Costa Elton-Facco-Alves, Penteado Marcela-Moreira, Maior Bruno-Sotto
MSc and PhD in Dental Implantology from São Leopoldo Mandic University, Campinas, São Paulo, Brazil.
PhD in Prosthesis from Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University, São José Dos Campos, São Paulo, Brazil.
J Clin Exp Dent. 2023 Feb 1;15(2):e96-e101. doi: 10.4317/jced.59885. eCollection 2023 Feb.
The placement of zygomatic implants is an alternative used for rehabilitation of edentulous patients with atrophic maxilla. However, the complexity of the various techniques suggested in the literature requires high skill from surgeons. Aim: The objective of this research was to compare the biomechanical performance of traditional technique of zygomatic implant placement in relation to a new proposal, the Facco technique, through finite element analysis.
A three-dimensional geometric model of the maxilla was input into computer-aided design software (Rhinoceros version 4.0 SR8). STL file of the geometric models of implants and components supplied by the company Implacil De Bortoli was converted to volumetric solids through reverse engineering by RhinoResurf software (Rhinoceros version 4.0 SR8). Three groups were modeled: traditional technique, Facco technique without frictional contact and Facco technique with frictional contact, following the recommended position in each technique for implant placement. All models received a maxillary bar. Groups were exported to the computer-aided engineering software ANYSYS 19.2, in step format. Mechanical static structural analysis was requested with occlusal load of 120N. All elements were considered isotropic, homogeneous, and linearly elastic. Contacts were considered ideal and system fixation was considered at the bone tissue base.
There is similarity between the techniques. Microdeformation values capable of generating undesirable bone resorption were not observed in both techniques. Highest values in the posterior region of Facco technique were computed at the angle of part B close to the posterior implant.
Biomechanical behaviors of the two evaluated zygomatic implant techniques are similar. Prosthetic abutment (pilar Z) modifies the distribution of stresses over the zygomatic implant body. Highest stress peak was found in the pilar Z, but it is within acceptable physiological limits. Atrophic maxilla, zygomatic implants, surgical techniques, pilar Z, dental implants.
颧骨种植体的植入是用于上颌骨萎缩的无牙患者修复的一种替代方法。然而，文献中提出的各种技术的复杂性要求外科医生具备高超的技能。目的：本研究的目的是通过有限元分析比较颧骨种植体植入传统技术与一种新方法——法科技术的生物力学性能。
将上颌骨的三维几何模型输入计算机辅助设计软件（Rhino 4.0 SR8版）。由Implacil De Bortoli公司提供的种植体和组件的几何模型的STL文件通过RhinoResurf软件（Rhino 4.0 SR8版）的逆向工程转换为实体模型。按照每种技术中推荐的种植体植入位置，建立了三组模型：传统技术组、无摩擦接触的法科技术组和有摩擦接触的法科技术组。所有模型均植入上颌杆。将这些组以步骤格式导出到计算机辅助工程软件ANSYS 19.2中。要求进行机械静态结构分析，咬合负载为120N。所有单元均被视为各向同性、均匀且线弹性的。接触被视为理想状态，系统固定被视为基于骨组织。
两种技术之间存在相似性。在两种技术中均未观察到能够产生不良骨吸收的微变形值。法科技术后部区域的最高值计算于靠近后部种植体的B部分角度处。
两种评估的颧骨种植技术的生物力学行为相似。修复基台（支柱Z）改变了颧骨种植体主体上的应力分布。在支柱Z处发现了最高应力峰值，但它在可接受的生理限度内。上颌骨萎缩、颧骨种植体、手术技术、支柱Z、牙种植体。
