Effects of buccal thickness augmentation on bone remodeling after maxillary anterior implantation

Keke Zheng, Nobuhiro Yoda, Junning Chen, Zhipeng Liao, Jingxiao Zhong, Shigeto Koyama, Christopher Peck, Michael Swain, Keiichi Sasaki, Qing Li

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


The biomechanics associated with buccal bone thickness (BBT) augmentation remains poorly understood, as there is no consistent agreement in the adequate BBT to avoid over-loading resorption or over-augmenting surgical difficulty. This study utilizes longitudinal clinical image data to establish a self-validating time-dependent finite element (FE)-based remodeling procedure to explore the effects of different buccal bone thicknesses on long-term bone remodeling outcomes in silico. Based upon the clinical computed tomography (CT) scans, a patient-specific heterogeneous FE model was constructed to enable virtual BBT augmentation at four different levels (0.5, 1.0, 1.5, and 2.0 mm), followed by investigation into the bone remodeling behavior of the different case scenarios. The findings indicated that although peri-implant bone resorption decreased with increasing initial BBT from 0.5 to 2 mm, different levels of the reduction in bone loss were associated with the amount of bone augmentation. In the case of 0.5 mm BBT, overloading resorption was triggered during the first 18 months, but such bone resorption was delayed when the BBT increased to 1.5 mm. It was found that when the BBT reached a threshold thickness of 1.5 mm, the bone volume can be better preserved. This finding agrees with the consensus in dental clinic, in which 1.5 mm BBT is considered clinically justifiable for surgical requirement of bone graft. In conclusion, this study introduced a self-validating bone remodeling algorithm in silico, and it divulged that the initial BBT affects the bone remodeling outcome significantly, and a sufficient initial BBT is considered essential to assure long-term stability and success of implant treatment.

Original languageEnglish
Pages (from-to)133-145
Number of pages13
JournalBiomechanics and Modeling in Mechanobiology
Issue number1
Publication statusPublished - 2020 Feb 1


  • Bone remodeling validation
  • Buccal bone thickness (BBT)
  • Iterative finite element analysis (FEA)
  • Overloading bone resorption
  • Virtual surgery

ASJC Scopus subject areas

  • Biotechnology
  • Modelling and Simulation
  • Mechanical Engineering


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