Issues in bone mechanics related to oral implants

The development and maintenance of the dental implant-to-tissue interface is clearly of paramount importance in the determination of clinical success. Yet, the precise mechanism with which bone responds to mechanical load remains unknown. A review of current thought on the performance of cortical and cancellous bone as structural foundations for dental implants is provided, with particular emphasis on the influence of its three-dimensional architecture at the macroscopic level. The mechanical response of bone is reported to depend upon the direction, magnitude, rate, and duration of loading. Quantitative relationships have been established to correlate cancellous bone strength and stiffness to its apparent density. Such data provide useful insights into the modeling/remodeling response of bone tissue, which is arguably the ultimate predictor of implant longevity.