Biomechanical analysis of influence of implant configuration and bone quality on implant stability in augmented posterior maxilla

The present study applied FE methods to evaluate the biomechanical effects induced by implant configuration and bone quality within an augmented posterior maxilla. The aim of this study was to ascertain the optimal choice of implant on the basis of actual bone conditions. A couple of simplified maxillary segment models vary in bone quality (D2, D3 and D4 type) were constructed. Imlants were embedded into the atrophic posterior maxilla with only 8 mm residual bone height (RBH). An oblique force of 150 N was applied to the occlusal surface of implant and maximal equivalent von-Mises (EQV) stress was evaluated. The standard implant with its apical part embedded in high-stiffness graft exhibited the best stress distribution pattern among all groups. The short wide implant could also realize a desirable stress allocation similar to high-stiffness group in D2 and D3 bone. Stress in supporting bone increased concomitantly with the reduction of bone quality. Short wide implant could realize a desirable stress distribution when bone quality was preferable. Bone quality should be one of the crucial factors taken into consideration before implant placement. Grafted maxillary sinus augmentation was more recommended for implant rehabilitation in maxilla with poor quality.