Regenerated Bone Quality as a Determinant of Bone Turnover and Prognosis in Short Plateau Implants: A Finite Element Study

Background/Objectives: Finite element analysis (FEA) can predict biomechanical performance of dental implants in compromised bone. In the posterior maxilla, low bone density, thin cortex, and variable regenerated bone stiffness may lead to pathological peri-implant strains. This study examined the effects of implant diameter, cortical thickness, cancellous bone type, and regenerated bone elasticity on strain distribution in short plateau (Bicon SHORT®) implants. Methods: Three-dimensional FEA models of type III and IV maxillae with cortical layers of 1.0, 0.75, and 0.5 mm were developed. Implants of 4.5, 5.0, and 6.0 mm diameter were tested, with regenerated bone elasticity set to 25–100% of cortical values. An oblique load of 120.9 N at 75° was applied under full osseointegration, and first principal strains were compared with Frost’s 3000 με threshold. Results: Cortical strains remained at physiological levels, but cancellous bone in type IV often exceeded 3000 με, especially with smaller diameters and low regenerated stiffness. Enlarging implant diameter to 6.0 mm lowered cancellous maximal first principal strain by up to 56% in type III and 36% in type IV bone. Reduced regenerated bone elasticity markedly increased risk, particularly with cortical thickness < 0.75 mm. Conclusions: Biomechanical risk depends on implant diameter and regenerated bone quality. Wide short implants (6.0 mm) most effectively limited pathological strain under low cortical support and poor regenerated stiffness. Patient-specific FEA may guide implant choice and improve outcomes in atrophic maxilla rehabilitation.