Rathod Drusti K, Chakravarthy Chitra, Suryadevara Sri Sujan, Patil Ravi S, Wagdargi Shivaraj S
Raichur, Karnataka 584103 India Department of Oral and Maxillofacial Surgery, Navodaya Dental College and Hospital.
Department of Oral and Maxillofacial Surgery, Anil Nerukonda Institute of Dental Sciences, Vishakhapatnam, Andra Pradesh India.
J Maxillofac Oral Surg. 2023 Apr 9;22(3):1-7. doi: 10.1007/s12663-023-01914-7.
The aim of this study was to assess the stress distribution of the zygomatic implants in maxillectomy cases and to understand the long-term prognosis of this rehabilitation option using finite element analysis.
A three-dimensional finite element model was designed using computed tomography of a patient who underwent maxillectomy post-mucormycosis. Zygomatic implants and abutments were designed based on the manufacturer's design. Quad zygomatic implants were placed in the canine and premolar region into the zygomatic bone bilaterally. A prosthesis with an entire complement of teeth extending from the first molar teeth bilaterally was designed and attached to the multiunit abutments and zygomatic implants. Forces were applied to the zygomatic implants at six different locations bilaterally on the prosthesis which included occlusal and laterally directed forces on the central incisor region, canine region, and molar region using von Mises criteria. A three-dimensional finite element analysis was run, and maximum stress distribution was recorded at various loads. Statistical Package for Social Sciences for Windows version 22.0 Released 2013. Armonk, NY: IBM Corp., was used to perform statistical analyses. Kruskal-Wallis test was used to compare the mean stress values. Multiple comparisons of mean difference in stress values between force applications in implant were done using Dunn's post hoc test.
The maximum stress was observed at the distal head of the implant in the models. Minimum stress was observed at the apex of the implant in the models. The mean stress values based on force application in the bone and fixed prosthesis showed less significance when compared to the zygomatic implants which was statistically significant at = 0.03.
本研究旨在通过有限元分析评估上颌骨切除病例中颧骨种植体的应力分布，并了解这种修复方式的长期预后情况。
利用一名毛霉菌病后接受上颌骨切除术患者的计算机断层扫描设计三维有限元模型。根据制造商的设计方案设计颧骨种植体和基台。双侧在犬牙和前磨牙区域的颧骨内植入四颗颧骨种植体。设计一个从双侧第一磨牙开始延伸至全口牙齿的修复体，并将其连接到多单位基台和颧骨种植体上。使用冯·米塞斯准则，在修复体双侧的六个不同位置对颧骨种植体施加力，这些位置包括中切牙区域、犬牙区域和磨牙区域的咬合向力和侧向力。进行三维有限元分析，并记录不同载荷下的最大应力分布。使用2013年发布的Windows版社会科学统计软件包22.0（纽约州阿蒙克市：IBM公司）进行统计分析。采用Kruskal-Wallis检验比较平均应力值。使用邓恩事后检验对种植体不同受力情况下应力值的平均差异进行多重比较。
在模型中，种植体远端头部观察到最大应力。在模型中，种植体根尖处观察到最小应力。与颧骨种植体相比，基于骨和固定修复体受力情况的平均应力值差异较小，在α = 0.03时具有统计学意义。
