Fixture design effects on posterior dental implant stability using finite element analysis (FEA): a systematic review

Sep 30, 2026

Tooth loss is prevalent in the posterior region, requiring dental implants with optimized fixture designs to achieve biomechanical stability. This systematic review, written using PRISMA 2020, evaluates how fixture design parameters affect posterior implant stability outcomes such as stress and strain via finite element analysis. Searches across PubMed, ScienceDirect, MDPI, SpringerLink, and OpenAire (2020–12 Jan 2025) yielded 39 studies from 3,562, narratively synthesized by design variables and assessed with ROBFEAD.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages30

Reading Time1 h 16 min

AccessFree to download

Abstract

Introduction

Tooth loss and clinical relevance

Contributing factors and epidemiology

Kriswanto etal. Head & Face Medicine (2026) 22:2 [https://doi.org/10.1186/s13005-025-00566-x](https://doi.org/10.1186/s13005-025-00566-x) Head & Face Medicine REVIEW Open Access Fixture design effects on posterior dental implant stability using finite element analysis (FEA): a systematic review Kriswanto Kriswanto 1,2,3*, Jamari Jamari 1,3, Rachael Andika2,3, Athanasius Priharyoto Bayuseno 1, Abdulfatah Abdu Yusuf4,5 and Muhammad Imam Ammarullah 1,3,5* Abstract Tooth loss is prevalent in the posterior region, and dental implants require optimized fixture design to ensure biomechanical stability, which is often the approach using finite element analysis (FEA) . This systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines in its writing, aimed to assess the influence of fixture design on posterior implant biomechanical stability, such as stress and strain, by FEA analysis. The study search used PubMed, ScienceDirect, MDPI, SpringerLink, and OpenAire databases to find studies that analyzed fixture level, body shape, thread characteristics, diameter, length, and neck model, covering studies published between 2020 and 12 January 2025. Data from 39 of the 3,562 studies were synthesized narratively, guided by SWiM, and grouped by design parameters, with bias assessed using ROBFEAD. Tissue-level fixtures outperformed bone-level fixtures in reducing cortical bone stress and improving fatigue resistance, while the tapered body shape increased stress distribution in low-density bone (D4) . Square threads minimize micro stress and movement, and larger diameters and lengths increase stability, although excessive dimensions increase cortical stress. The micro-thread neck design reduces bone resorption. The high risk of bias resulting from the lack of mechanical validation, isotropic assumptions, and static loading conditions requires attention when interpreting research findings. Clinical or experimental validation is required. Future studies should standardize thread reporting, use computed tomography (CT)-based modeling, and simulate dynamic loading for patient-specific designs. Keywords Fixture design, Posterior, Dental implant, Stability, Finite element analysis (FEA), Patient *Correspondence: Kriswanto Kriswanto[kriswanto@mail. unnes.ac.id](kriswanto@mail. unnes.ac.id)[ ](kriswanto@mail. unnes.ac.id)Muhammad Imam Ammarullah [imamammarullah@gmail.com](imamammarullah@gmail.com) 1Department of Mechanical Engineering, Faculty of Engineering, Universitas Diponegoro, Semarang, Central Java 50275, Indonesia 2Department of Mechanical Engineering, Faculty of Engineering, Universitas Negeri Semarang, Semarang, Central Java 50229, Indonesia 3Undip Biomechanics Engineering & Research Centre (UBM-ERC), Universitas Diponegoro, Semarang, Central Java 50275, Indonesia 4Department of Mechanical Engineering, College of Engineering, University of Liberia, Monrovia, Montserrado 1000, Liberia 5Bioengineering and Environmental Sustainability Research Centre, University of Liberia, Monrovia, Montserrado 1000, Liberia Introduction Tooth loss substantially impacts a person’s quality of life, especially interfering with important oral functions such as mastication and speech [1–4]. Dental caries, periodontal disease, malocclusion, systemic disorders, trauma, tooth impaction, smoking, drug use, and aging can be factors that contribute to tooth loss [5–10]. Dental caries are caused by the prolonged interaction between acidogenic bacteria, fermentable carbohydrates, and saliva, which damage tooth enamel [11]. Periodontal disease, a chronic inflammatory condition affecting the supporting structures of the teeth, arises from the body’s © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate c

FAQs

What is the main objective of the systematic review?

To assess how fixture design influences posterior dental implant biomechanical stability measured by stress and strain using finite element analysis (FEA).

Which databases were used to search for eligible studies?

PubMed, ScienceDirect, MDPI, SpringerLink, and OpenAire were used to locate studies published between 2020 and 12 January 2025.

What design aspects and outcomes does the review focus on?

It groups evidence by fixture parameters including fixture level, body shape, thread characteristics, diameter, length, and neck model, and synthesizes outcomes related to biomechanical stability.

Sep 30, 2026

Uploaded by Sophia Brooks