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Table 1 All studies in the literature that considered with an actual validation of FEA

From: Finite element analysis of dental implants with validation: to what extent can we expect the model to predict biological phenomena? A literature review and proposal for classification of a validation process

Ranking Authors Year FE model FEM geometry reference Material properties of tissues around implants Validation Material of validation model Comparison items
A Heckmann et al. [10] 2006 Implants embedded in a bone block CAD: bone block with a cortical layer and cancellous layer was constructed by CAD Homogeneous isotropic linear elasticity: cortical and trabecular bone (1) In vitro testing: strain gauge on implant support bridge in resin bone model
(2) In vivo testing: strain gauge on pontic of a 3-unit bridge in humans
(1) Epoxy resin
(2) In vivo: in a patient’s mouth
Surface strain of resin/resin
B Hou et al. [12] 2009 Implants embedded in bone (rat’s mouth) CT: CT data of the implant in a rat model Not mentioned In vivo experiment: implants placed in rat, and histologic findings compared after loading In vivo: rat Histologic findings
B Natali et al. [11] 1997 Implants embedded in a bone block CAD: bone section constructed by CAD Homogeneous isotropic linear elasticity: cortical and trabecular bone In vivo experiment: implant insertion in animal (dog) for loading and creation of sections of bone and implants In vivo: dog Visualization of change in bone and stress analysis by FEA
B Cha et al. [13] 2015 Implant engaged in bone disc (model was used to calculate torque) CAD: based on histology of the bone–implant interface Homogeneous isotropic linear elasticity In vivo experiment: implant insertion in animal (mice) with different insertion torques In vivo: mice Histomorphometric analyses
C Nagasao et al. [16] 2009 Implants embedded in normal mandibles and reconstructed mandible (with fibulae or ribs) and under mastication movement (dynamic condition) CT: dry mandibles, ribs, and fibulae Homogeneous isotropic linear elasticity: cortical and cancellous bone of every part of mandible, fibula, and rib Mechanical testing: implant embedded in 3 full mandibles and surface strain under loading measured by strain gauge Dry mandible as mandible Surface strain of bone under same conditions in FEA/experiment
C Nagasao et al. [17] 2010 Implants embedded in normal mandibles and reconstructed mandible (with fibulae or ribs) under mastication movement (dynamic condition) CT: dry mandibles, ribs, and fibulae Homogeneous isotropic linear elasticity: cortical and cancellous bone of every part of mandible, fibula, and rib Mechanical testing: implant embedded in 2 full mandibles and surface strain under loading measured by strain gauge Dry mandible as mandible Surface strain of bone under same conditions in FEA/experiment
C Eser et al. [18] 2009 Four implants embedded in the maxilla with bar superstructure CAD: model of nonanatomic maxilla, individualized arch form according to implant alignment Homogeneous isotropic linear elasticity: cortical bone, cancellous bone, Ti, Alloy, bar-superstructure Ex vivo strain gauge measurement of cadaver’s maxilla (with implants) Cadaver Surface strain of bone (maxilla)
C Nagasao et al. [19] 2006 Implants embedded in normal maxilla and cleft maxilla CT and CAD: normal maxilla: CT from a dry skull; palatal cleft, alveolar cleft, and complete cleft were designed by computer Homogeneous isotropic linear elasticity: cortical and trabecular bone Mechanical testing: strain measurement by strain gauge and implant embedded in actual skull model Dry skull Surface strain of bone
D Bardyn et al. [20] 2010 Implants embedded in bone (polyurethane foam and sheep bone) CT: polyurethane foam block and sheep bone Nonhomogeneous: calculated from CT data Mechanical testing in both polyurethane foam and sheep bone: measurement of removal torque of the implant Polyurethane foam and sheep bone Removal torque of implants
D Olsen et al. [21] 2005 Implants embedded in porcine mandibles from CT data and application of loading on the implant of FEM CT: porcine mandibles Nonhomogeneous: calculated from CT data Mechanical testing: comparison of displacement with actual measurements under the same testing load Block of porcine mandible Implant displacement under loading
D Huang et al. [22] 2002 Implant embedded in bone block CAD: bone block model constructed by CAD Homogeneous isotropic linear elasticity: cortical and trabecular bone In vitro model testing experiments: implant in bone cubic and measurement of resonance frequencies Bone section from lumbar vertebrae of hogs Value of resonance frequency
D Hasan et al. [23] 2012 Implant (implant and abutment together) embedded in bovine bone CT: scan of the models used for the experiment (implant embedded in bovine rib) Homogeneous isotropic linear elasticity: bovine cortical bone, bovine cancellous bone Mechanical tests: implant displacement and rotation under loading were measured using a biomechanical measurement system (laser pinhole and camera) Bovine rib section as mandible bone Displacement of the abutment
D Chatzigianni et al. [24] 2011 Mini-implant embedded in bone CT: scan of the specimen used for the experiment (implant embedded in bovine rib) Homogeneous isotropic linear elasticity: bovine cortical bone, bovine cancellous bone Mechanical tests: implant displacement and rotation under loading were measured using a 3D mobility measurement system (laser beams and camera) Bovine rib section as mandible bone Displacement of the abutment
E1 Tiossi et al. [14] 2013 Implants and tooth (acrylic) embedded in resin block model, crowns (splint and non-splint) CAD: epoxy model block Nil (in this FEM, there was a resin block only and no living tissue simulation) Digital image correlation (DIC): images of deforming body captured and strain calculated. Mechanical testing with implants embedded in resin block Resin block as mandible bone Calculated surface strain by DIC and FEA
E2 Ozçelik et al. [25] 2007 Three-unit bridge fixed prosthesis (with rigid connector and non-rigid) supported by an implant and a natural tooth, with an adjacent tooth and surrounding bone CAD: a bone section (2D) was constructed by CAD with a cortical layer and spongious bone and PDL Homogeneous isotropic linear elasticity: enamel, dentin, pulp, cortical bone, cancellous bone Photoelastic stress analysis methods (PSAM): implants placed in photoelastic resin, then force loaded and photograph taken Photoelastic resin as bone Stress distribution in bone/resin
E3 Chou et al. [26] 2014 A section of mandible and implant CT data and 2D FE model used in previous study Homogeneous isotropic linear elasticity Mechanical testing: implant embedded in resin bone and strain measured by strain gauge 3D printer to build acrylic-based polymer Surface strain of bone
E3 Mobilio et al. [29] 2013 Implant embedded in a bone block CAD: bone block built by CAD with a cortical (1.5 mm) and trabecular (28.5 mm) layer Homogenous anisotropic linear elasticity cortical bone: orthotopic linearly elastic material; trabecular bone: transversely isotropic linearly elastic material Mechanical testing: implant embedded in resin block and strain measured by strain gauge Resin block as mandible bone Load and strain relationship
E3 Chang et al. [30] 2012 Short implants with crowns embedded in left posterior segment of maxilla CT: CT scan of a dry human male skull Homogeneous isotropic linear elasticity: cortical bone, cancellous bone (high and low density) Mechanical testing: strain measured by strain gauge and implant embedded in resin block under loading ABS plastic bone as maxillary bone Surface strain of bone/resin
E3 Tu et al. [31] 2010 Implant embedded in resin block CAD: a resin block with a cortical layer and cancellous layer was constructed by CAD Nil (in this FEM, there was a resin block only and no living tissue simulation) Mechanical testing: strain measured by strain gauge and implant embedded in resin mandible section Resin bone as mandible bone Surface strain of bone/resin
E3 Lin et al. [32] 2010 Implant embedded in the left maxilla with crown CT of intact healthy male patient Homogeneous isotropic linear elasticity: cortical bone, cancellous bone Mechanical testing: strain measured by strain gauge and implant embedded in resin mandible section ABS plastic bone as maxillary bone Surface strain of bone/resin
E3 Qian et al. [33] 2009 Implant embedded in bone block CAD: a bone cubic with cortical layer and cancellous layer was constructed by CAD Homogeneous isotropic linear elasticity: cortical bone, cancellous bone (1) In vitro experiment: mechanical testing with resin bone and digital image correlation to calculate displacement of implant and strain on bone
(2) Literature data: strain gauge measurement in model experiment
Resin block as mandible bone (1) Displacement of implant and strain on bone
(2) Surface strain of bone
E3 Karl et al. [34] 2009 Implant embedded in base made by 3 materials CAD: acrylic, G10 epoxy resin, aluminum Homogeneous isotropic linear elasticity: acrylic, G10 epoxy resin, aluminum Mechanical testing: strain gauge. FEA-calculated strain was compared with strain gauge results Acrylic resin, glass-filled epoxy, aluminum Surface strain of acrylic resin, glass-filled epoxy, aluminum
E3 Hsu et al. [35] 2009 Implant embedded in resin block (with resin’s parameter for consistence with experiment) Nil Homogeneous isotropic linear elasticity: Resin (epoxy and Tempron) Mechanical testing: implant embedded in resin bone section and surface strain under loading was measured by strain gauge Resin block as mandible bone Surface strain of resin/resin
E3 Nagasawa et al. [36] 2008 Implant embedded in a bone block (only compact bone) CAD: a bone block (compact bone) was constructed by CAD Homogeneous isotropic linear elasticity: compact bone Mechanical loading test for implant, sectioned longitudinally Nil Implant deformation; no scientific values
E3 Huang et al. [37] 2005 Splinted or non-splinted 2-unit crowns supported by 2 or 3 implants embedded in bone CT: CT of posterior portion of a cadaver mandible Homogeneous anisotropic linear elasticity cortical bone: orthotopic linearly elastic material; trabecular bone: transversely isotropic linearly elastic material Mechanical test: strain measured by strain gauge on model Acrylic resin as mandible bone Surface strain of resin/bone
E3 Iplikçioğlu et al. [38] 2003 Implant embedded in bone block CAD: a resin block model was constructed by CAD Nil (in this FEM, there was a resin model only and no living tissue simulation) Mechanical test: measurement of stress on the implant, abutment, and resin Resin block as bone Stress distribution in resin and implants
E3 Chang et al. [27] 2016 Ball attachment overdenture (mandible, implant and attachment, mucosa, denture) CT: from a single human mandible (edentulous 65-year-old woman) Homogeneous isotropic linear elasticity Mechanical test: strain measured by strain gauge on surface of bone model Rapid prototype ABS plastic bone model, and a 3-mm layer of silicone to simulate mucosa Surface strain of resin/bone
E3 Rezende et al. [28] 2015 Bone section with embedded implant and prosthesis (metal coping and porcelain), screws CT: in vitro model (resin bone) Homogeneous isotropic linear elasticity Mechanical test: strain measured by strain gauge on surface of bone model Polyurethane resin Surface strain of resin/bone
E3 Chang et al. [39] 2012 Implants embedded in maxilla section with imperfect and perfect osseointegration under force loading CT: data of maxillary first molar area Inhomogeneous anisotropic linear elasticity cortical bone: anisotropic Trabecular bone: transversely isotropic linearly elastic material Mechanical testing: strain measured by strain gauge and implant embedded in resin block Resin block as maxillary bone Surface strain of bone/resin block
E3 Chang et al. [40] 2012 Implants and crowns in a section of the maxilla CAD: a bone block with a cortical layer and cancellous layer was constructed by CAD Homogeneous anisotropic linear elasticity compact bone, cancellous bone Mechanical testing: strain measured by strain gauge and implant embedded in resin block ABS resin block as mandible bone Surface strain of bone/resin block
E4 Zhiyong et al. [41] 2004 (1) Single tooth in bone block
(2) Single implant in bone block
(3) Various FPD supported by tooth and implant
CAD: a bone block model was constructed by CAD Homogeneous isotropic linear elasticity: cortical and trabecular bone, dentin, PDL Mechanical testing: comparison of displacement with actual measurements under the same tested loading conditions Not mentioned Implant displacement under loading
E4 Chang et al. [42] 2012 Implant embedded in a bone block CAD: a bone block with a cortical layer and cancellous layer was constructed by CAD Homogeneous isotropic linear elasticity: compact bone, cancellous bone Mechanical testing: pullout testing of mini-implant inserted in synthetic bone material Synthetic bone material as mandible bone Pullout strength of mini-implant
E5 Inglam et al. [43] 2013 Implant embedded in a bone block CAD: a bone block with a cortical layer and cancellous layer was constructed by CAD Homogeneous anisotropic linear elasticity cortical bone: orthotopic isotropic
Trabecular bone: transversely isotropic linearly elastic material
Mechanical testing: strain measured by strain gauge and implant embedded in resin block Resin block as mandible bone Surface strain of bone/resin block
E5 Necchi et al. [44] 2003 Implant (fixture, abutment, and connecting screw) Nil Nil Mechanical failure tests: preloading and functional loading conditions Not mentioned Maximum breaking force
E5 Genna et al. [45] 2003 Implant embedded in bone block CAD: a resin block model was constructed by CAD Nil (in this FEM, there was a resin model only and no living tissue simulation) Cyclic mechanical fatigue testing: implant placed in epoxy resin and section of specimen examined under microscope Epoxy resin block as bone Comparison of locations of stress focus
E5 Perriard et al. [46] 2002 Different types of implant bodies and abutments embedded in resin CAD: epoxy resin as bone Nil (in this FEM, there was a resin model only and no living tissue simulation) Mechanical fatigue testing of implant model: until half of samples still survived under loading Resin block Comparison of locations of stress concentrations
F1 Bruno Salles Sotto-Maior et al. [47] 2016 A bone model of mandibular right posterior region CT: from a patient’s mandible Homogeneous isotropic linear elasticity: cortical and trabecular bone Clinical findings of bone loss at 1-year follow-up In vivo: radiographic films of patients Mechanoregulatory tissue model was employed to monitor the morphological changes in bone subjected to biomechanical loading
F1 Wang et al. [48] 2013 A 3D model of maxillary bone CT image of maxillary bone section missing both central incisors Homogeneous isotropic linear elasticity Radiographs qualitatively compared regarding resemblance between computational remodeling results and clinical data In vivo: radiographic films of patients Comparison of variations in maxillary bone densities
F1 Choi et al. [50] 2012 Implants embedded in anterior maxilla CT: anterior maxillary bone Homogeneous isotropic linear elasticity compact bone, cancellous bone Comparison of model implant displacement under the same load with clinical outcomes in literature Literature Model implant displacement
F1 Shen et al. [51] 2010 Implant embedded in mandibular right first molar area CAD: a bone block with a cortical layer and cancellous layer was constructed by CAD Homogeneous anisotropic linear elasticity: cortical bone, cancellous bone Clinical data; comparison of implant displacement value under 20-N loading from clinical data Clinical results Implant displacement under loading
F1 Lin et al. [52] 2010 Implant embedded in mandible (cortical and cancellous bone), crown, teeth CT: in vivo CT of a segment of mandible Inhomogeneous anisotropic linear elasticity: cortical bone, cancellous bone (properties varied with density) Clinical data: comparison of bone density with other clinical follow-up X-ray images X-ray images of human X-ray images
F2 MacGinnis et al. [49] 2014 3D skull model with masked sutures CT: from 42-year-old man, 3D skull image excluding the mandible Homogeneous isotropic linear elasticity Comparison with past literature   Comparison with conclusions of past literature
F2 Fanuscu et al. [53] 2004 Unilateral edentulous posterior maxilla with grafted sinus CAD: unilateral edentulous posterior maxilla with grafted sinus was constructed by computer Homogeneous isotropic linear elasticity: cortical and trabecular bone Validation with previous study by one of the authors in which photoelastic modeling with similar geometry was used   Location of stress
F2 Mellal et al. [54] 2004 Cylindrical implant, bone consisting of a cancellous core coated with cortical envelope CAD: a bone section model was constructed by CAD Homogeneous isotropic linear elasticity: cortical and trabecular bone Literature: systematic search of the literature was conducted to relate the numerical predictions to existing in vivo data   
F2 Zarone et al. [55] 2003 Mandible with 6 implants and prosthetic superstructure Laser: a man’s total mandible by laser digitizer Homogeneous isotropic linear elasticity: cortical and trabecular bone Data from previous experiments: comparisons of range of medial convergence during opening and protrusive movements   
G Bulaqi et al. [56] 2015 Implants embedded in a bone block CT data: mandible Homogeneous isotropic linear elasticity Comparison with theoretically predicted values (calculated with the equations)   values of conical to wretch torque ratio
G Vayron et al. [57] 2015 Implants embedded in a bone block CAD: cortical bone, newly formed bone, and trabecular bone Homogeneous isotropic mechanical properties Comparison with results using a 2D finite difference numerical model