{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T12:57:25Z","timestamp":1773838645155,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFB"],"abstract":"<jats:p>Low-density cancellous bone results in reduced trabecular support and may increase crestal cortical strain around implants. Osseodensification (OD) compacts trabecular bone and may create a peri-osteotomy densified zone, but its strain-level effects in osteoporotic-like bone are unclear. This study evaluated whether an OD-inspired peri-implant densified trabecular zone reduces crestal cortical strain compared with conventional drilling (CD) in an osteoporotic-like model. A three-dimensional finite element model of a mandibular posterior segment with a 2.0-mm cortical shell and D4 cancellous core was constructed with a 4.3 \u00d7 11.4-mm titanium implant and a cemented monolithic zirconia crown. CD used a 4.0-mm osteotomy in D4 bone. The OD model used the same osteotomy plus a concentric peri-implant densified shell with radial density gradation from D1 to D3. The implant\u2013bone interface was defined as bonded. Static 100 N axial and 45\u00b0 oblique loads were applied. Outcomes were \u03b5eq, \u03b5max, and \u03b5min, summarized as mean top-10 nodal values. OD reduced crestal cortical strains under both loads. Under axial loading, \u03b5eq, \u03b5max, and |\u03b5min| decreased by 17.7%, 19.0%, and 24.1%, respectively. Under oblique loading, the corresponding reductions were 9.8%, 8.0%, and 8.9%. Oblique loading produced higher cortical strains than axial loading in both models. OD-inspired peri-implant densification reduced crestal cortical strain in this osteoporotic-like model, whereas oblique loading remained the main driver of elevated strain. These findings support occlusal\/prosthetic strategies that minimize oblique forces and warrant experimental and clinical validation.<\/jats:p>","DOI":"10.3390\/jfb17030149","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:10:04Z","timestamp":1773825004000},"page":"149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanostat-Informed Strain Mapping of Osseodensification-Inspired Peri-Implant Densification Versus Conventional Drilling in Osteoporotic-like Low-Density Cancellous Bone: A 3D Static Linear Finite Element Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-8101","authenticated-orcid":false,"given":"Mesut","family":"Tuzlali","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagehan","family":"Baki","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5770-9163","authenticated-orcid":false,"given":"Nazik \u0130rem","family":"\u00d6n\u00fcg\u00f6ren","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4798-4548","authenticated-orcid":false,"given":"K\u00fcbra","family":"Aral","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Faculty of Dentistry, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-5571","authenticated-orcid":false,"given":"Erkan","family":"Bah\u00e7e","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Faculty of Engineering, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7366-345X","authenticated-orcid":false,"given":"C\u00fcneyt As\u0131m","family":"Aral","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Faculty of Dentistry, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref_1","first-page":"55","article-title":"Osseointegration: A review of the fundamentals for assuring cementless skeletal fixation","volume":"2014","author":"Isaacson","year":"2014","journal-title":"Orthop. Res. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s43465-024-01316-y","article-title":"Fixation Failure in Osteoporotic Bone: A Review of Complications and Outcomes","volume":"59","author":"Mukhopadhaya","year":"2025","journal-title":"Indian J. Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.jcot.2020.06.028","article-title":"Advancements in osteoporotic spine fixation","volume":"11","author":"Tandon","year":"2020","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_4","first-page":"46","article-title":"An overview and management of osteoporosis","volume":"4","year":"2017","journal-title":"Eur. J. Rheumatol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Shen, Y., Huang, X., Wu, J., Lin, X., Zhou, X., Zhu, Z., Pan, X., Xu, J., Qiao, J., and Zhang, T. (2022). The Global Burden of Osteoporosis, Low Bone Mass, and Its Related Fracture in 204 Countries and Territories, 1990\u20132019. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.882241"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.berh.2010.10.003","article-title":"Osteoporosis and fragility fractures","volume":"24","author":"Wilson","year":"2010","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.ijom.2017.05.021","article-title":"Dental implants in patients with osteoporosis: A systematic review with meta-analysis","volume":"47","author":"Kudo","year":"2018","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1007\/s00784-023-05005-2","article-title":"Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis","volume":"27","author":"Lemos","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.33425\/2639-9490.1142","article-title":"Medication-Related Osteonecrosis of the Jaw\u20132024 Update","volume":"8","author":"Seo","year":"2024","journal-title":"Oral Health Dent. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1111\/clr.14453","article-title":"Medication-Related Osteonecrosis of the Jaws in Patients on Antiresorptive Medication With Dental Implants. A Scoping Review","volume":"36","author":"Andersen","year":"2025","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.joms.2022.02.008","article-title":"American Association of Oral and Maxillofacial Surgeons\u2019 Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update","volume":"80","author":"Ruggiero","year":"2022","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s00784-020-03432-z","article-title":"Effect of bone quality and quantity on the primary stability of dental implants in a simulated bicortical placement","volume":"25","author":"Rues","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101749","DOI":"10.1016\/j.jormas.2023.101749","article-title":"Risk factors associated with early implant failure: A retrospective review","volume":"125","author":"Yari","year":"2024","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.11607\/jomi.4817","article-title":"A Novel Osseous Densification Approach in Implant Osteotomy Preparation to Increase Biomechanical Primary Stability, Bone Mineral Density, and Bone-to-Implant Contact","volume":"32","author":"Huwais","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/ID.0000000000000358","article-title":"New Osseodensification Implant Site Preparation Method to Increase Bone Density in Low-Density Bone: In Vivo Evaluation in Sheep","volume":"25","author":"Trisi","year":"2016","journal-title":"Implant. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/cid.13007","article-title":"Osseodensification effect on implants primary and secondary stability: Multicenter controlled clinical trial","volume":"23","author":"Bergamo","year":"2021","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mohammadi, M., Mohamadi Moghadam, M., and Arab-Zozani, M. (2025). Primary and secondary stability in implants placed in low-density bone using conventional vs. osseodensification technique: A systematic review and meta-analysis. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-07201-w"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e70126","DOI":"10.1002\/cre2.70126","article-title":"The Effect of Osseodensification on Implant Stability and Marginal Bone Levels: A Randomized Control Clinical Trial","volume":"11","author":"Politi","year":"2025","journal-title":"Clin. Exp. Dent. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1002\/ar.a.10119","article-title":"Bone\u2019s mechanostat: A 2003 update","volume":"275","author":"Frost","year":"2003","journal-title":"Anat. Rec. A Discov. Mol. Cell. Evol. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1002\/jbmr.1599","article-title":"Bones\u2019 adaptive response to mechanical loading is essentially linear between the low strains associated with disuse and the high strains associated with the lamellar\/woven bone transition","volume":"27","author":"Sugiyama","year":"2012","journal-title":"J. Bone Min. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Marques, F.C., Boaretti, D., Walle, M., Scheuren, A.C., Schulte, F.A., and M\u00fcller, R. (2023). Mechanostat parameters estimated from time-lapsed in vivo micro-computed tomography data of mechanically driven bone adaptation are logarithmically dependent on loading frequency. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1140673"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Fontes Pereira, J., Costa, R., Nunes Vasques, M., Salazar, F., Mendes, J.M., and Infante da C\u00e2mara, M. (2023). Osseodensification: An Alternative to Conventional Osteotomy in Implant Site Preparation: A Systematic Review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12227046"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s11914-023-00776-9","article-title":"Using Finite Element Modeling in Bone Mechanoadaptation","volume":"21","author":"Meslier","year":"2023","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/j.identj.2024.08.005","article-title":"Finite element analysis in the Dental Sciences: A Bibliometric and a Visual Study","volume":"75","author":"Xie","year":"2025","journal-title":"Int. Dent. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.dental.2023.04.002","article-title":"Finite element analysis in implant dentistry: State of the art and future directions","volume":"39","author":"Falcinelli","year":"2023","journal-title":"Dent. Mater."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13005-025-00566-x","article-title":"Fixture design effects on posterior dental implant stability using finite element analysis (FEA): A systematic review","volume":"22","author":"Kriswanto","year":"2025","journal-title":"Head Face Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/s13191-012-0189-7","article-title":"Evaluation of stress distribution in bone of different densities using different implant designs: A three-dimensional finite element analysis","volume":"13","author":"Premnath","year":"2013","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11025","DOI":"10.1016\/j.ceramint.2016.03.245","article-title":"The bending stress distribution in bilayered and graded zirconia-based dental ceramics","volume":"42","author":"Fabris","year":"2016","journal-title":"Ceram. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jmbbm.2016.06.007","article-title":"Biomechanical and histologic basis of osseodensification drilling for endosteal implant placement in low density bone. An experimental study in sheep","volume":"63","author":"Lahens","year":"2016","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Pisarciuc, C., Dan, I., and Cioar\u0103, R. (2023). The Influence of Mesh Density on the Results Obtained by Finite Element Analysis of Complex Bodies. Materials, 16.","DOI":"10.3390\/ma16072555"},{"key":"ref_31","first-page":"202","article-title":"Stress and strain distribution in three different mini dental implant designs using in implant retained overdenture: A finite element analysis study","volume":"9","author":"Aunmeungtong","year":"2016","journal-title":"Oral Implantol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8851098","DOI":"10.1155\/2023\/8851098","article-title":"A Nonlinear Three-Dimensional Finite Element Analysis of Stress Distribution and Microstrain Evaluation in Short Dental Implants with Three Different Implant-Abutment Connections in Single and Splinted Conditions in the Posterior Mandible","volume":"2023","author":"Talreja","year":"2023","journal-title":"Int. J. Dent."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"53","DOI":"10.34172\/joddd.2022.009","article-title":"A 3-D finite element analysis of the effect of dental implant thread angle on stress distribution in the surrounding bone","volume":"16","author":"Sadr","year":"2022","journal-title":"J. Dent. Res. Dent. Clin. Dent. Prospect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1080\/10255842.2023.2190832","article-title":"Preventing stress singularities in peri-implant bone\u2014A finite element analysis using a graded bone model","volume":"27","author":"Roffmann","year":"2024","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"\u0130lter Er, \u00d6., and \u00c7elenk, S. (2025). Finite Element Analysis of Stress Distribution in Immature Permanent Incisors Following MTA Apexification with Different Coronal Base Materials. Biomimetics, 10.","DOI":"10.3390\/biomimetics10110746"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/ar.1092190104","article-title":"Bone \u201cmass\u201d and the \u201cmechanostat\u201d: A proposal","volume":"219","author":"Frost","year":"1987","journal-title":"Anat. Rec."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.medengphy.2016.08.008","article-title":"Numerical prediction of peri-implant bone adaptation: Comparison of mechanical stimuli and sensitivity to modeling parameters","volume":"38","author":"Piccinini","year":"2016","journal-title":"Med. Eng. Phys."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1002\/jbm.b.34154","article-title":"The effect of osseodensification drilling for endosteal implants with different surface treatments: A study in sheep","volume":"107","author":"Lahens","year":"2019","journal-title":"J. Biomed. Mater. Res. B Appl. Biomater."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Baek, Y.-W., Lim, Y.-J., and Kim, B. (2023). Comparison of Implant Surgery Methods of Cortical Tapping and Cortical Widening in Bone of Various Density: A Three-Dimensional Finite Element Study. Materials, 16.","DOI":"10.3390\/ma16083261"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Yang, Y., Liu, Y., Yuan, X., Ren, M., Chen, X., Luo, L., Zheng, L., and Liu, Y. (2023). Three-dimensional finite element analysis of stress distribution on short implants with different bone conditions and osseointegration rates. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-02945-9"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Mederos, P., Rodr\u00edguez-Guerra, J., Gonz\u00e1lez, J.E., Picardo, A., and Torres, Y. (2025). A Finite Element Analysis of a New Dental Implant Design: The Influence of the Diameter, Length, and Material of an Implant on Its Biomechanical Behavior. Materials, 18.","DOI":"10.3390\/ma18122692"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S178","DOI":"10.1080\/10255842.2020.1813424","article-title":"Influence of dental implant designs on the strain at the peri-implant cortical bone: A finite element study","volume":"23","author":"Londono","year":"2020","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"10797","DOI":"10.1038\/s41598-021-90142-5","article-title":"The limit of tolerable micromotion for implant osseointegration: A systematic review","volume":"11","author":"Kohli","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"265412","DOI":"10.1155\/2013\/265412","article-title":"Micromotion of Dental Implants: Basic Mechanical Considerations","volume":"2013","author":"Winter","year":"2013","journal-title":"J. Med. Eng."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1055\/s-0039-1697833","article-title":"Bite force and influential factors on bite force measurements: A literature review","volume":"4","author":"Koc","year":"2010","journal-title":"Eur. J. Dent."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1007\/s10237-016-0787-0","article-title":"Linear viscoelasticity-bone volume fraction relationships of bovine trabecular bone","volume":"15","author":"Manda","year":"2016","journal-title":"Biomech. Model. Mechanobiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1002\/jbmr.2437","article-title":"Bone volume fraction and fabric anisotropy are better determinants of trabecular bone stiffness than other morphological variables","volume":"30","author":"Maquer","year":"2015","journal-title":"J. Bone Min. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"106675","DOI":"10.1016\/j.cmpb.2022.106675","article-title":"Reporting guidelines for in-silico studies using finite element analysis in medicine (RIFEM)","volume":"216","author":"Mathur","year":"2022","journal-title":"Comput. Methods Prog. Biomed."}],"container-title":["Journal of Functional Biomaterials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-4983\/17\/3\/149\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:31:22Z","timestamp":1773826282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-4983\/17\/3\/149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,18]]},"references-count":48,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jfb17030149"],"URL":"https:\/\/doi.org\/10.3390\/jfb17030149","relation":{},"ISSN":["2079-4983"],"issn-type":[{"value":"2079-4983","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,18]]}}}