Three-dimensional finite element analysis of zygomatic implants for rehabilitation of patients with a severely atrophic maxilla. 2023

Kevin George Varghese, and Nirmal Kurian, and Nitasha Gandhi, and Sumir Gandhi, and Angleena Y Daniel, and Hemiya Anna Thomas, and Nishanth A Sudharson, and Samiksha Wadhwa
Assistant Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India. Electronic address: kevinkottackal@gmail.com.

BACKGROUND Stresses applied to zygomatic implants have been determined to be transferred mainly to the zygomatic bone; however, consensus regarding the stress distribution pattern in the bone surrounding zygomatic implants has not yet been reached. OBJECTIVE The purpose of this 3-dimensional (3D) finite element analysis (FEA) study was to visually compare the stress distribution pattern in 2 different zygomatic implant treatment modalities and evaluate the effect of masseter musculature involvement. METHODS A 3D FEA craniofacial model was constructed from the computed tomography (CT) data of a selected patient with a severely atrophic edentulous maxilla. Modeled zygomatic and conventional implants were inserted into the craniofacial model supporting a prosthesis superstructure. Two types of treatment were considered in the study: 2 zygomatic implants placed bilaterally or 2 zygomatic implants placed in conjunction with at least 2 conventional implants at the anterior maxilla. The models were loaded with a vertical force of 150 N, a lateral force of 50 N, and a distributed occlusal force of 300 N applied to the insertion area of the masseter muscle. The stresses on and deformations of the bones and implants were then observed and compared with and without the involvement of the musculature component. RESULTS The stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull; however, a difference in distribution pattern was observed when the models were loaded without applying the muscle component. The maximum deformation of bones surrounding the implants occurred in the abutment connection of the conventional anterior implant in the model with an additional conventional anterior implant. CONCLUSIONS The FEA revealed the stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull. However, the stresses in both models were concentrated in the zygomatic bone when incorporating the muscle component. Therefore, incorporating muscular force into FEA studies could affect the analysis result.

UI MeSH Term Description Entries
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001284 Atrophy Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. Atrophies
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic
D015050 Zygoma Either of a pair of bones that form the prominent part of the CHEEK and contribute to the ORBIT on each side of the SKULL. Cheek Bone,Jugal Bone,Malar Bone,Zygomatic Arch,Arches, Zygomatic,Zygomatic Arches,Arch, Zygomatic,Bone, Cheek,Bone, Jugal,Bone, Malar,Bones, Cheek,Bones, Jugal,Bones, Malar,Cheek Bones,Jugal Bones,Malar Bones,Zygomas
D015921 Dental Implants Biocompatible materials placed into (endosseous) or onto (subperiosteal) the jawbone to support a crown, bridge, or artificial tooth, or to stabilize a diseased tooth. Dental Implants, Mini,Dental Prosthesis, Surgical,Implants, Dental,Dental Implant,Dental Prostheses, Surgical,Implant, Dental,Prostheses, Surgical Dental,Prosthesis, Surgical Dental,Surgical Dental Prostheses,Surgical Dental Prosthesis,Dental Implant, Mini,Mini Dental Implant,Mini Dental Implants
D019094 Dental Prosthesis, Implant-Supported A prosthesis that gains its support, stability, and retention from a substructure that is implanted under the soft tissues of the basal seat of the device and is in contact with bone. (From Boucher's Clinical Dental Terminology, 4th ed) Denture, Implant-Supported,Implant-Supported Dental Prosthesis,Implant-Supported Denture,Prosthesis Dental, Implant-Supported,Dental Prostheses, Implant-Supported,Dental Prosthesis, Implant Supported,Dental, Implant-Supported Prosthesis,Dentals, Implant-Supported Prosthesis,Denture, Implant Supported,Dentures, Implant-Supported,Implant Supported Dental Prosthesis,Implant Supported Denture,Implant-Supported Dental Prostheses,Implant-Supported Dentures,Implant-Supported Prosthesis Dental,Implant-Supported Prosthesis Dentals,Prostheses, Implant-Supported Dental,Prosthesis Dental, Implant Supported,Prosthesis Dentals, Implant-Supported,Prosthesis, Implant-Supported Dental
D020342 Finite Element Analysis A computer based method of simulating or analyzing the behavior of structures or components. Analysis, Finite Element,Analyses, Finite Element,Element Analyses, Finite,Element Analysis, Finite,Finite Element Analyses

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