Abstract This study aims to evaluate the stress distribution in atrophic maxilla rehabilitation of bruxism patients using various implant types via finite element analysis (FEA). Four implant configurations were modeled: quad zygomatic, zygomatic with transnasal, zygomatic with pterygoid, and subperiosteal implants. A CT-derived 3D anatomical model was subjected to vertical (1000 N) and oblique (500 N) loading scenarios to simulate forces associated with bruxism. Cortical bone and implant stress values (Pmax, Pmin, and Von Mises) were analyzed. Results demonstrated that the subperiosteal model exhibited the lowest stress on surrounding bone, whereas the quad zygoma model showed the highest. Models integrating pterygoid or transnasal implants with zygomatic implants demonstrated more homogeneous force distribution and reduced peak stress compared to quad zygoma alone. Model 3 (zygoma + pterygoid) yielded the most balanced stress profile, suggesting reduced mechanical complications under bruxism conditions. Although all stress values remained below physiological thresholds, elevated levels under oblique forces imply heightened risk in bruxism patients. FEA results indicate that combining implant types can optimize load transmission and minimize biomechanical risks, especially in cases with severe maxillary atrophy. These findings support clinical decision-making in selecting implant configurations tailored for patients with parafunctional habits like bruxism.
Manav et al. (Tue,) studied this question.