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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v15.i2.30
pages 139-152

Mechanobiology of Bone and Mechanocoupling of Endosseous Titanium Oral Implants

Murat C. Cehreli
Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, 06100 Sihhiye, Ankara, Turkey
Kivanc Akca
Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, 06100 Sihhiye, Ankara, Turkey

ABSTRACT

Objective. To provide an evidence-based overview and critical evaluation of the mechanobiology of bone and mechanocoupling of osseointegrated oral implants and the consequences of varying clinical and potential artificial loading regimens on bone tissue differentiation around implants. Methods: The literature was searched, using MEDLINE® and manual tracing of references cited in key papers as well as submitted fundamental studies otherwise not elicited, for original research articles and review articles relating to the mechanobiology of bone and load-bearing endosseous implants and the time-dependent biological and biomechanical outcome of conventional-, early-, immediate-, and artificial-loading regimens on initial and long-term effectiveness of oral implants. Conclusions: Implant design, particularly implant surface, has a decisive role on interface force transmission but not on the long-term clinical effectiveness of oral implants. Overloading and stress shielding have often been cited as the primary biomechanical factors leading to marginal bone loss around implants, although there is no consensus on these factors. Low-magnitude, high-frequency mechanical signals may be future candidates for promoting osseointegration and increasing bone density and bone mass around load-bearing osseointegrated implants. Computational technologies and (bio)sensors used for mechanobiological/biomechanical evaluation of bone and oral implants are still at their early stages of application, which results in a little pool of evidence on mechanocoupling of oral implants and biomechanical evaluation of various clinical loadings.