title: Finite element analysis of zygomatic implants in intrasinus and extramaxillary approaches for prosthetic rehabilitation in severely atrophic maxillae.
abstract: OBJECTIVE
  To compare the extramaxillary approach with the widely used intrasinus approach via finite element method.
  
  
  METHODS
  A unilateral three-dimensional model of the craniofacial area surrounding the region of interest was developed using computed tomography image datasets. The zygomatic implants were modeled using three-dimensional computer-aided design software and virtually placed according to the described techniques together with one conventional implant and a prosthesis. The bone was assumed to be linear isotropic with a stiffness of 13.4 GPa, while the implants were of titanium alloy with a stiffness of 110 GPa. Masseter forces were applied at the zygomatic arch, and occlusal loads were applied to the surface of the prosthesis. The stresses and displacements generated on the surrounding bone and within the implant due to the simulated loading configuration were analyzed.
  
  
  RESULTS
  The bone-implant interface and zygomatic implant body for the intrasinus approach produced 1.41- and 4.27-fold higher stress, respectively, compared with the extramaxillary approach under vertical loading. However, under lateral loading, the extramaxillary approach generated 2.48-fold higher stress than the intrasinus at the bone-implant interface. The zygomatic implant in the extramaxillary approach had twofold higher micromotion than those with intrasinus approach under lateral loading.
  
  
  CONCLUSIONS
  No one technique was found to be superior; however, if lateral loading is used, the intrasinus approach is the most favorable for the rehabilitation of severely atrophic maxillae.
authors.affiliation: Faculty of Biomedical Engineering and Health Sciences, Universiti Tecknologi Malaysia, Johor Bahru, Malaysia.
authors.forename: Muhammad Ikman
authors.initials: MI
authors.lastname: Ishak
authors.forename: Mohammed Rafiq Abdul
authors.initials: MR
authors.lastname: Kadir
authors.forename: Eshamsul
authors.initials: E
authors.lastname: Sulaiman
authors.forename: Noor Hayaty Abu
authors.initials: NH
authors.lastname: Kasim
mesh_terms: D001284:Atrophy; D001732:Bite Force; D017076:Computer-Aided Design; D003722:Dental Alloys; D015921:Dental Implants; D017267:Dental Prosthesis Design / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported / Q000379:methods*; D003799:Dental Stress Analysis / Q000379:methods*; D020342:Finite Element Analysis; D006801:Humans; D008406:Masseter Muscle; D008437:Maxilla / Q000473:pathology*; D008443:Maxillary Sinus; D003765:Models, Dental; D014025:Titanium; D015050:Zygoma
chemical_list: D003722:Dental Alloys; D015921:Dental Implants; D014025:Titanium