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Updated: Feb 8, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Stresses generated by two zygomatic implant placement techniques associated with conventional inclined anterior
Paulo H T Almeida1, Sergio H Cacciacane1, Fabiana M G França1
1Department of Dental Surgery, São Leopoldo Mandic Institute and Dental Research Center, Campinas, SP, Brazil.
Purpose:
To make a comparative evaluation, by means of the finite element method, of the stress generated on supporting tissues and prosthetic system components, using zygomatic implants with the exteriorized and extramaxillary techniques, and different placement positions, associated either with inclined anterior implants, or those without inclination.
Materials And Methods:
Eight (8) tridimensional models were created to represent the clinical situations being researched, using the dataset of scanned images of an edentulous model. The implants and prosthetic components were photographed on millimeter paper and inserted into Rhinoceros 3D modeling computer software. From the measurements made on the image, the virtual models were made. The application force was distributed on the occlusal surface of the working side of the left maxillary first molar, first and second premolars, and incisal regions of the central incisor, simulating the occlusal load during mastication, in a total of 150 N.
Results:
The extramaxillary technique presented considerable variation in increased tension on the prosthesis screws and bone tissue. In the exteriorized technique, the highest tension values occurred in the region of the ridge, and the lowest, on the zygomatic process; the absence of cantilever reduced the stress on bone tissue in almost all regions.
Conclusion:
The exteriorized technique was shown to be more favorable to the distribution of stresses on the micro-unit screws and bone tissue, with the model with zygomatic implant placed in the region of the first molar and inclined anterior implant presenting the best results.
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