Comparison of Zygomatic Implants and Implantize Compact from Boneeasy: A Finite Element Analysis for Bending and Safety Factor

   

Luís M. M. Santos¹, José L. T. Figueiredo², Rui P. L. M. Coelho³, Sara D. G. Carvalho⁴ and Maria I. Martins⁵

¹Private practice at Clinica Luís Mesquita Santos, Portugal

²Private practice at Lusíadas Hospital Oporto, Portugal

³Project Manager at Boneeasy research Center, Portugal

⁴Boneeasy research center

⁵FEUP, Oporto, Portugal

^*Corresponding author: Rui P. L. M. Coelho, Project Manager at Boneeasy research Center, Portugal.

Citation: Santos LMM, Figueiredo JLT, Coelho RPLM, Carvalho SDG, Martins MI. Comparison of Zygomatic Implants and Implantize Compact from Boneeasy: A Finite Element Analysis for Bending and Safety Factor.   J Oral Med and Dent Res. 5(3):1-9.

Received:  July 22, 2024 | Published: August 02, 2024

Copyright^© 2024 genesis pub by Santos LMM, et al. CC BY-NC-ND 4.0 DEED. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International License. This allows others distribute, remix, tweak, and build upon the work, even commercially, as long as they credit the authors for the original creation

DOI: https://doi.org/10.52793/JOMDR.2024.5(3)-65

Abstract

The history of maxillofacial implants dates back to ancient civilizations where rudimentary attempts to replace missing facial structures were made using materials like ivory and wood. Significant advancements occurred in the 20th century with the development of biocompatible materials and modern surgical techniques. The introduction of titanium implants by Dr. Per-Ingvar Branemark in the 1960s revolutionized the field due to titanium's excellent osseointegration properties.

Zygomatic implants were developed as a specialized solution for patients with severe maxillary bone loss, where traditional dental implants are not feasible [1-9]. Today, maxillofacial implants are extensively used for trauma reconstruction, congenital defects, and post-oncological surgeries, continually evolving with advancements in material science and 3D printing technologies(c15). This study compares the performance of zygomatic implants and Implantize Compact from Boneeasy through Finite Element Analysis (FEA), focusing on bending and safety factors. The principle underlying this comparison is that for an implant to achieve osseointegration, the micro-vibration should be under 50 microns [1, 2, 10-14, 14-22]. Zygomatic implants were analyzed under various conditions, and their results were compared with those of the Implantize Compact system. Results showed that zygomatic implants exceed the micro-vibration threshold for osseointegration, while the Implantize Compact system remains within acceptable limits, suggesting its higher potential for successful osseointegration.

Keywords

Zygomatic Implants; Implantize Compact from Boneeasy; Maxillofacial implants; Osseointegration

Introduction

Zygomatic implants were pioneered by Dr. Per-Ingvar Brånemark in the late 1980s and early 1990s as an innovative solution for patients with severe maxillary bone loss, where conventional dental implants were not an option. These implants are anchored in the zygomatic bone, or cheekbone, which provides a dense and stable foundation for the prosthetics. The technique initially addressed the needs of cancer patients and those with significant maxillary atrophy. Over the decades, zygomatic implants have evolved with improved designs and surgical techniques, significantly enhancing their success rates and expanding their use in complex maxillofacial reconstructions [1, 2,15-17, 24-27].

Osseointegration is crucial for the success of zygomatic implants, as it ensures a stable and long-lasting foundation for prosthetic rehabilitation. This biological process involves the direct structural and functional connection between the living bone and the surface of the implant, typically made from biocompatible materials like titanium. Effective osseointegration minimizes the risk of implant failure, enhances load distribution, and improves the overall stability and functionality of the implant. For zygomatic implants, which are used in cases of severe maxillary bone loss, achieving robust osseointegration is essential to support the prosthetic structures and to facilitate optimal outcomes in complex maxillofacial reconstructions [17-27].

Finite Element Analysis (FEA) is a crucial computational tool in the field of implant dentistry, particularly for zygomatic implants. It simulates and assesses the mechanical behavior of implants and the surrounding bone, predicting stress distribution and identifying potential failure points at the bone-implant interface. This information is vital for understanding and optimizing osseointegration, the process where the bone forms a direct structural and functional connection with the implant. Optimal stress distribution, revealed through FEA, promotes a favorable biological response, enhancing bone growth and implant stability. By allowing for the refinement of implant designs and surgical techniques, FEA helps ensure robust osseointegration, which is essential for the long-term success and load-bearing capacity of zygomatic implants.

This study aims to compare zygomatic implants and the Implantize Compact system from Boneeasy using Finite Element Analysis (FEA) to determine their potential for osseointegration. According to Brånemark et al. (2001), for successful osseointegration, micro-vibrations should be under 50 microns, highlighting the critical role of mechanical stability in implant success. The study evaluates the minimum safety factor and total displacement of both implant systems to assess their performance under varying loading conditions, aiming to optimize design and surgical techniques for enhanced bone integration and long-term implant durability. By leveraging FEA, this research contributes to advancing implant dentistry by providing insights into stress distribution and biomechanical interactions critical for achieving robust osseointegration in complex maxillofacial reconstructions.

Material and Method

The study involved testing implants of varying lengths (30, 40, 50, and 57.5 mm) at different angulations (30, 40, and 50 degrees) to the occlusal plane. Zygomatic implants engaged the zygomatic bone at an average depth of 7 mm (Figure1,2).

Figure 1: The 7mm constriction of the Zygomatic implant.

Figure 2: Applied force of 200 Nw at 50º.

Implantize Compact system involved a complex configuration with multiple screws for enhanced fixation. An occlusal force of 200 Nw, perpendicular to the occlusal plane, was applied, and FEA was performed using Autodesk Fusion 360 (Figure 3,4).

Figure 3: Constrictions for the Implantize Compact.

Figure 4: Applied force of 200 Nw.

Results

Zygomatic Implants

Figure 5: Amount of displacement and safety factor simulation.

Fixation Length (mm)	Implant Length (mm)	Angle (º)	Minimum Safety Factor	Total Displacement (mm)
7	30	30	0.5341	0.2452
	40	30	0.4213	0.3151
	50	30	0.3493	0.3754
7	40	30	0.5053	0.6875
	40	30	0.3972	0.8837
	50	30	0.3357	1.053
7	50	30	0.392	1.481
	40	30	0.3075	1.903
	50	30	0.2594	2.268
7	57.5	30	0.314	2.366
	40	30	0.246	3.042
	50	30	0.2074	3.625

Table 1: Zygomatic Implants Results.

Graphic 1: Decrease of the safety factor in function of the increasing of the length and the angle of the force.

Graphic 2: Increase of displacement in function of the increasing of the length and the angle of the force.

All tested configurations exceeded the 50-micron threshold for micro-vibrations, with displacement increasing with both implant length and angulation.

Implantize Compact

Figure 8: Displacement and safety factor of Implantize Compact.

Name	Minimum	Maximum
Safety Factor (Per Body)	4.562	15
Stress (von Mises)	1.176E-04 MPa	214.834 MPa
1st Principal	-72.364 MPa	158.408 MPa
3rd Principal	-283.491 MPa	50.064 MPa
Normal XX	-247.482 MPa	81.736 MPa
Normal YY	-126.88 MPa	140.111 MPa
Normal ZZ	-125.335 MPa	53.814 MPa
Shear XY	-28.438 MPa	73.178 MPa
Shear YZ	-41.366 MPa	46.826 MPa
Shear ZX	-54.23 MPa	75.541 MPa
Displacement
Total	0.00 mm	0.014 mm
X	-0.004 mm	0.001 mm
Y	-8.119E-04 mm	0.011 mm
Z	-3.283E-04 mm	0.011 mm