FE-simulation Of The Maxillary Sinus
Floor Augmentation
Author(s)
J. Lenz, S. Rues, H. P. Schierle, K. Schweizerhof
& H. J. Schindler1
Abstract
The sinus floor augmentation was put into practice about 20 years ago to provide
the severely atrophic maxilla (alveolar ridge inappropriate for classical
implantation) with dental implants. In the most frequently used surgical method
a window-like lid is milled into the buccal bone shell adjacent to the paranasal
sinus in the region of teeth 5 - 7, and the bone lid is carefully flapped into the
sinus without injuring the mucous membrane. Thus, a cavity is created into
which either autologous bone material (e.g. from the chin or iliac crest) and/or
bone substitute can be augmented to yield an adequately spacious support for (up
to three) implants. After sufficient maturation of the graft (healing phase of
several months) the implants can be connected to a superstructure. In this
contribution the sinus floor is geometrically reproduced on the basis of a selfdeveloped
three-dimensional model of the facial skull which contains all cortical
and spongy structures. With the aid of the Finite Element Method (FEM) the
distributions of stress, strain and displacement in the cortical and spongy bone as
well as in the graft are analysed under different masticatory loads with special
attention to the force deduction in the different structures. A variation of
Young’s modulus Egraft of the augmented material between 0.01 and 15 GPa
(cortical bone), thus simulating different degrees of maturation, proves that
already about half of the external axial force is picked up by the graft when it
reaches the maturation of spongy bone (2 GPa). Furthermore, the analysis shows
that for Egraft = 2 GPa the microstrains under average chewing forces fall into the
physiological or mild overuse window according to Frost’s Mechanostat Theory.
Keywords: implantology, sinus lift, augmentation, bone remodeling, FEM.
Keywords
implantology, sinus lift, augmentation, bone remodeling, FEM.
Related Book
Other papers in this volume
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