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Year 2025, Volume: 59 Issue: 2, 138 - 143, 21.05.2025
https://doi.org/10.26650/eor.20241439180

Abstract

Project Number

This work was supported by the Necmettin Erbakan University Research Fund Grant [Project number: 211224006].

References

  • 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
  • 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
  • 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
  • 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
  • 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
  • Fife TD. Benign paroxysmal positional vertigo. Semin Neurol 2009;29:500-8. doi: 10.1055/s-0029-1241041. google scholar
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium 1994;15:152-62. google scholar
  • 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
  • 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

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

Year 2025, Volume: 59 Issue: 2, 138 - 143, 21.05.2025
https://doi.org/10.26650/eor.20241439180

Abstract

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.

Ethical Statement

Not required.

Supporting Institution

This work was supported by the Necmettin Erbakan University Research Fund Grant [Project number: 211224006].

Project Number

This work was supported by the Necmettin Erbakan University Research Fund Grant [Project number: 211224006].

Thanks

The authors would like to thank Kaan Yardimci (Mechanical Engineer) and Tinus Technologies for their contributions and support

References

  • 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
  • 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
  • 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
  • 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
  • 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
  • Fife TD. Benign paroxysmal positional vertigo. Semin Neurol 2009;29:500-8. doi: 10.1055/s-0029-1241041. google scholar
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium 1994;15:152-62. google scholar
  • 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
  • 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
There are 27 citations in total.

Details

Primary Language English
Subjects Dentistry (Other)
Journal Section Original Research Articles
Authors

Alparslan Esen 0000-0001-7419-3210

Çağrı Esen 0000-0002-4358-1293

Project Number This work was supported by the Necmettin Erbakan University Research Fund Grant [Project number: 211224006].
Publication Date May 21, 2025
Submission Date February 18, 2024
Acceptance Date April 24, 2024
Published in Issue Year 2025 Volume: 59 Issue: 2

Cite

EndNote Esen A, Esen Ç (May 1, 2025) Finite element analysis of stresses on the skull base caused by trauma during sinus lift with mallet and osteotome. European Oral Research 59 2 138–143.