Bone changes were reported after implant placement in three phases: healing, remodeling, and equilibrium. The remodeling phase is launched confronting the altered pattern of force transmission to the bone tissue. To withstand the applied functional load, continuous remodeling is conducted to reach a “steady state.” Mechanical stimulus is the primary bone modifier influenced by other in situ variables as hormonal, metabolic, genetic factors [39].

Clinically, as affordable as the strain, bone regeneration is configured, whereas the over-stimulation leads to adverse effects [40]. The bone around unloaded implants showed a low mineral density index. [41] The process of inducing more dense bone depends mainly on the loading protocol conducted [42]. The peri-implant bone around progressively loaded implants illustrated minimal crestal bone loss than the bone around implants placed conventionally, and the later cited extended increase in peri-implant bone density by time [10]. Based on radiological assessment, Barone et al. [43] stated statistical significant dense bone around immediate rather than unloaded oral implants.

Histochemically, the mechanical effect controls bone formation and mass modification with a percentage about 40% comparing to other growth-related factors as hormonal or cytokine deliver about 10% of the postnatal changes in bone strength and mass. Thereby, mineralization and tissue reformation by osteoblasts are co-related to the local mechanical environment [44]. The blood supply and nutrition are mandatory as osteoblast acting on the osteoid bone formation [45]. Bone tissue that experienced physiologic load is liable for osteogenic deformation [46]. Thus, strain must be in the physiologic bone limit (500–3000 μ strain) according to the elasticity modulus, while overstrain (>5000 μ strain) precipitates fibrogenesis [44, 47].

Considering physiologic changes, the annual alveolar bone resorption is approximately fourfold more in mandible comparing to the maxilla [48]. A longitudinal monitoring of edentulous complete denture wearers admitted continuous reduction of the residual alveolar ridge throughout the study. The anterior part of the mandible showed the higher average of reduction compared to the estimated rate of the maxilla [49]. The variation between the jaws in alveolar bone reduction increased gradually during the first years of denture wearing. This evidenced the unfavorable response of the mandible to various functional stresses transmitted through the denture to the limited and diminished bearing area of the mandibular alveolar bone comparing to the maxilla [50].