Prof. Alper Sinder - "Comparison of stress distribution around all-on-four implants of different angulations and zygoma implants: a 7-model finite element analysis"
Key takeaways
- The study modeled seven maxillary rehabilitation configurations, from a standard all-on-four to a quad zygoma design.
- Quad zygomatic implants produced the most stable, lowest-stress outcome for both bone and implant material in the analysis.
- Von Mises stresses in zygomatic implants were lower than in conventional dental implants, despite the longer implant and greater distance between prosthesis and bone anchorage.
- Anterior implant angulation of 0 versus 17 degrees showed no statistically significant difference in stress, so clinicians can angulate as the atrophic anterior maxilla requires.
- Posterior all-on-four implants tilted at 45 degrees generated higher stress than those at 30 degrees, favoring the shallower angle when bone permits.
- The FEA model was derived from a patient DICOM scan converted to STL with Hounsfield-unit-calibrated cortical and trabecular bone, loaded at 200 N axially and 50 N laterally.
- For bruxism, Sindel recommends Botox one month before prosthesis delivery plus temporary soft splints during a roughly one-month adaptation period, not indefinitely.
What you'll learn
- Why quad zygoma yields lower bone and implant stress than all-on-four in the atrophic maxilla
- How posterior tilt angle (30 vs 45 degrees) changes stress around all-on-four implants
- Why anterior angulation (0 vs 17 degrees) is not stress-critical in severe resorption
- Building a realistic FEA model from a patient DICOM/STL scan with Hounsfield-calibrated bone
- Managing bruxism at full-arch delivery with pre-op Botox and temporary soft splints
About the guest
Prof. Alper Sindel
Prof. Alper Sindel is an oral and maxillofacial surgeon and professor at the Faculty of Dentistry, Akdeniz University in Antalya, Turkey, where he serves as head of department. He completed his dental training at Hacettepe University in Ankara and his maxillofacial surgery residency in Ankara, and undertook further training in the UK under Prof. Velupillai Ilankovan. His research spans maxillofacial and orthognathic surgery, finite element analysis, and dental, zygomatic and maxillofacial implantology.
