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Influence of Implant Length on the Biomechanical Behavior of Pterygoid Implant-supported Maxillary Prostheses: A Finite Element Analysis


Authors:

Rimsha Bhatta

Ravi Chandran

Yuanyuan Duan, BDS – Assistant Professor, School of Dentistry, University of Mississippi Medical Center

Abstract:

Purpose of the Study: Pterygoid implants have been used as an alternative solution for the rehabilitation of atrophic posterior maxilla in the clinical practice, however there is still a lack of systematic research on their biomechanical behavior. The aim of this study is to create three-dimensional (3D) computational models of pterygoid implant-supported maxillary prostheses and to evaluate the influence of implant length on the biomechanical behavior of pterygoid implant-supported maxillary prostheses using Finite Element Analysis (FEA) method.

Methods: 3D models composed of a standardized human skull, pterygoid implants, regular dental implants and maxillary prostheses were created using an interactive medical image processing software (Simpleware ScanIP, Synopsis) based on micro-CT (Skyscan 1172, Microphotonics) and cone-beam CT (iCAT, Imaging Sciences International) images. Four different clinical scenarios were simulated to investigate the influence of pterygoid implant length (11.5mm, 13mm, 15mm and 18mm) on the stress distribution of pterygoid implants. Volume meshes were created in Simpleware and then exported to a commercial FEA software (ABAQUS, Simulia). An axial loading of 150N was applied to the occlusal surfaces uniformly to simulate the physiological human occlusal force. All the stress calculations were performed in ABAQUS.

Results: Highest von Mises stress values were found to be located at the abutment region of pterygoid implant for all four cases. The model with 18mm pterygoid implant has the highest von Mises stress of 17.71 MPa among all four cases, while the model with 11.5mm implant has the lowest von Mises stress value of 12.42 MPa among all the cases. However, the model with 13mm implant had a higher von Mises stress value than the model with 15mm implant.

Conclusion: FEA models of pterygoid implant-supported prostheses were successfully created based on CT data. Model with 18mm implant had the highest von Mises stress value among all four cases while model with 11.5mm implant had the lowest von Mises stress. More consideration should be given when longer implants are used in the pterygoid region.

Articles: 1. Rodriguez, X., Rambla, F., Lopez, L. D. M., Mendez, V., Vela, X., & Garcia, J. J. (2014). Anatomical Study of the Pterygomaxillary Area for Implant Placement: Cone Beam Computed Tomographic Scanning in 100 Patients. The International Journal of Oral & Maxillofacial Implants, 29(5), 1049–1052. doi: 10.11607/jomi.3173. 2. Curi, Marcos Martins, et al. “Retrospective Study of Pterygoid Implants in the Atrophic Posterior Maxilla: Implant and Prosthesis Survival Rates Up to 3 Years.” The International Journal of Oral & Maxillofacial Implants, vol. 30, no. 2, 2015, pp. 378–383., doi:10.11607/jomi.3665. 3. Candel E, Peñarrocha D, Peñarrocha M. Rehabilitation of the atrophic posterior maxilla with pterygoid implants: a review. J Oral Implantol. 2012;38 Spec No:461–466.

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