Characterizing Airflow Profile In The Maxillary Sinus By Using CFD Modeling

Objectives: Although Sven Kurbel throw out the presented concept of atmospheric pressure as a force that fills developing bones in 2004, it's not clear whether the atmospheric pressure is a force continue shaping the sinus floor bone/bone graft or not. It is still not completely understood the reason of pneumatization after extraction, and how the crestal atrophy together with pneumatization result in the maxillary bony height losing. The purpose of this study is to investigate the bony biomechanical response to the airflow in sinus and to predict the reconstruction of the sinus floor bone after tooth extraction and sinus lift.
Methods: Three cadaver sample were scanned with CBCT system, The inclusion criteria for specimens were no inflammation and no cysts in the maxillary sinus, at least one of the patient's maxillary posterior teeth loss. The 3D Computational fluid dynamics (CFD) model of a maxillary bone was constructed on the basis of CBCT data.The numerical simulations were performed using an CFD algorithm, which incorporates an airflow effect on the bone wall of maxillary sinus.
Results: The simulated remodeling results were visualized by examining the mechanical stress/strain distributions in maxillary sinus and nasal cavity respectively. Different bone responses under airflow conditions were compared quantitatively and qualitatively. The velocity of streamline in nasal cavity and maxillary sinus were also developed. There is no static pressure and sheer stress concentration in sinus and nasal cavity. Therefore tress/strain concentrations occur out of the sinus floor region. And the velocity of streamline showed barely influence on the sinus floor region.
Conclusions: This study revealed that the influence of airflow on the the sinus floor region is minimal. Tooth extraction and sinus lift will lead to different airflows in the maxillary sinus on both sides, but it has little influence on the bone wall of the maxillary sinus compared with the airflow fields in the nasal canal. It is expected that these bone remodeling simulation can be helpful in evaluating the feasibility of bone reconstructions after tooth extraction or sinus lift surgery.