Biomechanical impact of buccal and palatal cortical bone defects on anterior maxillary dental implants: a 3D FEA study

Abstract

Dental implants in the aesthetic zone are biomechanically challenging due to limited buccal and palatal alveolar bone availability. While buccal bone remodeling after extraction is well documented, the biomechanical influence of palatal cortical wall thickness, particularly in the presence of dehiscence, remains unclear. This study evaluated the effect of buccal–palatal bone configurations on the stress and strain distribution around a dental implant using three-dimensional finite element analysis. A three-dimensional finite element model of a Dyna DC 4.0 × 13 mm implant was constructed in a D3-maxillary anterior segment. Five cortical bone configurations were simulated, including buccal and palatal dehiscences and symmetrical cortical wall thickness patterns. All materials were assumed to be isotropic, homogeneous, and linearly elastic, with complete osseointegration. Implant stresses were assessed using the von Mises criterion, while cortical and trabecular bone responses were evaluated using microstrain analysis based on Wolff’s law. Palatal dehiscence models (1 and 2 mm) demonstrated the highest biomechanical demand, with peak implant stress reaching 599 MPa and cortical and trabecular microstrain increasing to 2289–2490 µε and 1126–1128 µε, respectively. Buccal dehiscence resulted in more homogeneous and clinically acceptable stress patterns in contrast to the palatal dehiscence situations. These findings indicate that palatal cortical wall thickness is a critical determinant of peri-implant biomechanical behavior in the anterior maxilla. Thin or dehisced palatal bone severely limits load distribution, promotes stress accumulation at the implant neck, and elevates strain to levels associated with accelerated marginal bone remodeling and related failure, whereas buccal defects have considerably smaller biomechanical impact.