Finite Element Analysis of Stress Distribution in Different Connector Designs of Zygomatic Implant–Supported Prosthetic Rehabilitation for Bilateral Maxillary Defects

Objectives This study used finite element analysis to compare the biomechanical behavior of ring, horseshoe, and bilateral independent connectors in zygomatic implant-supported prostheses for bilateral maxillary defects, analyzing stress distribution and load transfer to guide connector design optimization. Materials and Methods Five patients with bilateral maxillary defects rehabilitated using zygomatic implant–supported prostheses were included. Postoperative CBCT data were used to reconstruct patient-specific skull bone models and zygomatic implant structures. Three restorative configurations—ring-shaped, horseshoe-shaped, and bilateral independent—were constructed with their respective connector frameworks and prostheses. All models were meshed in 3-matic and analyzed in ANSYS Workbench under vertical, lateral, and combined loading conditions. Maximum von Mises stresses in the bone, implant–connector complex, and prosthesis were calculated and compared across configurations. Results Marked differences were observed among the three structures. Vertical and combined loads generated higher stresses than lateral loads, with stress concentration mainly at the implant–abutment junction and the zygomatic bone interface. The ring-shaped connector showed the most uniform stress distribution and the lowest peak stress, compared with the horseshoe-shaped and bilateral independent designs. Conclusions Connector configuration significantly influences the biomechanics of zygomatic implant-supported prosthetic systems. The ring-shaped connector, by forming a bilateral closed mechanical loop, evenly distributes occlusal loads and minimizes local stress concentration, demonstrating superior load dispersion and structural stability. It represents an optimal design strategy for bilateral maxillary defect rehabilitation.