Enhancing implant therapy success through comprehensive evaluation of implant biomechanics: a systematic review

Dental implants are recognized as the optimal solution for replacing missing teeth due to their high success rates and broad applications. However, not all dental implant therapies yield successful outcomes, and failures can occur due to various biological and mechanical factors. This systematic review aims to evaluate primary studies focusing on the biomechanical properties of dental implants, to identify key factors that contribute to the success of implant therapy.

A comprehensive search was conducted across electronic databases, including MEDLINE (PubMed), EMBASE, Google Scholar, and CAB Abstracts. The search strategy incorporated six significant biomechanical properties, utilizing keywords and Boolean operators. The review encompassed human and animal studies, including observational studies, trials, and in vitro investigations. Out of 234 titles obtained from the online search, 59 studies were selected for full-text review following the abstract screening. Among these, nine full-text articles were selected for data extraction and analysis. All the included studies were conducted in vitro and therefore provide preclinical biomechanical evidence that may not directly translate to clinical outcomes. Among the in vitro studies, six assessed loss of preload, five assessed fatigue strength, four examined implant-abutment connection design, and one evaluated implant diameter.

Preload values decreased over time, with the most loss occurring within 10 seconds of tightening. The 8-degree internal conical implant demonstrated superior performance to the interior hex design. Studies also indicated a higher rate of complications (such as porcelain chipping and de-cementation) in cantilever groups. Biomechanical properties such as preload, torque, cantilever design, and implant abutment design significantly influence the success rates of dental implants.

This review provides important parameters for successful implant therapy, albeit with certain limitations.