone. Since full
osseointegration is not clinically realistic,
the refined finite element models assume
partial osseointegration. The proposed
technique represents partial osseointegra-
tion by introducing transition regions
between the bone and the implant. These
transition regions in the jaw bone which
surround the implant are assigned material
properties that correspond to the assumed
degree of osseointegration. This way,
although the contact type between the
transition regions and the implant is a
perfect bond, the assumption is no longer
necessarily full osseointegration of the
peri-implant bones. As a result, the pro-
posed technique can simulate more sce-
narios in terms of bone type and degree of
osseointegration. From the stress–strain
data obtained, the biomechanics of the
peri-implant bones can be observed and
analysed.
To refine the models further, the transi-
tion regions as well as the bulk bone are
considered to be non isotropic. Bones are
known to be anisotropic. Assuming bone
to be isotropic may deviate the calculated
stress–strain from the actual stress–strain
as opposed to when the bone is assumed to
be non isotropic. The stress and strain
calculated under the assumption of iso-
tropy was reported to be 20–30% lower
than those under the assumption of trans-
verse isotropy.11 The assigned transver-
sely isotropic elastic properties adopted in
this study are expected to adequately
approximate the behaviour of anisotropic
bones.
From the results of the case study, the
highest stress occurred at the crestal por-
tion of cortical bone, specifically at the
transition region which is adjacent to the
implant. It was also revealed that stress
was distributed mostly in the cortical
bone. The less dense the bone, for example

Table 5. Ratio of highest stress and strain induced at cortical bone and the corresponding yield
strength and maximum allowable strain.
Osseointegration
Bone type (%)
II 25
50
75
100
III 25
50
75
100
IV 25
50
75
100
comparing bone type IV to bone type II,
the higher the stress induced in the cortical
bone and the less stress distributed in the
cancellous bone. This indicates that a
higher density bone distributes a load
better throughout the peri-implant bone.
This condition occurs at any given degree
of osseointegration, which suggests that a
lower density bone is more prone to
implantation failure because of its higher
tendency to overload. This finding is in
agreement with clinical reports that state
lower density bones have much lower
survival rates than denser bones.15–17
When analysing the effects of degree of
osseointegration on the induced stress–
strain in a peri-implant bone, both stress
and strain should be considered. The
induced stress can be withstood by the bone
as long as its magnitude is lower than the
bone’s strength. At the same time, the
induced strain should be considered. As
shown, a bone with a higher degree of
osseointegration must bear higher stress,
but the strain caused was also lower. With
respect to strain, a bone with less osseoin-
tegration must compensate for the load by
deforming its shape even more. The stress–
strain relation is a form of energy (area
under stress–strain curve equals to strain
energy) which means that for bone with
lower osseointegration, the bone cells must
dissipate much higher energy. The energy
is dissipated by heat or deformation, or
even fracture. This implies that implanta-
tion which generates less osseointegration
is more susceptible to failure.
A further analysis that can be conducted
from the stress–strain conditions in peri-
implant bone is to determine the safety of
an implant based on the criteria of bone
overload. By pre-setting the bone overload
criterion for a static load, it can be deter-
mined whether the stress induced in peri-
implant bone breaches the bone strength
threshold. The yield strength of cortical
FEA of partially osseointegrated bone
Stress to yield Strain to yield
strength ratio strain ratio
1.65 1.18
0.86 0.68
0.58 0.48
0.44 0.37
1.93 1.96
1.19 1.27
0.89 0.96
0.72 0.78
3.29 1.60
1.78 2.69
1.67 1.86
1.31 1.49
bone at 160 MPa as suggested by van
Staden et al.6 can be used as the bone
overload criterion. Since bone properties
at various degrees of osseointegration are
based on the fraction values of the bulk
bone properties, the yield strength should
also be determined accordingly. Table 5
shows the ratio between the stress induced
in cortical bone and the yield strength of
cortical bone for a particular case study.
This ratio helps to explain the result above
in which a higher degree of osseointegra-
tion resulted in higher stress in peri-
implant bone. For example, cortical bone
type III with 75% osseointegration was
subjected to up to 106 MPa stress whereas
that with 50% osseointegration was sub-
jected to 95 MPa. The stress magnitude of
106 MPa was still below the former’s
strength (which is 89% of its strength)
whilst the corresponding stress magnitude
exceeded the latter’s strength (119% of its
strength). Hence, the seemingly higher
stress was still safe for the respective bone
whilst the lower stress yielded the respec-
tive cortical bone. So, a bone with a higher
degree of osseointegration is safer because
the stress induced is lower relative to its
yield strength. Implantation was consid-
ered safe for the following conditions:
osseointegration of above 50% for bone
type II (ratio equals to 1 at around 46%);
and osseointegration of above 75% for
bone type III (ratio is unity at 66%).
The case study suggests that full
osseointegration is not mandatory
for successful implantation and that
partial osseointegration can also suffice.
Although a higher degree of osseointegra-
tion is desirable, a low degree of osseoin-
tegration to a certain level is still fairly
acceptable. These are in agreement with
clinical findings, which relate degree of
osseointegration to implant survival rate.
Histologic evidence of well functioning
implants retrieved after 18 months (due to
1095
accident which fractured the abutments)
reported by Uehara et al.18 showed 87.5%
and 97.4% osseointegration. Histomor-
phologic analysis on functional and clini-
cally stable implants before retrieval due
to prosthetic reasons after 8–13 years
reported osseointegration of approxi-
mately 20–84%.19 A similar finding was
reported for immediately loaded transi-
tional implants, where retrieval after 6–
27 months, which showed no mobility,
recorded osseointegration of 25.1–
83%.20 Those reports recorded successful
implantations within a wide range of
degrees of osseointegration, from 20%
to 98%. Extrapolation from the case study,
where the required osseointegration for
bone type II was at least 46% and for
bone type III was at least 66%, showed
that a very low osseointegration of 20%
can also result successful implantation if
the applied external load (e.g. occusal
load) is much lower than 100 MPa. From
a different view, peri-implant bone with a
very high degree of osseointegration (of
98%) can withstand an external load much
higher than 100 MPa.
It should be noted that the case study
involved only static loading, albeit the
occlusal load is cyclic. Although the
number varies, as an estimate, an average
person chews 420 times per standard
meal.21 That accumulates to a large num-
ber of cyclic loads during an implant’s
lifetime. The strength of a bone is low-
ered when subjected to cyclic loading, so
it is likely that when cyclic loading is
involved, a higher degree of osseointe-
gration would be required for safe
implantation.
In conclusion, a refinement technique
that includes the degree of osseointegra-
tion into the finite element analysis of
peri-implant bone was proposed and its
implementability was demonstrated.
Bone type and degree of osseointegration
have a significant effect on the finite ele-
ment analysis. Within the limitation of the
case study, bone type IV was the least
performing, regardless of its degree of
osseointegration. Denser bones are not
necessarily fully osseointegrated to
achieve safe performance. The refinement
technique proposed was implementable
and is expected to better represent peri-
implant bone conditions.
Funding
None.
Competing interests
None declared.
1096 Kurniawan et al.
Ethical approval
Not required.
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Address:
Joong Yeon Lim
Department of Mechanical
Robotics
and Energy Engineering
Dongguk University
26
Pil-dong 3-ga
Jung-gu
Seoul 100-715
Republic of Korea
Tel: +82 2 2260 3810
Fax: +82 2 2263 9379
E-mails: jylim@dongguk.edu,
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