How Dental Implants Stimulate Bone
Posted on 10/19/2020 by Greg Kammeyer |
Dental implants stimulate the bone around them, helping to maintain jaw bone compared to conventional treatments. In this blog I will review some of the studies that show what happens to the jaw bone after teeth are lost, when dentures are worn, what the effects on the bone occurs.
Bone Loss After Extraction: A systematic review of 18 implant papers, looked at the how dental implants can preserve the residual alveolar ridge.[1], the loss of the periodontal ligament with tooth extraction leaves alveolar bone with progressive resorption. The resorption shows variation in rate with rapid bone loss in the first 6 months (up to 50%) after extraction and continues in the following 2 years [2].
Bone Maintenance with Dental Implants: Many authors [3-5] revealed the predictability of dental implants to stimulate bone density at healing and adapt to the applied load that the implant supported teeth provide. Like other body bones, and according to Wolff’s law, bone has the ability to differentiate/harden with different stresses applied to it [6]. This bone stimulation is started from the time of surgical implant placement and continued to support the implant to withstand the increasing forces [7-10]. A radiographic-based quantitative study carried by Ichikawa et al. [11] displayed an improvement of bone density and bone formation related to load applied after a short period of implant service. Within 9-year follow-up for 81 patients, Dhima et al. [12] found and average of 0.94 mm growth of bone. In another study, peri-implant bone density grew around implants after 5 years of follow-up [13].
Bone Loss under Conventional Dentures: Residual alveolar ridge shows significant long term resorption under the conventional complete denture. The annual alveolar bone resorption is approximately fourfold more in the lower jaw comparing to the upper jaw [14]. A long term monitoring of complete denture wearers showed continuous bone loss throughout the study. [15]. 10 years after implant placement, a significant increase in peri-implant bone density was noted in a clinical study for 18 patients [16]. Taylor [17] reported the mandibular growing for about 3 mm with a hybrid prosthesis.
Sennerby et al. [18] concluded that the treatment with hybrid prostheses seems to reduce bone resorption in the mandible. Kordatzis et al. [19] concluded 1-mm annual reduction in bone loss at using implant overdenture, with tissue support, comparing to the conventional denture. Certainly the bone loss with dentures and implant overdentures, it is understandable that patients become progressively less satisfied with these conventional replacement teeth.
Within the limitation of this review and based on previous studies, implant restoration has a noticeable residual alveolar ridge preservation which varies from reducing rate of physiologic resorption to bone apposition. However, the extension of this preservation from the implant to surrounding bony area, horizontally and vertically, is unknown. So, further studies are needed to elaborate the extension of preservation and the influencing factors.
Daniel Lin et al International Journal of Implant Dentistry 2016
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2. Atwood DA. Bone loss of edentulous alveolar ridges. J Periodontol. 1979;50(4 Spec No):11–21.
3. Cooper LF. Biologic determinants of bone formation for osseointegration: clues for future clinical improvements. J Prosthet Dent. 1998;80(4):439–49.
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5. Appleton RS, Nummikoski PV, Pigno MA, Cronin RJ, Chung KH. A radiographic assessment of progressive loading on bone around single osseointegrated implants in the posterior maxilla. Clin Oral Implants Res. 2005;16(2):161–7.
6. Ichikawa T, Miyamoto M, Horisaka Y, Horiuchi M. Radiographic analysis of a two-piece apatite implant: part II. Preliminary report of 2-year observation. Int J Oral Maxillofac Implants. 1997;9(2):214–22.
7 Hassler CR, Rybicki EF, Cummings KD, Clark LC. Quantification of bone stresses during remodeling. J Biomech. 1980;13(2):185–90.
8 Akca K, Iplikcioglu H. One-year follow-up of an implant with early radiographic signs of loss of osseointegration: case report. Clin Implant Dent Relat Res. 2002;4(1):43–6.
9 Brägger U, Hugel-pisoni C, Bürgin W, Buser D, Lang NP. Correlations between radiographic, clinical and mobility parameters after loading of oral implants with fixed partial dentures. A 2 years longitudinal study.pdf. Clin Oral Implants Res. 1996;7(3):230–9
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11 Kivovics P, Jáhn M, Borbély J, Márton K. Frequency and location of traumatic ulcerations following placement of complete dentures. Int J Prosthodont. 2007;20(4):397–401.
12 Dhima M, Balshi T, Wolfinger G, Petropoulos VC, Balshi S. A retrospective analysis of mandibular bone height changes associated with 81 screw-retained implant-supported prostheses with distal cantilevers: a long-term follow-up analysis. Int J Oral Maxillofac Implants. 2013;28(3):854–9
13 Kreisler M, Behneke N, Behneke A, d’Hoedt B. Residual ridge resorption in the edentulous maxilla in patients with implant-supported mandibular overdentures: an 8-year retrospective study. Int J Prosthodont. 2003;16(3):295–300.
14. Saulacic N, Abboud M, Pohl Y. Clinical and radiographic outcome of dental implants supporting fixed prostheses: the relevance of cortical bone formation. Implant Dent. 2012;21(4):323–9
15 Atwood DA, Coy WA. Clinical, cephalometric, and densitometric study of reduction of residual ridges. J Prosthet Dent. 1971;26(3):280–95
15 Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J Prosthet Dent. 1972;27(2):120–32.
16. Jacobs R, Pittayapat P, Van Steenberghe D, De Mars G, Gijbels F, Van Der Donck A, et al. A split-mouth comparative study up to 16 years of two screw-shaped titanium implant systems. J Clin Periodontol. 2010;37(12):1119–27.
17. Sennerby L, Carlsson G, Bergman B, Warfvinge J. Mandibular bone resorption in patients treated with tissue-integrated prostheses and in complete-denture wearers. Acta Odontol Scand. 1988;46(3):135–40.
18.Betts NJ, Barber HD, Powers MP, Wu L, Hennig T, Fonseca RJ. Osseous changes following placement of the transmandibular implant system in edentulous mandibles. Implant Dent. 1993;2(1):11–7.
19.Kordatzis K, Wright PS, Meijer HJ. Posterior mandibular residual ridge resorption in patients with conventional dentures and implant overdentures. Int J Oral Maxillofac Implants. 2003;18(3):447–52.
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