Evalution of Pterygoid Implants With Partial or Full-Arch Rehabilitations

Objectives: Implant placement in the posterior maxilla is often challenging. In fact severe bone resorption, extensive maxillary sinuses, and poor bone density often lead to inadequate amount of residual bone for implants placement without a bone augmentation. Pterygoid implants (PI) can be an alternative technique able to resolve the problem of inadequate bone volume in the posterior maxilla. The aim of this study is to evaluate implant success rate and marginal bone loss (MBL) around PI supporting partial or full-arch rehabilitation.
Methods: The study included a sample of 28 partially or totally edentulous patients with inadequate bone voume in posterior maxilla to place implants without bone augmentation. PI were placed in third or second molars sites in order to avoid distal cantilevers in partial or full-arch rehabilitation. Implants sites were prepared using a combinations of surgical drills and piezo-electric tips. All intra- and post-operative surgical, healing, or prosthetic complication rates were recorded. Clinical and radiographic examinations were scheduled with a 6-month follow-up of functional loading to evaluate implant survival and success rates, MBL, peri-implant health around PI.
Results: In total, 48 implants were inserted. Surgical complication rate was 6.2%. No healing complications occurred. Implant survival rate was 97.9%. Prosthetic success rate was 91.7%. Mean follow-up time was 12 months. Post-loading cumulative survival and prosthetic success rates were 100%. 0.8mm and 0.4mm MBL were recorded after reopening surgery and functional loading, respectively. No signs of mucositis or peri-implantits were observed during follow-up period.
Conclusions: PI can be considered a predictable option for rehabilitation of atrophic posterior maxilla in order to avoid bone augmentation surgery. Success and complication rates seem to be similar to other surgical techniques. Longer follow-up and larger sample size are required to validate these results.