Journal of Oral Implantology December 2014 - (Page 699)

CLINICAL Implants Placed in the Nasopalatine Canal to Rehabilitate Severely Atrophic Maxillae: A Retrospective Study With Long Follow-up ˜ David Penarrocha, DDS, MSc, PhD1 Eugenia Candel, DDS, MSc1 Jose Luis Calvo Guirado, DDS, PhD2 Luigi Canullo, DDS, PhD3 ˜ Maria Penarrocha, MD, DDS, PhD1* To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients with atrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between 2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell's class V) rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. A preoperative computed tomography scan was obtained of all patients and all surgeries were performed by the same surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using the pointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al; patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a mean age of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatine canal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 in other locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, which disappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures (after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of 84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with the prosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease of cleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy. This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patients using implant-supported prostheses. Key Words: nasopalatine canal, maxillary atrophy, dental implants INTRODUCTION T 1 he rehabilitation of atrophic maxillae with implant-supported prostheses is complicated by low bone quantity and quality.1 After the loss of teeth, a vertical and horizontal resorption of the anterior Department of Stomatology, Valencia University Medical and Dental School. 2 Faculty of Medicine and Dentistry, University of Murcia. 3 Private practice in Rome, Italy. * Corresponding author, e-mail: Maria.Penarrocha@uv.es DOI: 10.1563/AAID-JOI-D-12-00145 maxilla occurs.2 The nasopalatine canal tends to lengthen and the neurovascular bundles inside may ultimately emerge from the ridge crest.3,4 Even in cases of severe resorption, dense cortical bone remains anterior to this canal.2 In patients with severe maxillary atrophy, anchorage of implants in the bone remaining around the nasopalatine canal is an alternative to bone grafting that provides sufficient anterior support to enhance the biomechanics of the implant-supported prosthesis. The incisive canal ranges in length from 4 to 26 mm and is related to maxillary bone height; it has Journal of Oral Implantology 699

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2014

Effect of Splinting in Accuracy of Two Implant Impression Techniques
Assessment of the Stress Transmitted to Dental Implants Connected to Screw-Retained Bars Using Different Casting Techniques
Retentiveness of Various Luting Agents Used With Implant-Supported Prosthesis: An In Vitro Study
Role of rhBMP-2 and rhBMP-7 in the Metabolism and Differentiation of Osteoblast-Like Cells Cultured on Chemically Modified Titanium Surfaces
Coated vs Uncoated Implants: Bone Defect Configurations After Progressive Peri-implantitis in Dogs
Why Guided When Freehand Is Easier, Quicker, and Less Costly?
Advanced Platelet-Rich Fibrin: A New Concept for Cell-Based Tissue Engineering by Means of Inflammatory Cells
Flapless Alveolar Ridge Preservation Utilizing the ‘‘Socket-Plug’’ Technique: Clinical Technique and Review of the Literature
Implants Placed in the Nasopalatine Canal to Rehabilitate Severely Atrophic Maxillae: A Retrospective Study With Long Follow-up
Severe Mandibular Atrophy Treated With a Subperiosteal Implant and Simultaneous Graft With rhBMP-2 and Mineralized Allograft: A Case Report
Full-Mouth Rehabilitation of a Patient With Ectodermal Dysplasia With Dental Implants
The 2-Visit CAD-CAM Implant-Retained Overdenture: A Clinical Report
Assessment of Implant-Related Treatment With Edited Three-Dimensional Reconstructed Images From Cone-Beam Computerized Tomography: A Technical Note
Retrieval of a Separated Implant Screwdriver Fragment
Correction of Esthetic Complications of a Malpositioned Implant: A Case Letter
Fixed Partial Denture Treatment With Mini Dental Implants
Replacement of an Implant and Prosthesis in the Premaxilla Due to a Malposition and Prosthetic Failure: A Clinical Case Letter
A New Restorative Technique for the Perishing Implant Due to Abutment Screw Fracture
Fit of CAD/CAM Implant Frameworks: A Comprehensive Review

Journal of Oral Implantology December 2014