Effect of bone mineral density on dental implant osseointegration: A finite element simulation and sensitivity analysis using a modified mechano-regulation algorithm.

Abstract

This study aimed to develop and evaluate a finite element (FE) based peri-implant healing simulation that explicitly incorporates bone mineral density (BMD) into a modified mechano-regulation algorithm for predicting dental implant osseointegration. The effects of BMD and clinically relevant design and loading conditions on predicted outcomes were also investigated. A 2D axisymmetric FE model of a dental implant, cortical bone, cancellous bone, and peri-implant callus was constructed to compute strain and interstitial fluid flow during healing. The modified mechano-regulation algorithm with BMD-dependent material properties was integrated into the FE model. Osseointegration was quantified using bone-implant contact (BIC) and the average Young's modulus (E_avg) of the callus. Model predictions were validated against published week-8 BIC data under two BMD conditions, and sensitivity analyses were performed for implant diameter, peri-implant gap size, and axial displacement. Across the BMD range of 0.35-0.65 g/cm³, higher BMD was associated with faster maturation toward bone and higher BIC and E_avg. At week 8, BIC increased from 22.4% to 58.3% and E_avg from 623 to 1568 MPa as BMD increased from 0.35 to 0.65 g/cm³. Implant diameter showed smaller effects than BMD, whereas peri-implant gap size and axial displacement had larger effects, particularly at low BMD. This BMD-aware mechanobiological simulation enables comparative assessment of osseointegration across varying bone qualities and clinically plausible conditions.