<div>
	穿颧骨种植上颌窦区种植体定位方案的三维有限元分析
</div>

doi:10.12439/kqhm.1005-4979.2024.05.007

《口腔颌面外科杂志》 ›› 2024, Vol. 34 ›› Issue (5): 371-378. doi: 10.12439/kqhm.1005-4979.2024.05.007

穿颧骨种植上颌窦区种植体定位方案的三维有限元分析

李静 1 ，李晨曦 2，3 ，裴培4 ，陈程5 ，龚忠诚2

（ 1. 新疆医科大学第一附属医院（附属口腔医院）口腔外科门诊，乌鲁木齐 830054；2. 新疆医科大学第一附属医院（附属口腔医院）口腔颌面肿瘤外科，新疆维吾尔自治区口腔医学研究所，乌鲁木齐 830054；3. 华中科技大学同济医学院附属协和医院口腔医学中心，口腔颌面发育与再生湖北省重点实验室，武汉 430022；4. 新疆医科大学第一附属医院（附属口腔医院）口腔修复种植科，乌鲁木齐 830054；5. 新疆大学软件工程学院，乌鲁木齐 830046 ）

出版日期:2024-10-28 发布日期:2024-10-31

Three-dimensional finite element analysis of implant positioning protocols in the maxillary sinus region for zygomatic bone implantation

LI Jing1, LI Chenxi2,3, PEI Pei4, CHEN Cheng5, GONG Zhongcheng2

(1. Department of Oral Surgery, the First Affiliated Hospital/Affiliated Stomatology Hospital of Xinjiang Medical University, Urumqi 830054; 2. Department of Oral and Maxillofacial Oncology & Surgery, the First Affiliated Hospital/Affiliated Stomatology Hospital of Xinjiang Medical University,Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054; 3. Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, School of Stomatology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan 430022;4. Department of Prosthodontics and Dental Implantology, the First Affiliated Hospital/ Affiliated Stomatology Hospital of Xinjiang Medical University, Urumqi 830054;5. College of Software Engineering, Xinjiang University, Urumqi 830046, China)

Online:2024-10-28 Published:2024-10-31

摘要/Abstract

摘要： 目的：探究上颌窦沟槽（sinus slot，SS）技术和经上颌窦外（extra sinus，ES）技术结合常规种植体行穿颧种植修复后的生物力学分布特点，为功能性修复上颌骨重度萎缩提供理论基础。方法：通过患者的高分辨计算机断层扫描（computed tomography，CT）资料建立有限元分析（finite element analysis，FEA）模型，虚拟化穿颧种植体（zygomatic implant，ZI）分别置于 SS 和 ES 模型，并结合使用 2 枚或 4 枚常规种植体。分析种植体 von Mises 应力值及牙槽骨中的主应力值。结果：配置 2 枚常规种植体 +2 枚 ES ZI 的 von Mises 应力值最大（292 MPa）；而 4 枚常规种植体 +2 枚 SS ZI 的最小（ 184 MPa）。配置 2 枚常规种植体 +2 枚 SS ZI 的最高主应力值最大（31 MPa）；而 4 枚常规种植体 +2 枚 ES ZI 的最小（ 12 MPa）。配置 4 枚常规种植体 +2 枚 SS ZI 的最低主应力值最小（ |-58| MPa）；而 2 枚常规种植体 +2 枚 ES ZI 的最大（ |-81| MPa）。结论：使用 2 枚SS ZI 和4枚常规种植体联合修复重度萎缩的上颌骨，在生物力学方面安全性更高。

关键词: 上颌骨重度萎缩, 穿颧种植体, 三维有限元分析, 应力分布

Abstract: Objective: To compare the distribution characteristics of biochemical stress on two techniques of zygomatic implant (ZI), sinus slot (SS) and extra sinus (ES), in combination with conventional implants respectively, and to provide theoretical basis for functional restoration of severe atrophic maxilla. Methods: Finite element analysis (FEA) models were constituted based on high-resolution computed tomography (CT) scanning data of a patient. ZIs were virtually placed into models with SS or ES techniques combined with two or four conventional implants. The von Mises stress values in implants and the principal stress values in alveolar bone were analyzed. Results: The highest von Mises stress was in the configuration of 2 conventional implants and 2 ZIs with ES technique (292 MPa). The lowest von Mises stress level in ZIs was in the configuration of 4 conventional implants and 2 ZIs with the SS technique (184 MPa). The highest maximum principal stress was in the configuration of 2 conventional implants and 2 ZIs with SS technique (31 MPa). The lowest maximum principal stress was in the configuration of 4 conventional implants and 2 ZIs with ES technique (12 MPa). The lowest minimum principal stress was in the configuration of 4 conventional implants and 2 ZIs with the SS technique (|-58| MPa). The highest minimum principal stress value in bone was in the configuration of 2 conventional implants and 2 ZIs with ES technique (|-81| MPa). Conclusion: Two ZIs with the SS technique and four conventional implants may be biomechanically safer for the rehabilitation of severe atrophic maxilla.

Key words: severe atrophic maxilla, zygomatic implant, three-dimensional finite element analysis, stress distribution

中图分类号:

R782

李静, 李晨曦, 裴培, 陈程, 龚忠诚.

穿颧骨种植上颌窦区种植体定位方案的三维有限元分析

[J]. 《口腔颌面外科杂志》, 2024, 34(5): 371-378.

LI Jing, LI Chenxi, PEI Pei, CHEN Cheng, GONG Zhongcheng. Three-dimensional finite element analysis of implant positioning protocols in the maxillary sinus region for zygomatic bone implantation[J]. 《Journal of Oral and Maxillofacial Surgery》, 2024, 34(5): 371-378.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2024/V34/I5/371

参考文献

[1] Aparicio C, Manresa C, Francisco K, et al. Zygomatic implants: Indications, techniques and outcomes, and the zygomatic success code[J]. Periodontol 2000, 2014, 66(1): 41-58.
[2] D'Agostino A, Lombardo G, Favero V, et al. Complications related to zygomatic implants placement: A retrospective evaluation with 5 years follow-up[J]. J Craniomaxillofac Surg, 2021, 49(7): 620-627.
[3] Ishak MI, Abdul Kadir MR, Sulaiman E, et al. Finite element analysis of different surgical approaches in various occlusal loading locations for zygomatic implant placement for the treatment of atrophic maxillae[J]. Int J Oral Maxillofac Surg, 2012, 41(9): 1077-1089.
[4] Nave PD, Queralt AV. Zygomatic implants for the rehabilitation of atrophic maxillae: A retrospective study on survival rate and biologic complications of 206 implants with a minimum follow-up of 1 year[J]. Int J Oral Maxillofac Implants, 2020, 35(6): 1177-1186.
[5] Ramezanzade S, Yates J, Tuminelli FJ, et al. Zygomatic implants placed in atrophic maxilla: An overview of current systematic reviews and meta-analysis[J]. Maxillofac Plast Reconstr Surg, 2021, 43(1): 1.
[6] Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period[J]. Scand J Plast Reconstr Surg Suppl, 1977, 16: 1-132.
[7] Brånemark PI, Gröndahl K, Ohrnell LO, et al. Zygoma fixture in the management of advanced atrophy of the maxilla: Technique and long-term results[J]. Scand J Plast Reconstr Surg Hand Surg, 2004, 38(2): 70-85.
[8] Padovan LEM, Suzuki D, Kluppel LE, et al. Factors influencing implant and prosthesis survival in zygomatic implant-supported fixed rehabilitation: A retrospective study[J]. Odontology, 2021, 109(4): 965-972.
[9] Ferrara ED, Stella JP. Restoration of the edentulous maxilla: The case for the zygomatic implants[J]. J Oral Maxillofac Surg, 2004, 62(11): 1418-1422.
[10] Maló P, Nobre MD, Lopes I. A new approach to rehabilitate the severely atrophic maxilla using extramaxillary anchored implants in immediate function: A pilot study[J]. J Prosthet Dent, 2008, 100(5): 354-366.
[11] Bothur S, Jonsson G, Sandahl L. Modified technique using multiple zygomatic implants in reconstruction of the atrophic maxilla: A technical note[J]. Int J Oral Maxillofac Implants, 2003, 18(6): 902-904.
[12] Wu YQ, Wang F, Huang W, et al. Real-time navigation in zygomatic implant placement: Workflow[J]. Oral Maxillofac Surg Clin North Am, 2019, 31(3): 357-367.
[13] Stella JP, Warner MR. Sinus slot technique for simplification and improved orientation of zygomaticus dental implants: A technical note[J]. Int J Oral Maxillofac Implants, 2000, 15(6): 889-893.
[14] Chrcanovic BR, Pedrosa AR, Neto Custódio AL. Zygomatic implants: A critical review of the surgical techniques[J]. Oral Maxillofac Surg, 2013, 17(1): 1-9.
[15] Borgonovo A, Grandi T, Vassallo S, et al. Extrasinus zygomatic implants for the immediate rehabilitation of the atrophic maxilla: 1-year postloading results from a multicenter prospective cohort study[J]. J Oral Maxillofac Surg, 2021, 79(2): 356-365.
[16] Vaidyanathan AK, Banu RF. Finite element analysis—Concepts for knowledge and implementation in dental research[J]. J Indian Prosthodont Soc, 2022, 22(3): 211-214.
[17] Almeida PHT, Cacciacane SH, França FMG. Stresses generated by two zygomatic implant placement techniques associated with conventional inclined anterior implants[J]. Ann Med Surg (Lond), 2018, 30: 22-27.
[18] Romeed SA, Hays RN, Malik R, et al. Extrasinus zygomatic implant placement in the rehabilitation of the atrophic maxilla: Three-dimensional finite element stress analysis[J]. J Oral Implantol, 2015, 41(2): e1-e6.
[19] Duan YY, Chandran R, Cherry D. Influence of alveolar bone defects on the stress distribution in quad zygomatic implant-supported maxillary prosthesis[J]. Int J Oral Maxillofac Implants, 2018, 33(3): 693-700.
[20] Costa EF, Penteado MM, Maior BS. Comparative analysis of biomechanical response between zygomatic implant and Facco technique through the three-dimensional finite element method[J]. J Clin Exp Dent, 2023, 15(2): e96-e101.
[21] Atalay B, Doğanay Ö, Saraçoğlu BK, et al. Clinical evaluation of zygomatic implant-supported fixed and removable prosthesis[J]. J Craniofac Surg, 2017, 28(1): 185-189.
[22] Sales PH, Gomes MV, Oliveira-Neto OB, et al. Quality assessment of systematic reviews regarding the effectiveness of zygomatic implants: An overview of systematic reviews[J]. Med Oral Patol Oral Cir Bucal, 2020, 25(4): e541-e548.
[23] 吴迪, 汤春波. 穿颧种植用于上颌后部骨量不足种植修复的研究进展 [J]. 口腔医学, 2020, 40(7): 639-643.
[24] 张彤, 刘洪臣, 王延荣, 等. 上颌骨复合体三维有限元模型的建立 [J]. 中华口腔医学杂志, 2000, 35(5): 374-376.
[25] Wen HL, Guo WH, Liang R, et al. Finite element analysis of three zygomatic implant techniques for the severely atrophic edentulous maxilla[J]. J Prosthet Dent, 2014, 111(3): 203-215.
[26] Vrielinck L, Blok J, Politis C. Survival of conventional
dental implants in the edentulous atrophic maxilla in
combination with zygomatic implants: A 20-year retrospective study[J]. Int J Implant Dent, 2022, 8(1): 27.
[27] Araújo PP, Sousa SA, Diniz VB, et al. Evaluation of patients undergoing placement of zygomatic implants using sinus slot technique[J]. Int J Implant Dent, 2016, 2(1): 2.
[28] Ishak MI, Kadir MR, Sulaiman E, et al. Finite element analysis of zygomatic implants in intrasinus and extramaxillary approaches for prosthetic rehabilitation in severely atrophic maxillae[J]. Int J Oral Maxillofac Implants, 2013, 28(3): e151-e160.
[29] Tuminelli FJ, Walter LR, Neugarten J, et al. Immediate loading of zygomatic implants: A systematic review of implant survival, prosthesis survival and potential complications[J]. Eur J Oral Implantol, 2017, 10(Suppl 1): 79-87.
[30] Davó R, David L. Quad zygoma: Technique and realities[J].Oral Maxillofac Surg Clin North Am, 2019, 31(2): 285-297.
[31] Davó R, Pons O. 5-year outcome of cross-arch prostheses supported by four immediately loaded zygomatic implants: A prospective case series[J]. Eur J Oral Implantol, 2015, 8(2): 169-174.
[32] Varghese KG, Gandhi N, Kurian N, et al. Rehabilitation of the severely resorbed maxilla by using quad zygomatic implant-supported prostheses: A systematic review and meta-analysis[J]. J Prosthet Dent, 2023, 130(4): 543-552.
[33] Aboul-Hosn Centenero S, Lázaro A, Giralt-Hernando M, et al. Zygoma quad compared with 2 zygomatic implants: A systematic review and meta-analysis[J]. Implant Dent, 2018, 27(2): 246-253.
[34] Van Staden RC, Guan H, Loo YC. Application of the finite element method in dental implant research[J]. Comput Methods Biomech Biomed Engin, 2006, 9(4): 257-270.

选择文件类型/文献管理软件名称

选择包含的内容

穿颧骨种植上颌窦区种植体定位方案的三维有限元分析

Three-dimensional finite element analysis of implant positioning protocols in the maxillary sinus region for zygomatic bone implantation

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

编辑推荐

Metrics

本文评价

[1]	甘露1，魏杰2，王冬梅3，马健1. 模拟咀嚼静态载荷nFA/PEEK牙种植体周应力分布特点[J]. 《口腔颌面外科杂志》, 2015, 25(5): 341-.
[2]	佟隽瑶1，魏杰2，马健1. 不同植入角度nFA/PEEK微种植体支抗的有限元应力分析[J]. 《口腔颌面外科杂志》, 2015, 25(3): 204-.

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

穿颧骨种植上颌窦区种植体定位方案的三维有限元分析

Three-dimensional finite element analysis of implant positioning protocols in the maxillary sinus region for zygomatic bone implantation

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

编辑推荐

Metrics

本文评价