scholarly journals Different Treatment Modalities Using Dental Implants in the Posterior Maxilla: A Finite Element Analysis

2021 ◽  
Vol 32 (1) ◽  
pp. 34-41
Author(s):  
Dimorvan Bordin ◽  
Mariane Boaventura de Castro ◽  
Marco Aurélio de Carvalho ◽  
Anderson Macena de Araujo ◽  
Altair Antoninha Del Bel Cury ◽  
...  
Keyword(s):  
Shear Stress ◽  
Bone Graft ◽  
Maxillary Sinus ◽  
Bone Tissue ◽  
Standard Length ◽  
Treatment Modalities ◽  
Biomechanical Behavior ◽  
Short Implants ◽  
Posterior Maxilla ◽  
Short Implant

Abstract The objective of this study was to compare the biomechanical behavior of peri-implant bone tissue and prosthetic components in two modalities of treatment for posterior region of the maxilla, using short implants or standard-length implants associated with bone graft in the maxillary sinus. Four 3D models of a crown supported by an implant fixed in the posterior maxilla were constructed. The type of implant: short implant (S) or standard-length implant with the presence of sinus graft (L) and type of crown retention: cemented (C) or screwed (S) were the study factors. The models were divided into SC- cemented crown on a short implant; SS- screwed crown on the short implant; LC- cemented crown on a standard-length implant after bone graft in the maxillary sinus and LS- crown screwed on a standard-length implant after bone graft in the maxillary sinus. An axial occlusal loading of 300 N was applied, divided into five points (60N each) corresponding to occlusal contact. The following analysis criteria were observed: Shear Stress, Maximum and Minimum Main Stress for bone tissue and von Mises Stress for the implant and prosthetic components. The use of standard-length implants reduced the shear stress in the cortical bone by 35.75% and the medullary bone by 51% when compared to short implants. The length of the implant did not affect the stress concentration in the crown, and the cement layer acted by reducing the stresses in the ceramic veneer and framework by 42%. Standard-implants associated with cemented crowns showed better biomechanical behavior.

scholarly journals A 3D finite element analysis of bone tissue in three-unit implant-supported prostheses configurations through varying configuration factors (single-unit and splinted crowns in straight-line and offset configurations) and implant lengths in the maxillary posterior region

2021 ◽  
Vol 10 (5) ◽  
pp. e56510515336
Author(s):  
Victor Eduardo de Souza Batista ◽  
Fellippo Ramos Verri ◽  
Cleidiel Aparecido Araújo Lemos ◽  
Ronaldo Silva Cruz ◽  
Pedro Yoshito Noritomi ◽  
...  
Keyword(s):  
Finite Element ◽  
Bone Tissue ◽  
Single Unit ◽  
Three Dimensional ◽  
Element Analysis ◽  
3D Finite Element ◽  
Biomechanical Behavior ◽  
Straight Line ◽  
Short Implants ◽  
Implant Length

The objective of the present study was to analyze the stress and microstrain on cortical bone tissue caused by occlusal forces on three-unit implant-supported prostheses placed in the maxillary posterior region through varying configuration factors and implant lengths using 3D finite element analysis. Fifteen three-dimensional models were simulated with the support of the In Vesalius, SolidWorks 2016, and Rhinoceros 4.0 software programs. Each three-dimensional model included a maxillary bone block corresponding to the region from the 1st premolar to the 1st right molar with three EH implants measuring 4.0 mm in diameter, which supported the three-unit metal-ceramic screw-retained prosthesis through varying configuration factors (single-unit and splinted crowns: straight-line and tripod design) and implant lengths (10, 8.5, and 7 mm × Ø4 mm). The FEMAP 11.4.2 program was used to generate the finite element models in the pre- and post-processing phases. Bone tissue was analyzed using Maximum Principal Stress (MPa) and Microstrain (με) maps. The highest stress/microstrain values were observed in oblique loading. In addition, splinting associated with the offset configuration generated improved biomechanical behavior. Furthermore, the association of short implants with longer implants did not exhibit any biomechanical benefits. Moreover, a reduced implant length (i.e., 7 mm) generated unfavorable biomechanical behavior. Splinting was effective in reducing the stress/microstrain on cortical bone tissue, especially when associated with the offset configuration of the implants. Also, an increased implant length decreased the stress/microstrain in the bone tissue, and splinted short implants presented similar biomechanical behavior to short implants associated with longer implants.

Early Implant Placement in Bilateral Sinus Floor Augmentation Using Iliac Bone Block Grafts in Severe Maxillary Atrophy: A Clinical, Histological, and Radiographic Case Report

2009 ◽  
Vol 35 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Alessandro Acocella ◽  
Roberto Sacco ◽  
Paolo Nardi ◽  
Tommaso Agostini
Keyword(s):  
Bone Graft ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Autologous Bone Graft ◽  
Bone Block ◽  
Alveolar Ridge ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Maxillary Atrophy

Abstract Effectively restoring a grossly atrophic maxilla can be difficult for the implant surgeon. The placement of dental implants in patients who are edentulous in the posterior maxilla can present difficulties because of deficient posterior alveolar ridge and increased pneumatization of the maxillary sinus, resulting in a minimal hard tissue bed. Implant placement requires adequate quality and quantity of bone, especially in the posterior maxilla. Insufficient bone height and width in this area of the maxilla, because of expansion of the maxillary sinus and atrophic reduction of the alveolar ridge, represents a contraindication for conventional insertion of dental implants. The reconstruction of edentulous patients with adequate bone volume and density by the use of bone graft and, subsequently, the placement of dental implants has become a viable treatment option with high predictability. It is commonly shared that autologous bone graft is the gold standard grafting method in the augmentation of Higmoro antrum and in any kinds of guided bone regeneration. In this article, the authors report a case of severe maxillary atrophy that is augmented by block bone graft harvested from iliac crest. An early placement of implants is possible due to the quick healing of the site, as proven by histologic examinations.

Engineered Bone by Autologous Osteoblasts on Polymeric Scaffolds in Maxillary Sinus Augmentation: Histologic Report

2010 ◽  
Vol 36 (6) ◽  
pp. 491-496 ◽  
Author(s):  
Carlo Mangano ◽  
Adriano Piattelli ◽  
Lucia Tettamanti ◽  
Francesco Mangano ◽  
Alessandro Mangano ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Bone Tissue ◽  
Dental Implant ◽  
Sinus Augmentation ◽  
Maxillary Sinus Augmentation ◽  
Initial Stability ◽  
Polymeric Scaffolds ◽  
Sinus Cavity ◽  
Posterior Maxilla ◽  
Regenerative Therapies

Abstract Several regenerative therapies have been used for maxillary sinus grafting. However, recent advances in modern bone tissue engineering techniques have been evaluated. The aim of this histologic report was to evaluate the bone obtained by a culture of autogenous osteoblasts seeded on polyglycolic-polylactid scaffolds in maxillary sinus augmentation. A 56-year-old partially edentulous male with severe atrophy of the posterior maxilla received 6 polyglycolid-polylactid disks (8 mm diameter × 2 mm depth, Oral Bone), each carrying 1.5 million autogenous osteoblasts into the depth of the sinus cavity. After 6 months healing, a bone core was harvested and histologically evaluated. The augmented maxillary sinus with engineered bone presented a mean of 28.89% and 71.11% of bone and medullary spaces, respectively. Data from this case report demonstrate that the newly formed bone provided by engineered bone tissue allowed proper initial stability for dental implant placement. However, the role of this new bone in the long-term success of dental implant anchorage needs further investigation.

scholarly journals Synthetic Putty and Simultaneous Short Implant Placement in Crestal Sinus Lifting Procedures: 13–36 Months Follow-Up: A Case Series

2021 ◽  
Author(s):  
Maarten J Boogaard
Keyword(s):  
Bone Graft ◽  
Bone Growth ◽  
Case Series ◽  
Good Alternative ◽  
Sinus Lift ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Sinus Lifting ◽  
Sinus Floor ◽  
Short Implant

Introduction: Aim of this investigation is to show that in sites with less than 4 mm of bone height of the sinus floor, synthetic putty bone graft and simultaneous short implant placement in crestal sinus lifting procedures result in sufficient bone gain, and is a valuable option to the more invasive lateral-window approach. Case presentation: Four patients missing a single tooth or more in the posterior maxilla with remaining alveolar ridge height of less than 4mm underwent crestal sinus lift procedures with bone grafting using a synthetic putty material simultaneously. Loading of the short implants was done with a minimum of 4 months after placement showing bone growth around the implant and lift of the Schneiderian membrane between 2.3mm-7.3mm. Conclusion: Crestal sinus lift, in combination with a short implant and a synthetic putty bone graft, is a good alternative for lateral more invasive sinus lift when the thickness of the sinus floor is less than 4mm.

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon
Keyword(s):  
Maxillary Sinus ◽  
Surgical Techniques ◽  
Lateral Sinus ◽  
Sinus Floor Elevation ◽  
Second Molar ◽  
Sinus Wall ◽  
Posterior Maxilla ◽  
Significant Difference ◽  
Sinus Floor ◽  
Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

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