In the past few decades, 3D-printed dental implants have been manufactured, and significant studies have demonstrated the pre-clinical validation of such systems. However, studies have yet to tackle the ever-present issue of preventing the jumping gap to enhance overall outcomes. The present study details the utilization of patient computed tomography (CT) data to design and subsequently fabricate a multi-component customized dental implant assembly and customized instruments using direct metal laser sintering (DMLS) technology. The workflow was validated for two patient data sets (cases 1 and 2), which were used to render and print custom implant assemblies; the simulation data for these were compared with a commercially available solution. The present study incorporated a prototype stage as well as subjecting the customized implant assemblies to both static (Case 1: 38.89–77.81 MPa vs 75.47–158.09 MPa; Case 2: 83.95–106.65 MPa vs 55.23–126.57 MPa) and dynamic finite element analysis (Case 1: 41.08–84.09 MPa vs 75.45–187.91 MPa; Case 2: 106.81–108.70 MPa vs 79.18–135.48 MPa) along with resonance frequency analysis (Case 1: 7763.2 Hz vs 7003.6 Hz; Case 2: 7910.1 Hz vs 7102.1 Hz) as well as residual stress analysis. The assembly’s stress patterns and resonance frequencies were evaluated against a commercially available implant system. It was observed that the customized implant assemblies tended to outperform the commercially available solution in most simulated scenarios.
ChenXXieLChenJ, et al. Design and fabrication of custom-made dental implants. J Mech Sci Technol2012; 26(7): 1993–1998.
2.
TurkyilmazIMcGlumphyEA. Influence of bone density on implant stability parameters and implant success: a retrospective clinical study. BMC Oral Health2008; 8: 32.
3.
BrånemarkPIAdellRBreineU, et al. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg1969; 3(2): 81–100.
LazzaraRJ. Immediate implant placement into extraction sites: surgical and restorative advantages. Int J Periodontics Restorative Dent1989; 9(5): 332–343.
6.
NymanSLangNPBuserD, et al. Bone regeneration adjacent to titanium dental implants using guided tissue regeneration: a report of two cases. Int J Oral Maxillofac Implants1990; 5(1): 9–14.
7.
NemcovskyCEArtziZMosesO. Rotated split palatal flap for soft tissue primary coverage over extraction sites with immediate implant placement. Description of the surgical procedure and clinical results. J Periodontol1999; 70(8): 926–934.
8.
KarabudaCSandalliPYalcinS, et al. Histologic and histomorphometric comparison of immediately placed hydroxyapatite-coated and titanium plasma-sprayed implants: a pilot study in dogs. Int J Oral Maxillofac Implants1999; 14(4): 510–515.
9.
KohalRJHürzelerMBMotaLF, et al. Custom-made root analogue titanium implants placed into extraction sockets. An experimental study in monkeys. Clin Oral Implants Res1997; 8(5): 386–392.
10.
HarrisWHWhiteREJrMcCarthyJC, et al. Bony ingrowth fixation of the acetabular component in canine hip joint arthroplasty. Clin Orthop Relat Res1983; 176: 7–11.
11.
RegishKMSharmaDPrithvirajDR. An overview of immediate root analogue zirconia implants. J Oral Implantol2013; 39(2): 225–233.
12.
CarlssonLRöstlundTAlbrektssonB, et al. Implant fixation improved by close fit. Cylindrical implant-bone interface studied in rabbits. Acta Orthop Scand1988; 59(3): 272–275.
13.
CaudillRFMeffertRM. Histological analysis of the osseointegration of endosseous implants in simulated extraction sockets with and without e-PTFE barriers. Part I. Preliminary findings. Int J Periodontics Restorative Dent1991; 11: 207–215.
14.
KnoxRCaudillRMeffertR. Histologic evaluation of dental endosseous implants placed in surgically created extraction defects. Int J Periodontics Restorative Dent1991; 11: 365–375.
15.
SalamaHRoseLFSalamaM, et al. Immediate loading of bilaterally splinted titanium root-form implants in fixed prosthodontics—A technique reexamined; two case reports. Int J Periodontics Restorative Dent1995; 15: 344–361.
16.
EspositoMGrusovinMGWillingsM, et al. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev2013; 28: CD003878.
17.
TrisiPTodiscoMConsoloU, et al. High versus low implant insertion torque: a histologic, histomorphometric, and biomechanical study in the sheep mandible. Int J Oral Maxillofac Implants2011; 26: 837–849.
18.
MarquezanMOsórioASant'AnnaE, et al. Does bone mineral density influence the primary stability of dental implants? A systematic review. Clin Oral Implants Res2012; 23: 767–774.
19.
SciasciPCasalleNVazLG. Evaluation of primary stability in modified implants: analysis by resonance frequency and insertion torque. Clin Implant Dent Relat Res2018; 20: 274–279.
20.
TabassumAMeijerGJWolkeJG, et al. Influence of surgical technique and surface roughness on the primary stability of an implant in artificial bone with different cortical thickness: a laboratory study. Clin Oral Implants Res2010; 21: 213–220.
21.
AkoğlanMTatliUKurtoğluC, et al. Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla. Clin Implant Dent Relat Res2017; 19: 624–631.
22.
AnilSAldosariAA. Impact of bone quality and implant type on the primary stability: an experimental study using bovine bone. J Oral Implantol2015; 41(2): 144–148.
23.
WangTMLeeMSWangJS, et al. The effect of implant design and bone quality on insertion torque, resonance frequency analysis, and insertion energy during implant placement in low or low- to medium-density bone. Int J Prosthodont2015; 28(1): 40–47.
24.
KimDGHujaSSTeeBC, et al. Bone ingrowth and initial stability of titanium and porous tantalum dental implants: a pilot canine study. Implant Dent2013; 22(4): 399–405.
25.
LevineBRSporerSPoggieRA, et al. Experimental and clinical performance of porous tantalum in orthopedic surgery. Biomaterials2006; 27(27): 4671–4681.
26.
BencharitSByrdWCAltarawnehS, et al. Development and applications of porous tantalum trabecular metal-enhanced titanium dental implants. Clin Implant Dent Relat Res2014; 16(6): 817–826.
27.
Customized dental implant assembly, Patent No. 438759, Date of Grant: 13-07-2023. Indian Patent Application No. 202111056440.
28.
PektaşÖTönükE. Mechanical design, analysis, and laboratory testing of a dental implant with axial flexibility similar to natural tooth with periodontal ligament. Proc IMechE, Part H: J Engineering in Medicine2014; 228(11): 1117–1125.
29.
ChenSTWilsonTgJrHämmerleCH. Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes. Int J Oral Maxillofac Implants2004; 19 Suppl: 12–25.
30.
ChenSTBeagleJJensenSS, et al. Consensus statements and recommended clinical procedures regarding surgical techniques. Int J Oral Maxillofac Implants2009; 24 Suppl: 272–278.
31.
PalattellaPTorselloFCordaroL. Two-year prospective clinical comparison of immediate replacement vs immediate restoration of single tooth in the esthetic zone. Clin Oral Implants Res2008; 19: 1148–1153.
32.
Calvo-GuiradoJLOrtiz-RuizAJLópez-MaríL, et al. Immediate maxillary restoration of single-tooth implants using platform switching for crestal bone preservation: a 12-month study. Int J Oral Maxillofac Implants2009; 24: 275–281.
33.
LindeboomJAHTjiookYKroonFHM. Immediate placement of implants in peri-apical infected sites: a prospective randomized study in 50 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2006; 101: 705–710.
34.
ChoudhurySRanaMChakrabortyA, et al. Design of patient-specific basal dental implant using finite element method and artificial neural network technique. Proc IMechE, Part H: J Engineering in Medicine2022; 236(9): 1375–1387.
35.
ComaneanuRMTarcoleaMVlasceanuD, et al. Virtual 3D reconstruction, diagnosis and surgical planning with mimics software. Int J Nano Biomater2012; 4(1): 69–77.
36.
PoeschlPWSchmidtNGuevara-RojasG, et al. Comparison of cone-beam and conventional multislice computed tomography for image-guided dental implant planning. Clin Oral Investig2013; 17(1): 317–324.
37.
GuoHZhouJBaiY, et al. A three-dimensional setup model with dental roots. J Clin Orthod2011; 45(4): 209–216.
38.
EraslanOİnan. The effect of thread design on stress distribution in a solid screw implant: a 3D finite element analysis. Clin Oral Investig2010; 14(4): 411–416.
39.
KitagawaTTanimotoYNemotoK, et al. Influence of cortical bone quality on stress distribution in bone around dental implant. Dent Mater J2005; 24(2): 219–224.
40.
JainVDommetiVKRanaM, et al. Influences of stresses on dental implant threads using finite-element analysis. J Long Term Eff Med Implants2019; 29(2): 125–133.
41.
SagomonyantsKBJarman-SmithMLDevineJN, et al. The in vitro response of human osteoblasts to polyetheretherketone (PEEK) substrates compared to commercially pure titanium. Biomaterials2008; 29(11): 1563–1572.
42.
YasodaKPonmagalRSBhuvaneshwariKS, et al. Automatic detection and classification of EEG artefacts using fuzzy kernel SVM and wavelet ICA (WICA). Soft Comput2020; 24: 16011–16019.
43.
AlghazzawiTFLemonsJLiuPR, et al. Influence of low-temperature environmental exposure on the mechanical properties and structural stability of dental zirconia. J Prosthodont2012; 21(5): 363–369.
44.
WangYChenXZhangC, et al. Studies on the performance of selective laser melting porous dental implant by finite element model simulation, fatigue testing and in vivo experiments. Proc IMechE, Part H: J Engineering in Medicine2019; 233(2): 170–180.
45.
BotheRTBeatonLEDavenportHA. Reaction of bone to multiple metallic implants. Surg Gynecol Obstet1940; 71: 598–602.
46.
LeventhalGS. Titanium, a metal for surgery. J Bone Joint Surg Am1951; 33: 473–474.
47.
AlbrektssonT. Hard tissue implant interface. Aust Dent J2008; 53(1): S34–S38.
48.
LianZGuanHIvanovskiS, et al. Effect of bone to implant contact percentage on bone remodeling surrounding a dental implant. Int J Oral Maxillofac Surg2010; 39: 690–698.
49.
BrentelASde VasconcellosLMOliveiraMV, et al. Histomorphometric analysis of pure titanium implants with porous surface versus rough surface. J Appl Oral Sci2006; 14: 213–218.
50.
SpectorM. Historical review of porous-coated implants. J Arthroplasty1987; 2: 163–177.
51.
ZardiackasLDParsellDEDillonLD, et al. Structure, metallurgy, and mechanical properties of a porous tantalum foam. J Biomed Mater Res2001; 58: 180–187.
52.
HackingSABobynJDTohK, et al. Fibrous tissue ingrowth and attachment to porous tantalum. J Biomed Mater Res2000; 52: 631–638.
53.
WigfieldCRobertsonJGillS, et al. Clinical experience with porous tantalum cervical interbody implants in a prospective randomized controlled trial. Br J Neurosurg2003; 17: 418–425.
54.
LeeJWWenHBBattulaS, et al. Outcome after placement of tantalum porous engineered dental implants in fresh extraction sockets: a canine study. Int J Oral Maxillofac Implants2015; 30(1): 134–142.
55.
KayabaşıOYüzbasıoğluEErzincanlıF. Static, dynamic and fatigue behaviors of dental implant using finite element method. Adv Eng Softw2006; 37(10): 649–658.
56.
CervinoGRomeoULauritanoF, et al. FEM and von Mises Analysis of OSSTEM ® dental implant structural components: evaluation of different direction dynamic loads. Open Dent J2018; 12: 219–229.
57.
CicciùMBramantiECecchettiF, et al. FEM and Von Mises analyses of different dental implant shapes for masticatory loading distribution. Oral Implantol2014; 7(1): 1–10.
58.
FiorilloLCicciùMD’AmicoC, et al. Finite element method and Von Mises investigation on bone response to dynamic stress with a novel conical dental implant connection. Biomed Res Int2020; 2020: 2976067.
59.
UdomsawatCRungsiyakullPRungsiyakullC, et al. Comparative study of stress characteristics in surrounding bone during insertion of dental implants of three different thread designs: a three-dimensional dynamic finite element study. Clin Exp Dent Res2018; 5(1): 26–37.
60.
GeramizadehMKatoozianHAmidR, et al. Static, dynamic, and fatigue finite element analysis of dental implants with different thread designs. J Long Term Eff Med Implants2016; 26(4): 347–355.
61.
SadrimaneshRSiadatHSadr-EshkevariP, et al. Alveolar bone stress around implants with different abutment angulation: an FE-analysis of anterior maxilla. Implant Dent2012; 21(3): 196–201.
62.
van EijdenTM. Biomechanics of the mandible. Crit Rev Oral Biol Med2000; 11(1): 123–136.
63.
RabelAKöhlerSGSchmidt-WesthausenAM. Clinical study on the primary stability of two dental implant systems with resonance frequency analysis. Clin Oral Investig2007; 11(3): 257–265.
64.
PattersonAEMessimerSLFarringtonPA. Overhanging features and the SLM/DMLS residual stresses problem: review and future research need. Technologies2017; 5(2): 15.
65.
Di SpiritoFGiordanoFDi PaloMP, et al. Customized 3D-printed mesh, membrane, bone substitute, and dental implant applied to guided bone regeneration in oral implantology: a narrative review. Dent J2024; 12(10): 303.
66.
OuldyerouAAminallahLMerdjiA, et al. Finite element analyses of porous dental implant designs based on 3D printing concept to evaluate biomechanical behaviors of healthy and osteoporotic bones. Mech Adv Mater Struct2023; 30(11): 2328–2340.
67.
OuldyerouAMerdjiAAminallahL, et al. Functionally graded ceramics (FGC) dental abutment with implant-supported cantilever crown: finite element analysis. Compos Commun2023; 38: 101514.
68.
MehboobHMehboobAAbbassiF, et al. Bioinspired porous dental implants using the concept of 3D printing to investigate the effect of implant type and porosity on patient’s bone condition. Mech Adv Mater Struct2022; 29(27): 6011–6025.
