Minimally Invasive Approach Based on Pterygoid and Short Implants for Rehabilitation of an Extremely Atrophic Maxilla

Cucchi, Alessandro; Vignudelli, Elisabetta; Franco, S; Corinaldesi, Giuseppe

doi:10.1097/id.0000000000000603

Cited by 12 publications

(12 citation statements)

References 23 publications

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“…Pterygoid implants in a full-arch rehabilitation obtain an optimal distribution of functional loads thanks to a wider implant-prosthetic polygon. Apart from a case report without immediate loading [31], the use of bilateral pterygoid implants associated with two to four standard fixtures in the anterior zone, with a flapless approach, has been reported by Stefanelli et al [26] for the immediate loading full-arch rehabilitation of the upper jaw. These authors adopted the dynamic navigation implantology after a digital accurate planning to reduce the risk of anatomical injuries and to facilitate prosthetic management.…”

Section: Discussionmentioning

confidence: 99%

“…The pterygoid implant, 13 to 20 mm long, works as the distal support for a prosthetic structure in the rehabilitation of posterior maxilla, avoiding any kind of distal cantilever; it by-passes the maxillary sinus and finds the primary stability involving the cortex of the pterygoid process of the sphenoid, the pyramidal process of the palatine bone after passing through the tuber maxillae. Tulasne introduced their use in 1989 to obviate the low density of the bone distally to the sinus [31]. This technique does not depend on the level of atrophy.…”

Section: Discussionmentioning

confidence: 99%

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Digital Approach for the Rehabilitation of the Edentulous Maxilla with Pterygoid and Standard Implants: The Static and Dynamic Computer-Aided Protocols

Franchina

Stefanelli

Gorini³

et al. 2020

MPs

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A full-arch rehabilitation of the edentulous upper jaw without grafting procedures exploits the residual alveolar or the basal bone, with the necessity of long implants placed with a particular orientation. The precision in planning and placing the fixtures is fundamental to avoid clinical problems and to allow an acceptable connection with the prosthesis. The computer-aided implantology resulted in more accuracy than the traditional one, with a high standard of correspondence between the virtual project and the real outcome. This paper reports about the two different digital protocols, static and dynamic, as support to implant-borne prosthetic rehabilitation of edentulous maxillae. Two pterygoid and two/four anterior standard implants were seated in both cases by two different operators, without flap raising, and immediately loaded. This approach avoided the posterior cantilever by-passing the maxillary sinus and was adequately planned and realized without any surgical or prosthetic error. The two digital flow-charts were described step by step, underlining each other’s advantages and drawbacks compared to a free-hand approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Digital Approach for the Rehabilitation of the Edentulous Maxilla with Pterygoid and Standard Implants: The Static and Dynamic Computer-Aided Protocols

Franchina

Stefanelli

Gorini³

et al. 2020

MPs

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“…However, for some situations such as extremely atrophic maxilla, this kind of treatment is often a challenge due to anatomical factors. Deficient bone height and thickness in the anterior region of the maxilla, and inadequate residual bone height due to maxillary expansion and/or resorption of alveolar bone with low bone density and quality are common in posterior regions of the maxilla, this generates inadequate dimensions of the ridge for the three-dimensional implant placement (Cucchi et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Total rehabilitation with implant-supported and implant-retained prostheses in atrophic maxillae: Aesthetic and functional resolution for totally edentulous patients

Fernandes¹,

Dias²,

Hoshino

et al. 2022

RSD

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Introduction: Implant-supported prostheses are an excellent treatment option for totally edentulous patients, however, some conditions, such as extremely atrophic jaws, may limit their application. Aims: to demonstrate and discuss, through a series of clinical cases, the functional aesthetic resolution of totally edentulous patients with atrophic maxillae, using three different implant-prosthesis approach. Methods and Material: This article describes a clinical case series of patients has between 65 and 75 years old, who lost all upper teeth and had severely atrophic jaws. Due to the bone situation of the maxilla, an osteotome was planned for sinus floor elevation and followed by an allogeneic bone graft. After 18 months of bone integration, osseointegrated implants were installed and different prostheses were made for each case. Conclusions: It is possible to conclude that with the use of advanced surgical and prosthetic planning it is possible to recover the aesthetics and function of a serious and complex clinical case.

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“…Grades IV and V are considered as extreme atrophies [4]. The most common alternatives in atrophic maxilla rehabilitation are bone grafting [5], pterygoid [6] or zygomatic implants [7], bone regeneration (with or without mesh) [8,9], and finally, short implants [10].…”

Section: Introductionmentioning

confidence: 99%

Implant Treatment in Atrophic Maxilla by Titanium Hybrid-Plates: A Finite Element Study to Evaluate the Biomechanical Behavior of Plates

Prados-Privado

Diederich²,

Prados-Frutos

2018

Metals

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A severely atrophied maxilla presents serious limitations for rehabilitation with osseointegrated implants. This study evaluated the biomechanical and long-term behavior of titanium hybrid-plates in atrophic maxilla rehabilitation with finite elements and probabilistic methodology. A three-dimensional finite element model based on a real clinical case was built to simulate an entirely edentulous maxilla with four plates. Each plate was deformed to become accustomed to the maxilla’s curvature. An axial force of 100 N was applied in the area where the prosthesis was adjusted in each plate. The von Mises stresses were obtained on the plates and principal stresses on maxilla. The difference in stress between the right and left HENGG-1 plates was 3%, while between the two HENGG-2 plates it was 2%, where HENGG means Highly Efficient No Graft Gear. A mean maximum value of 80 MPa in the plates’ region was obtained, which is a lower value than bone resorption stress. A probability cumulative function was computed. Mean fatigue life was 1,819,235 cycles. According to the results of this study, it was possible to conclude that this technique based on titanium hybrid-plates can be considered a viable alternative for atrophic maxilla rehabilitation, although more studies are necessary to corroborate the clinical results.

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Minimally Invasive Approach Based on Pterygoid and Short Implants for Rehabilitation of an Extremely Atrophic Maxilla

Abstract: This surgical approach, based on the combination of short implants in the premaxillary regions and pterygoid implants in the pterygomaxillary regions, represents a way to shorten treatment timing, minimize the risk of surgical complications, and reduce patient discomfort and costs.

Cited by 12 publications

References 23 publications

Digital Approach for the Rehabilitation of the Edentulous Maxilla with Pterygoid and Standard Implants: The Static and Dynamic Computer-Aided Protocols

Digital Approach for the Rehabilitation of the Edentulous Maxilla with Pterygoid and Standard Implants: The Static and Dynamic Computer-Aided Protocols

Total rehabilitation with implant-supported and implant-retained prostheses in atrophic maxillae: Aesthetic and functional resolution for totally edentulous patients

Implant Treatment in Atrophic Maxilla by Titanium Hybrid-Plates: A Finite Element Study to Evaluate the Biomechanical Behavior of Plates

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