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Maxillary "All-On-Four" treatment using zygomatic implants. A mechanical analysis.

P H de Moraes1, S Olate2, M de Arruda Nóbilo3

  • 1Division of oral and maxillofacial surgery, State University of Campinas, Piracicaba, Brazil.

Revue De Stomatologie, De Chirurgie Maxillo-Faciale Et De Chirurgie Orale
|January 27, 2016
PubMed
Summary

This study compared stress distribution in two "All-On-Four" maxillary procedures using zygomatic implants. Using four zygomatic implants showed lower stress on alveolar bone, suggesting better mechanical suitability for dental rehabilitation.

Keywords:
Dental implantsImplants dentairesMechanicalStressStress mécaniqueZygomas

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Biomechanical Engineering
  • Dental Implantology

Background:

  • Zygomatic implants offer a solution for dental rehabilitation in patients with severe maxillary atrophy.
  • The "All-On-Four" concept utilizes strategically placed implants to support a full-arch prosthesis.
  • Understanding stress distribution is crucial for optimizing implant placement and long-term success.

Purpose of the Study:

  • To experimentally evaluate stress distribution patterns in two different "All-On-Four" maxillary configurations involving zygomatic implants.
  • To compare the biomechanical outcomes of using two posterior zygomatic implants with either anterior conventional or anterior zygomatic implants.

Main Methods:

  • Polyurethane craniomaxillary models and surgical guides were used to determine optimal implant positioning.
  • Two groups were created: Group 1 (2 posterior zygomatic, 2 anterior conventional implants) and Group 2 (4 zygomatic implants).
  • Photoelastic models were subjected to unilateral compressive loading simulating molar bite forces to measure strain distribution.

Main Results:

  • Group 1 exhibited significant strain concentration in the orbital region near the zygomatic implant apex.
  • Group 2 demonstrated high strains in the lateral inferior orbital area, with reduced load on the alveolar bone.
  • Conventional anterior implants in Group 1 showed less strain compared to zygomatic implants.

Conclusions:

  • Zygomatic implants, particularly when used in a four-implant configuration, subject zygomatic bone and paranasal structures to high stress levels.
  • The biomechanical analysis suggests that utilizing four zygomatic implants is mechanically advantageous over a two-zygomatic implant approach for maxillary rehabilitation.
  • This finding supports the mechanical suitability of the four-zygomatic implant configuration for stabilizing full maxillary prostheses.