Finite element analysis of transnasal, zygomatic and pterygoid implants in the rehabilitation of the atrophic maxilla.

This study aimed to evaluate the stress distribution generated by transnasal, zygomatic, and pterygoid implants on the implants and surrounding bone in atrophic maxilla models using finite element stress analysis MATERIALS AND METHODS: Three atrophic maxilla models were designed. Model 1 included transnasal implants in regions 12 and 22 and zygomatic implants in regions 15 and 25. Model 2 consisted of four zygomatic implants in regions 12, 15, 22, and 25. Model 3 included transnasal implants in regions 12 and 22, zygomatic implants in regions 15 and 25, and pterygoid implants in regions 17 and 27. A vertical load of 150 N was applied separately to teeth 11 and 16 via a spherical food bolus model RESULTS: The highest Von Mises stress values on implants under both anterior and posterior loading were recorded in Model 1, whereas the lowest values were found in Model 3. For abutments, Model 2 exhibited the highest stress values, while Model 3 showed the lowest. In cortical bone, the highest stress values were observed in Model 2, whereas cancellous bone exhibited the highest stresses in Model 1. The lowest stress values in both bone types were consistently seen in Model 3 CONCLUSION: The combination of transnasal and zygomatic implants may serve as an alternative to the quad zygoma concept. However, incorporating pterygoid implants further reduces stress values and may provide biomechanical advantages in the rehabilitation of the atrophic maxilla.