Comparison of Implant Surgery Methods of Cortical Tapping and Cortical Widening in Bone of Various Density: A Three-Dimensional Finite Element Study

Purpose: The primary stability of a dental implant is critical for successful osseointegration during immediate loading. The cortical bone should be prepared to achieve enough primary stability, but not overcompressed. In this study, we investigated the stress and strain distribution in the bone around the implant induced by the occlusal force applied during immediate loading at various bone densities by the FEA method to compare cortical tapping and widening surgical techniques. Materials and Methods: A three-dimensional geometrical model of a dental implant and bone system was created. Five types of bone density combination (D111, D144, D414, D441 and D444) were designed. Two surgical methods—cortical tapping and cortical widening—were simulated in the model of the implant and bone. An axial load of 100 N and an oblique load of 30 N were applied to the crown. The maximal principal stress and strain were measured for comparative analysis of the two surgical methods. Results: Cortical tapping showed lower maximal stress of bone and maximal strain of bone than cortical widening when dense bone was located around the platform, regardless of the direction of the applied load. Conclusions: Within the limitations of this FEA study, it can be concluded that cortical tapping is biomechanically more advantageous to the implants under occlusal force during immediate loading, especially when the bone density around the platform is high.