Biomechanical Analysis of Grafted and Nongrafted Maxillary Sinus Augmentation in the Atrophic Posterior Maxilla with Three-Dimensional Finite Element Method.

Xuan Wang,Dongsheng Zhang,Haiwei Wu,Hongzhou Shen,Zhiyuan Gong,Tianqi Zhang,Enli Yang,Guanghai Jin

doi:10.1155/2020/8419319

Xuan Wang, Dongsheng Zhang + Show 6 more

Open Access

https://doi.org/10.1155/2020/8419319

Copy DOI

Abstract

This study is aimed at determining the optimal sinus augmentation approach considering the poor bone condition in the zone of atrophic posterior maxilla. A series of simplified maxillary segment models varying in residual bone height (RBH) and bone quality were established. A 10 mm standard implant combined with two types of maxillary sinus augmentation methods was applied with the RBH, which was less than 10 mm in the maxilla. The maximal equivalent von Mises (EQV) stress in residual bone was evaluated. Bone quality had an enormous impact on the stress magnitude of supporting bone. Applying sinus augmentation combined with grafts was suitable for stress distribution, and high-stiffness graft performed better than low-stiffness one. For 7 mm and 5 mm atrophic maxilla, nongrafted maxillary sinus augmentation was feasible in D3 bone. Poor bone quality was a negative factor for the implant in the region of atrophic posterior maxilla, which could be improved by grafts. Meanwhile, the choice of maxillary sinus augmentation approaches should be determined by the RBH and quality.

Highlights

Implant restoration is an effective means to restore the configuration and function of missing teeth
Attempting to simulate the atrophic posterior maxilla, the maxillary models were classified into two types of bone quality, D3 and dense trabecular bone (D4 bone) according to Lekholm et al [20]
Comparative analysis of D3 and D4 bone stresses shows that bone quality has a huge impact on the stress distribution of supporting bone (Figure 5)

Summary

Introduction

Implant restoration is an effective means to restore the configuration and function of missing teeth. Maxillary sinus augmentation is a predictable surgical method that increases the volume of the available bone [5, 6] and was developed to optimize alveolar bone configuration in the region of the posterior maxilla. Sinus floor augmentation with subsequent graft materials embedding has been attested to be an effective technique for correcting bone deficits by a series of clinical evidence [7]. A wide variety of graft materials are available for restoring the resorbed bone, including autologous bone, alloplasts, xenografts, allografts, or a combination of these [8]. A recent systematic review declared that there were no significant differences in the short-time success rate of implant placement between grafted and non-grafted sinus augmentation [13]

Objectives

Methods

Results

Conclusion