Simulation of the sinus floor elevation

Association between implant apex and sinus floor in posterior maxilla dental implantation: A three-dimensional finite element analysis

The aim of the present study was to evaluate the effect of the association between the implant apex and the sinus floor in posterior maxilla dental implantation by means of three-dimensional (3D) finite element (FE) analysis. Ten 3D FE models of a posterior maxillary region with a sinus membrane and different heights of alveolar ridge with different thicknesses of sinus floor cortical bone were constructed according to anatomical data of the sinus area. Six models were constructed with the same thickness of crestal cortical bone and a 1-mm thick sinus floor cortical bone, but differing heights of alveolar ridge (between 10 and 14 mm). The four models of the second group were similar (11-mm-high alveolar ridge and 1-mm-thick crestal cortical bone) but with a changing thickness of sinus floor cortical bone (between 0.5 and 2.0 mm). The standard implant model based on the Nobel Biocare^® implant system was created by computer-aided design (CAD) software and assembled into the models. The materials were assumed to be isotropic and linearly elastic. An inclined force of 129 N was applied. The maximum von Mises stress, stress distribution, implant displacement and resonance frequencies were calculated using CAD software. The von Mises stress was concentrated on the surface of the crestal cortical bone around the implant neck with the exception of that for the bicortical implantation. For immediate loading, when the implant apex broke into or through the sinus cortical bone, the maximum displacements of the implant, particularly at the implant apex, were smaller than those in the other groups. With increasing depth of the implant apex in the sinus floor cortical bone, the maximum displacements decreased and the implant axial resonance frequencies presented a linear upward tendency, but buccolingual resonance frequencies were hardly affected. This FE study on the association between implant apex and sinus floor showed that having the implant apex in contact with, piercing or breaking through the sinus floor cortical bone benefited the implant stability, particularly for immediate loading.

Maxillary Sinus Augmentation without Grafting Material with Simultaneous Implant Installation: A Three-Dimensional Finite Element Analysis

PURPOSE

The study aims to provide a theoretical guidance of postmaxillary implant in the augmented sinus without grafting materials by establishing a three-dimensional model of this new implant restorative technique, evaluating failure risk of sinus augmentation without grafting materials of different alveolar ridge heights, and analyzing stress distribution of different healing stage.

MATERIALS AND METHODS

Seventeen three-dimensional finite element models of a posterior maxillary region with sinus mucosa and different elevation heights were constructed according to anatomical data of sinus area, and the standard implant model based on Nobel Biocare implant system were created via computer-aided design software. All materials were assumed to be isotropic and linearly elastic. Axial force of 150 N was applied. The von Mises stress, stress distribution, and implant displacement were calculated with software.

RESULTS

With the height of the alveolar ridge reducing, the maximum von Mises stress of tissues and the displacement of the implant are on the rise, especially when the height of the bone is less than 7 mm. When the height decreased to 4 mm, the data may be doubled. After the stiff callus stage, the stress and displacement were close to the control model.

CONCLUSION

For maxillary sinus augmentation without grafting material implant technique, the stress of different tissues and the displacement of the implant were not increased much when the height of alveolar ridge is more than 7 mm. But if the alveolar bone height is less than 4 mm, this implant technique is not suggested. Immediately loading is not suggested and the loading opportunity should be after the stiff callus stage at least to improve the success rate.