Biomechanical Evaluation of Zygomatic Implant Use in Patients with Different Buccal Maxillary Defect Levels

Purpose: The purpose of this study was to examine the biomechanics of zygomatic implants that were planned on an atrophic maxilla with five different buccal defect types and two different bone types. Materials and Methods: Three-dimensional models of zygomatic implants, human skulls, and maxillary prostheses were modeled with SolidWorks software. Ten finite element models of skulls with five different buccal defect types and two different bone types were constructed to mimic various clinical scenarios. Two bilateral zygomatic implants and two anterior dental implants were inserted into all models. The data were processed by ANSYS Workbench software. Vertical occlusal (150-N) and masseteric (300-N) loads were simulated on a modeled prosthesis. The stresses on and deformations of the bones and implants were then observed and compared. Results: Maximum von Mises stress was found in skulls modeled with a type 4 defect and D3 bone type. Minimal stress values were found in the skull model with a type 1 buccal bone defect and D2 bone type. Displacement values were correlated with stress values. Conclusion: Cortical bone anchorage and bone type of zygomatic implants positively affect their biomechanics. Alveolar crest support has an effective role in the biomechanics of zygomatic implants. Keywords: atrophic maxilla, bone type, finite element analysis, zygomatic anatomy guided approach, zygomatic implant