Finite element analysis of various implant configurations using zygomatic and pterygoid implants in the rehabilitation of the atrophic maxilla

Aims: This study aimed to evaluate the biomechanical behavior of different implant-supported rehabilitation concepts involving zygomatic and pterygoid implants in the atrophic maxilla using finite element stress analysis (FESA). Methods: A 3D finite element model of an atrophic maxilla was generated from CT data and restored using three different implant configurations, including zygomatic and pterygoid implants. Linear static FESA was performed under vertical loading (150 N) in both anterior (tooth 11) and posterior (tooth 16) regions. Von Mises and principal stress values were calculated for implants, abutments, prosthetic substructure, and cortical and cancellous bone. Results: Under anterior loading, the highest von Mises stress on implants and abutments was observed in model III (56.07 MPa), while model II (27.937 MPa) showed the lowest. Under posterior loading, the highest stress on implants was recorded in model II (80.475 MPa), and the lowest in model III (31.123 MPa). Stress distribution in bone tissues varied across models, with model I generally showing the highest principal stress under posterior loading, and model III the lowest. The results highlighted that different implant configurations lead to significant variations in stress patterns. Conclusion: Among the evaluated configurations, model II provided superior biomechanical performance, suggesting that the implant combination in this model may offer a more favorable stress distribution in the prosthetic rehabilitation of the atrophic maxilla. These findings underscore the importance of implant design and placement strategy, which can be optimized using FESA prior to clinical application.