Comparação biomecânica de quatro modelos de tratamento para a maxila atrófica totalmente edêntula: análise de elementos finitos

Autores

DOI:

https://doi.org/10.33448/rsd-v11i10.32509

Palavras-chave:

Análise de elementos finitos; Implantes dentários; Maxila edêntula; Fenômenos biomecânicos.

Resumo

O objetivo deste estudo é avaliar por meio da análise de elementos finitos diferentes técnicas de reabilitação de maxila totalmente edêntula, considerando implantes, tecido ósseo, infraestrutura metálica e características de componentes protéticos, a partir de um modelo tridimensional. A distribuição do estresse no tecido ósseo, implantes e componentes foi analisada com quatro configurações (seis implantes instalados axialmente, técnica all-on-four, técnica M-4 e quatro implantes convencionais com dois implantes zigomáticos). Maior tensão no tecido ósseo foi encontrada em torno de implantes distais, em todos os grupos de tratamento, sem exceder os limites de resistência do osso cortical. O estresse de Von Mises foi maior na região distal de implantes distais das técnicas all-on-four e M-4. Maior concentração de estresse foi observada em componentes angulares de implantes zigomáticos. Os maiores valores de estresse mínimo de compressão foram concentrados no tecido ósseo peri implantar, especialmente no modelo de All-on-4. Portanto, a presente análise de elementos finitos revelou que as quatro configurações de tratamento (seis implantes instalados axialmente, técnica all-on-four, técnica M-4 e quatro implantes convencionais com dois implantes zigomáticos) para a maxila totalmente edêntula são viáveis e seguras, do ponto de vista biomecânico.

Referências

Almeida, E. O. De, Eduardo, M. S., Rocha, P., Júnior, A. C. F., & Júnior, M. M. (2010). Finite Element Stress Analysis of Edentulous Mandibles with Different Bone Types Supporting Multiple-Implant Superstructures. International Journal of Oral & Maxillofacial Implants, 25(6), 1108–1115.

Almeida, E. O., Rocha, E. P., Júnior, A. C. F., Anchieta, R. B., Poveda, R., Gupta, N., & Coelho, P. G. (2015). Tilted and short implants supporting fixed prosthesis in an atrophic maxilla: A 3D-FEA biomechanical evaluation. Clinical Implant Dentistry and Related Research, 17(S1), e332–e342. https://doi.org/10.1111/cid.12129

Aparicio, C., Manresa, C., Francisco, K., Ouazzani, W., Claros, P., Potau, J. M., & Aparicio, A. (2014). The Long-Term Use of Zygomatic Implants: A 10-Year Clinical and Radiographic Report. Clinical Implant Dentistry and Related Research, 16(3), 447–459. https://doi.org/10.1111/cid.12007

Asawa, N., Bulbule, N., Kakade, D., & Shah, R. (2015). Angulated implants: An alternative to bone augmentation and sinus lift procedure: Systematic review. Journal of Clinical and Diagnostic Research, 9(3), ZE10–ZE13. https://doi.org/10.7860/JCDR/2015/11368.5655

Atwood, D. A. (1971). Reduction of residual ridges: A major oral disease entity. The Journal of Prosthetic Dentistry, 26(3), 266–279. https://doi.org/10.1016/0022-3913(71)90069-2

Balshi, T. J., Lee, H. Y., & Hernandez, R. E. (1995). The use of pterygomaxillary implants in the partially edentulous patient: a preliminary report. The International Journal of Oral & Maxillofacial Implants, 10(1), 89–98. https://doi.org/10.1057/9780230583375

Bhering, C. L. B., Mesquita, M. F., Kemmoku, D. T., Noritomi, P. Y., Consani, R. L. X., & Barão, V. A. R. (2016). Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study. Materials Science and Engineering C, 69, 715–725. https://doi.org/10.1016/j.msec.2016.07.059

Bozkaya, D., Muftu, S., & Muftu, A. (2004). Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite elements analysis. Journal of Prosthetic Dentistry, 92(6), 523–530. https://doi.org/10.1016/j.prosdent.2004.07.024

Bozyel, D., & Faruk, S. T. (2021). Biomechanical behavior of all-on-4 and M-4 configurations in an atrophic maxilla: A 3D finite element method. Medical Science Monitor, 27. https://doi.org/10.12659/MSM.929908

Brånemark, P. I., Gröndahl, K., Öhrnell, L. O., Nilsson, P., Petruson, B., Svensson, B., Engstrand, P., & Nannmark, U. (2004). Zygoma fixture in the management of advanced atrophy of the maxilla: Technique and long-term results. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 38(2), 70–85. https://doi.org/10.1080/02844310310023918

Brånemark, P. I., Svensson, B., & Van Steenberghe, D. (1995). Ten‐year survival rates of fixed prostheses on four or six implants ad modum Brånemark in full edentulism. In Clinical Oral Implants Research (Vol. 6, Issue 4, pp. 227–231). https://doi.org/10.1034/j.1600-0501.1995.060405.x

Brunski, J. B. (2014). Biomechanical aspects of the optimal number of implants to carry a cross-arch full restoration. European Journal of Oral Implantology, 7 Suppl 2, S111-31.

Calandriello, R., & Tomatis, M. (2005). Simplified Treatment of the Atrophic Posterior Maxilla via Immediate/Early Function and Tilted Implants: A Prospective 1-Year Clinical Study. Clinical Implant Dentistry and Related Research, 7(s1), s1–s12. https://doi.org/10.1111/j.1708-8208.2005.tb00069.x

Choi, A. H., Conway, R. C., & Ben-Nissan, B. (2014). Finite-element modeling and analysis in nanomedicine and dentistry. Nanomedicine, 9(11), 1681–1695. https://doi.org/10.2217/nnm.14.75

Chrcanovic, B. R., Albrektsson, T., & Wennerberg, A. (2016). Survival and Complications of Zygomatic Implants: An Updated Systematic Review. Journal of Oral and Maxillofacial Surgery, 74(10), 1949–1964. https://doi.org/10.1016/j.joms.2016.06.166

Eskitascioglu, G., Usumez, A., Sevimay, M., Soykan, E., & Unsal, E. (2004). The influence of occlusal loading location on stresses transferred to implant-supported prostheses and supporting bone: A three-dimensional finite element study. Journal of Prosthetic Dentistry, 91(2), 144–150. https://doi.org/10.1016/j.prosdent.2003.10.018

Haack, J. E., Sakaguchi, R. L., Sun, T., & Coffey, J. P. (1995). Elongation and preload stress in dental implant abutment screws. The International Journal of Oral & Maxillofacial Implants, 10(5), 529–536.

Jensen, O. T., & Adams, M. W. (2009). The Maxillary M-4: A Technical and Biomechanical Note for All-on-4 Management of Severe Maxillary Atrophy-Report of 3 Cases. Journal of Oral and Maxillofacial Surgery, 67(8), 1739–1744. https://doi.org/10.1016/j.joms.2009.03.067

Jensen, O. T., & Adams, M. W. (2014). Secondary Stabilization of Maxillary M-4 Treatment with Unstable Implants for Immediate Function: Biomechanical Considerations and Report of 10 Cases After 1 Year in Function. The International Journal of Oral & Maxillofacial Implants, 29(2), 232–240. https://doi.org/10.11607/jomi.te59

Lang, L. A., Kang, B., Wang, R. F., & Lang, B. R. (2003). Finite element analysis to determine implant preload. Journal of Prosthetic Dentistry, 90(6), 539–546. https://doi.org/10.1016/j.prosdent.2003.09.012

Maló, P., de Araújo Nobre, M., Lopes, A., Ferro, A., & Moss, S. (2015). Extramaxillary surgical technique: Clinical outcome of 352 patients rehabilitated with 747 zygomatic implants with a follow-up between 6 months and 7 years. Clinical Implant Dentistry and Related Research, 17(S1), e153–e162. https://doi.org/10.1111/cid.12147

Malo, P., Rangert, B., & Nobre, M. (2003). “All‐on‐Four” Immediate‐Function Concept with Brånemark System® Implants for Completely Edentulous Mandibles: A Retrospective Clinical Study. Implant Dentistry, 5(Supplement I), 2–9. https://doi.org/10.1111/j.1708-8208.2003.tb00010.x

Malo, P., Rangert, B., & Nobre, M. (2005). All-on-4 immediate-function concept with Branemark System implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clinical Implant Dentistry and Related Research, 7(SUPPL. 1), S88-94.

Mattsson, T., Köndell, P.-Å., Gynther, G. W., Fredholm, U., & Bolin, A. (1999). Implant treatment without bone grafting in severely resorbed edentulous maxillae. Journal of Oral and Maxillofacial Surgery, 57(3), 281–287. https://doi.org/10.1016/S0278-2391(99)90673-0

Peñarrocha-Oltra, D., Candel-Martí, E., Ata-Ali, J., & Peñarrocha-Diago, M. (2013). Rehabilitation of the Atrophic Maxilla With Tilted Implants: Review of the Literature. Journal of Oral Implantology, 39(5), 625–632. https://doi.org/10.1563/AAID-JOI-D-11-00068

Rodríguez, X., Lucas-Taulé, E., Elnayef, B., Altuna, P., Gargallo-Albiol, J., Peñarrocha Diago, M., & Hernandez-Alfaro, F. (2016). Anatomical and radiological approach to pterygoid implants: a cross-sectional study of 202 cone beam computed tomography examinations. International Journal of Oral and Maxillofacial Surgery, 45(5), 636–640. https://doi.org/10.1016/j.ijom.2015.12.009

Selna, L. G., Shillingburg, H. T., & Kerr, P. A. (1975). Finite element analysis of dental structures — axisymmetric and plane stress idealizations. Journal of Biomedical Materials Research, 9(2), 237–252. https://doi.org/10.1002/jbm.820090212

Silva, G. C., Mendonça, J. A., Lopes, L. R., & Landre, J. (2010). Stress patterns on implants in prostheses supported by four or six implants: a three-dimensional finite element analysis. The International Journal of Oral & Maxillofacial Implants, 25(2), 239–246.

Stella, J. P., & Warner, M. R. (2000). Sinus slot technique for simplification and improved orientation of zygomaticus dental implants: a technical note. The International Journal of Oral & Maxillofacial Implants, 15(6), 889–893.

Tada, S., Stegaroiu, R., Kitamura, E., Miyakawa, O., & Kusakari, H. (2003). Influence of Implant Design and Bone Quality on Stress/Strain Distribution in Bone Around Implants: A 3-dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 18(3), 357–368.

Vrielinck, L., Blok, J., & Politis, C. (2022). Survival of conventional dental implants in the edentulous atrophic maxilla in combination with zygomatic implants: a 20-year retrospective study. International Journal of Implant Dentistry, 8, 27. https://doi.org/10.1186/s40729-022-00425-3

Watson, R. M., Davis, D. M., Forman, G. H., & Coward, T. (1991). Considerations in design and fabrication of maxillary implant-supported prostheses. International Journal of Prosthodontics, 4(3), 232–239.

Weischer, T., Schettler, D., Mohr, C., Weisher, T., Schettler, D., & Mohr, C. (1997). Titanium implants in the zygoma as retaining elements after hemimaxillectomy. The International Journal of Oral & Maxillofacial Implants, 12(2), 211–214.

Yates, J. M., Brook, I. M., Patel, R. R., Wragg, P. F., Atkins, S. A., El-Awa, A., Bakri, I., & Bolt, R. (2014). Treatment of the edentulous atrophic maxilla using zygomatic implants: Evaluation of survival rates over 5-10 years. International Journal of Oral and Maxillofacial Surgery, 43(2), 237–242. https://doi.org/10.1016/j.ijom.2013.08.012

Zampelis, A., Rangert, B., & Heijl, L. (2007). Tilting of splinted implants for improved prosthodontic support: A two-dimensional finite element analysis. Journal of Prosthetic Dentistry, 97(6 SUPPL.). https://doi.org/10.1016/S0022-3913(07)60006-7

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Publicado

25/07/2022

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MIYASAWA, E. M.; MACÊDO, F. C. de; VALENGA FILHO, J.; TROJAN, L. C.; KLÜPPEL, L. E.; PADOVAN, L. E. M. Comparação biomecânica de quatro modelos de tratamento para a maxila atrófica totalmente edêntula: análise de elementos finitos. Research, Society and Development, [S. l.], v. 11, n. 10, p. e135111032509, 2022. DOI: 10.33448/rsd-v11i10.32509. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32509. Acesso em: 17 jul. 2024.

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Ciências da Saúde