Research Article

DOI :10.26650/eor.20241439180 IUP :10.26650/eor.20241439180 Full Text (PDF)

Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome

Purpose: This study aimed to investigate the stress accumulation on the skull base caused by the forces applied to fracture the bone at the sinus floor during the closed trans-alveolar technique of sinus elevation.

Materials and Methods: This study was based on three-dimensional finite element analysis. Study models were determined as follows: Model 1, Model 2, and Model 3 (bone thickness at the sinus floor 1, 2, and 3 mm, respectively). The forces required for fracture of the bone at the base of the sinus were found to be 89,04 N, 138,88 N, and 210 N for Models 1, 2, and 3, respectively. The von Mises (VM), maximum principal (Pmax), and minimum principal (Pmin) stress values were examined at three different locations in the petrous part of the temporal bone. The highest stress values during the fracture process were recorded.

Results: During fracture, VM, Pmax, and Pmin stress values were highest in Model 3 and lowest in Model 1. When the most critical levels were analyzed, it was seen that all stress values in Model 3 were more than twice the values in Model 1.

Conclusion: In closed trans-alveolar sinus lifting, as the forces applied to break the bone at the sinus floor increase, the stress accumulation at the petrous part of the temporal bone increases in direct proportion. This increase in cranial base stress may lead to an increased risk of benign paroxysmal positional vertigo which is a major complication of closed sinus lifting.

Keywords: benign paroxysmal positional vertigo, finite element analysis, sinus lifting, mallet, osteotome

DOI :10.26650/eor.20241439180 IUP :10.26650/eor.20241439180 Full Text (PDF)

Çekiç ve osteotom ile sinüs yükseltme sırasında meydana gelen travmanın kafatası tabanında oluşturduğu streslerin sonlu elemanlar analizi

Alparslan Esen, Çağrı Esen

Amaç: Bu çalışmada kapalı transalveolar sinüs yükseltme tekniği sırasında sinüs tabanında bırakılan kemiğin kırılmasına yönelik uygulanan kuvvetlerin kafa tabanında neden olduğu stres birikiminin araştırılması amaçlandı.

Gereç ve yöntem: Bu çalışma üç boyutlu sonlu elemanlar analizine dayanmaktadır. Çalışma modelleri şu şekilde belirlendi: Model 1, Model 2 ve Model 3 (sinüs tabanındaki kemik kalınlığı sırasıyla 1, 2 ve 3 mm). Sinüs tabanındaki kemiğin kırılması için gerekli kuvvetler Model 1, 2 ve 3 için sırasıyla 89,04 N, 138,88 N ve 210 N olarak tespit edildi. Von Mises (VM), maksimum asal (Pmax) ve minimum asal (Pmin) stres değerleri, temporal kemiğin petröz kısmında üç farklı lokasyonda incelenmiştir. Kırılma sürecindeki en yüksek stres değerleri kaydedildi.

Bulgular: Kırılma sırasında VM, Pmax ve Pmin stres değerleri Model 3'te en yüksek, Model 1'de en düşüktü. En kritik seviyeler incelendiğinde Model 3'teki tüm stres değerlerinin Model 1'deki değerlerin iki katından fazla olduğu görüldü.

Sonuç: Kapalı transalveoler sinüs yükseltme işleminde sinüs tabanındaki kemiği kırmak için uygulanan kuvvetler arttıkça temporal kemiğin petröz kısmındaki stres birikimi de doğru orantılı olarak artar. Kranial taban stresindeki bu artış, kapalı sinüs kaldırmanın önemli bir komplikasyonu olan benign paroksismal pozisyonel vertigo riskinin artmasına yol açabilir.

Keywords: benign paroksismal pozisyonel vertigo, sonlu elemanlar analizi, sinüs yükseltme, çekiç osteotom

References

1. Nedir R, Nurdin N, Vazquez L, Abi Najm S, Bischof M. Osteotome Sinus Floor Elevation without Grafting: A 10-Year Prospective Study. Clin Implant Dent Relat Res 2016;18:609-17. doi: 10.1111/cid.12331. google scholar
2. Chen MH, Shi JY. Clinical and Radiological Outcomes of Implants in Osteotome Sinus Floor Elevation with and without Grafting: A Systematic Review and a Meta-Analysis. J Prosthodont 2018;27:394-401. doi: 10.1111/jopr.12576. google scholar
3. Lundgren S, Cricchio G, Hallman M, Jungner M, Rasmusson L, Sennerby L. Sinus floor elevation procedures to enable implant placement and integration: techniques, biological aspects and clinical outcomes. Periodontol 2000 2017;73:103-20. doi: 10.1111/prd.12165. google scholar
4. Emmerich D, Att W, Stappert C. Sinus floor elevation using osteotomes: a systematic review and meta-analysis. J Periodontol 2005;76:1237-51. doi: 10.1902/jop.2005.76.8.1237. google scholar
5. Saker M, Ogle O. Benign paroxysmal positional vertigo subsequent to sinus lift via closed technique. J Oral Maxillofac Surg ^k2005;63:1385-7. doi: 10.1016/j.joms.2005.05.296. google scholar
6. Fife TD. Benign paroxysmal positional vertigo. Semin Neurol 2009;29:500-8. doi: 10.1055/s-0029-1241041. google scholar
7. Cole SR, Honaker JA. Benign paroxysmal positional vertigo: Effective diagnosis and treatment. Cleve Clin J Med 2022;89:653-62. doi: 10.3949/ccjm.89a.21057. google scholar
8. Chen G, Li Y, Si J, Zhao X, Zhang T, Dai X, Yu G. Treatment and recurrence of traumatic versus idiopathic benign paroxysmal positional vertigo: a meta-analysis. Acta Otolaryngol 2019;139:727-33. doi: 10.1080/00016489.2019.1632484. google scholar
9. Sammartino G, Mariniello M, Scaravilli MS. Benign paroxysmal positional vertigo following closed sinus floor elevation procedure: mallet osteotomes vs. screwable osteotomes. A triple blind randomized controlled trial. Clin Oral Implants Res 2011;22:669-72. doi: 10.1111/j.1600-0501.2010.01998.x. google scholar
10. Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin JC, Pujol S, Bauer C, Jennings D, Fennessy F, Sonka M, Buatti J, Aylward S, Miller JV, Pieper S, Kikinis R. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging 2012;30:1323-41. doi: 10.1016/j.mri.2012.05.001. google scholar
11. Di Girolamo M, Napolitano B, Arullani CA, Bruno E, Di Girolamo S. Paroxysmal positional vertigo as a complication of osteotome sinus floor elevation. Eur Arch Otorhinolaryngol 2005;262:631-3. doi: 10.1007/s00405-004-0879-9. google scholar
12. Su GN, Tai PW, Su PT, Chien HH. Protracted benign paroxysmal positional vertigo following osteotome sinus floor elevation: a case report. Int J Oral Maxillofac Implants 2008;23:955-9. google scholar
13. Vernamonte S, Mauro V, Vernamonte S, Messina AM. An unusual complication of osteotome sinus floor elevation: benign paroxysmal positional vertigo. Int J Oral Maxillofac Surg 2011;40:216-8. doi: 10.1016/j.ijom.2010.07.010. google scholar
14. Al-Almaie S, Kavarodi AM, Al Faidhi A. Maxillary sinus functions and complications with lateral window and osteotome sinus floor elevation procedures followed by dental implants placement: a retrospective study in 60 patients. J Contemp Dent Pract 2013;14: 405-13. doi: 10.5005/jp-journals-10024-1336. google scholar
15. Akcay H, Ulu M, Kelebek S, Aladag I. Benign Paroxysmal Positional Vertigo Following Sinus Floor Elevation in Patient with Antecedents of Vertigo. J Maxillofac Oral Surg 2016;15:351-4. doi: 10.1007/s12663-016-0891-9. google scholar
16. Penarrocha M, Perez H, Garcia A, Guarinos J. Benign paroxysmal positional vertigo as a complication of osteotome expansion of the maxillary alveolar ridge. J Oral Maxillofac Surg 2001;59:106-7. doi: 10.1053/joms.2001.19307. google scholar
17. Kaplan DM, Slovik Y, Joshua BZ, Puterman M, Kraus M. Head shaking during Dix-Hallpike exam increases the diagnostic yield of posterior semicircular canal BPPV. Otol Neurotol 2013;34:1444-7. doi: 10.1097/MAO.0b013e3182953120. google scholar
18. Beshkar M, Hasheminasab M, Mohammadi F. Benign paroxysmal positional vertigo as a complication of orthognathic surgery. J Craniomaxillofac Surg 2013;41:59-61. doi: 10.1016/j.jcms.2012.05.012. google scholar
19. Deniz K, Akdeniz SS, Koç AÖ, Uckan S, Ozluoğlu LN. Evaluation of benign paroxysmal positional vertigo following Le Fort I osteotomy. Int J Oral Maxillofac Surg 2017;46:309-13. doi: 10.1016/j.ijom.2016.10.007. google scholar
20. Nigam A, Moffat DA, Varley EW. Benign paroxysmal positional vertigo resulting from surgical trauma. J Laryngol Otol 1989;103:203-4. doi: 10.1017/s0022215100108448. google scholar
21. Rodriguez Gutierrez C, Rodriguez Gomez E. Positional vertigo afterwards maxillary dental implant surgery with bone regeneration. Med Oral Patol Oral Cir Bucal 2007;12:151-3. google scholar
22. D'Ascanio L, Salvinelli F, Martinelli M. Benign paroxysmal positional vertigo: an unusual complication of molar teeth extraction. Br J Oral Maxillofac Surg 2007;45:176-7. doi: 10.1016/j.bjoms.2006.03.003. google scholar
23. Chiarella G, Leopardi G, De Fazio L, Chiarella R, Cassandro E. Benign paroxysmal positional vertigo after dental surgery. Eur Arch Otorhinolaryngol 2008;265:119-22. doi: 10.1007/s00405-007-0397-7. google scholar
24. Reddy K S, Shivu ME, Billimaga A. Benign paroxysmal positional vertigo during lateral window sinus lift procedure: a case report and review. implant Dent 2015;24:106-9. doi: 10.1097/ID.0000000000000188. google scholar
25. Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium 1994;15:152-62. google scholar
26. Misch CE., Resnik RR, Misch-Dietsh, F. Maxillary sinus anatomy, pathology and graft surgery. IN: Mish CE, ed. Contemporary implant Dentistry. 3rd ed. Mosby Elsevier 2008:905-74. google scholar
27. Klokkevold PR, Urban IA, Cochran DL. Advanced implant Surgical Procedures. IN: Newman MG, Takei H, Klokkevold PR, Carranza FA, eds. Carranza's Clinical Periodontology. 11th ed. Saunders Elsevier 2011:684-94. google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format

EXPORT

APA

Esen, A., & Esen, Ç. (2024). Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome. European Oral Research, 0(0), -. https://doi.org/10.26650/eor.20241439180

AMA

Esen A, Esen Ç. Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome. European Oral Research. 2024;0(0):-. https://doi.org/10.26650/eor.20241439180

ABNT

Esen, A.; Esen, Ç. Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome. European Oral Research, [Publisher Location], v. 0, n. 0, p. -, 2024.

Chicago: Author-Date Style

Esen, Alparslan, and Çağrı Esen. 2024. “Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome.” European Oral Research 0, no. 0: -. https://doi.org/10.26650/eor.20241439180

Chicago: Humanities Style

Esen, Alparslan, and Çağrı Esen. “Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome.” European Oral Research 0, no. 0 (Nov. 2024): -. https://doi.org/10.26650/eor.20241439180

Harvard: Australian Style

Esen, A & Esen, Ç 2024, 'Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome', European Oral Research, vol. 0, no. 0, pp. -, viewed 22 Nov. 2024, https://doi.org/10.26650/eor.20241439180

Harvard: Author-Date Style

Esen, A. and Esen, Ç. (2024) ‘Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome’, European Oral Research, 0(0), pp. -. https://doi.org/10.26650/eor.20241439180 (22 Nov. 2024).

MLA

Esen, Alparslan, and Çağrı Esen. “Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome.” European Oral Research, vol. 0, no. 0, 2024, pp. -. [Database Container], https://doi.org/10.26650/eor.20241439180

Vancouver

Esen A, Esen Ç. Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome. European Oral Research [Internet]. 22 Nov. 2024 [cited 22 Nov. 2024];0(0):-. Available from: https://doi.org/10.26650/eor.20241439180 doi: 10.26650/eor.20241439180

ISNAD

Esen, Alparslan - Esen, Çağrı. “Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome”. European Oral Research 0/0 (Nov. 2024): -. https://doi.org/10.26650/eor.20241439180

TIMELINE

Submitted	18.02.2024
Accepted	24.04.2024
Published Online	16.07.2024

LICENCE

Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.

European Oral Research