Journal of Oral Implantology September 2012 - (Page 461)

LITERATURE REVIEW Rehabilitation of the Atrophic Posterior Maxilla With Pterygoid Implants: A Review Eugenia Candel ˜ David Penarrocha ˜ Maria Penarrocha, PhD, DDS* The purpose of this article is to review the literature published and to assess the success of treatment of patients with atrophic posterior maxilla with pterygoid implants. Studies from 1992 to 2009 on patients with atrophic posterior maxilla rehabilitated with pterygoid implants were reviewed. Those reporting clinical series of at least 5 patients with atrophic posterior maxilla (Class IV and V of Cawood and Howell), rehabilitated with pterygoid implants and fixed prosthesis, and with 12 months minimum follow-up were included. In each study the following were assessed: number of patients, number of implants, surgical technique, prosthetic rehabilitation, success rate, bone loss, complications and patient satisfaction. Thirteen articles were included, reporting a total of 1053 pterygoid implants in 676 patients. The weighted average success of pterygoid implants was 90.7%; bone loss evaluated radiographically ranged between 0 and 4.5 mm. No additional complications compared with conventional implants were found, and patient satisfaction level with the prosthesis was high. Pterygoid implants have high success rates, similar bone loss levels to those of conventional implants, minimal complications and good acceptance by patients, being therefore an alternative to treat patients with atrophic posterior maxilla. Two anatomical locations in which implants are placed in the retromolar area can be distinguished: the pterygoid process and the pterygomaxillary region. Implant lengths and angulations vary between these two techniques. Key Words: pterygoid implants, implants in the pterygomaxillary region and maxillary tuber region INTRODUCTION he rear area of the maxillary bone has many limitations for the placement of dental implants,1–3 such as poor bone quality and quantity (usually a Class III or IV according to Lekholm and Zarb),4,5 the presence of the maxillary sinus, accessibility problems, and the difficult hygiene they entail.1,6,7 In addition to these anatomic peculiarities and difficult access, there is high occlusal loading in the molar regions in comparison with other areas, resulting in a lower success rate than elsewhere in the maxillary or the mandible.3,5,7 To solve these problems a variety of procedures have been reported in the literature: bone grafts; University of Valencia, Valencia, Spain. *Corresponding author, e-mail: DOI: 10.1563/AAID-JOI-D-10-00200 T sinus lifts; and tilted, zygomatic, and pterygoid implants.1,2,7,8 The use of pterygoid implants was described by Tulasne9 and subsequently used by many other researchers.1–19 They are anchored in the pterygoid; however, in some studies they are placed in a more anterior position, in the pterigomaxillary area and parallel to the posterior wall of the sinus. These implants have advantages over other techniques: They allow anchorage in the posterior atrophied/resorbed maxilla without sinus lifts or bone grafts, achieving stability and high rates of long-term success. In addition, posterior cantilevers can be eliminated and axial loading is improved.1,3,6,10 The aim of this review was to analyze the literature on pterygoid implants, studying surgical technique, prosthetic rehabilitation, success rate, bone loss, complications, and satisfaction level of patients. Journal of Oral Implantology 461

Table of Contents for the Digital Edition of Journal of Oral Implantology September 2012

American Academy of Implant Dentistry Foundation Supports Basic and Clinical Research
Evaluation of 3- to 8-Year Treatment Outcomes and Success Rates With 6 Implant Brands in Partially Edentulous Patients
Histometric Analysis of Bone Repair in Bone-Implant Interface Using a Polylactic/ Polyglycolic Acid Copolymer Associated With Implants in Rabbit Tibia
Fold-Over Flap Technique for Developing the Facial Gingival Contour: A Case Report
Rehabilitation of the Atrophic Posterior Maxilla With Pterygoid Implants: A Review
Immediate Loading of Maxillary and Mandibular Implant-Supported Fixed Complete Dentures: A 1- to 10-Year Retrospective Study
Immediate Loading of Single Post-Extractive Implants in the Anterior Maxilla: 12-Month Results From a Multicenter Clinical Study
Immediate Implants After Enucleation of an Odontogenic Keratocyst: An Early Return to Function
Effects of Different Abutment Connection Designs on the Stress Distribution Around Five Different Implants: A 3-Dimensional Finite Element Analysis
Implant-Prosthetic Rehabilitation of a Patient with Nonsyndromic Oligodontia: A Clinical Report
Planning for Immediate Loading of Implant-Supported Prostheses: Literature Review
Development of a Rat Model of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
Anorganic Bovine-Derived Hydroxyapatite vs β-Tricalcium Phosphate in Sinus Augmentation: A Comparative Histomorphometric Study
Peripheral Giant Cell Granuloma Associated With Dental Implants: Clinical Case and Literature Review
Bilateral Vertical Ridge Augmentation With Block Grafts and Guided Bone Regeneration in the Posterior Mandible: A Case Report
Cell Culture–Based Tissue Engineering as an Alternative to Bone Grafts in Implant Dentistry: A Literature Review

Journal of Oral Implantology September 2012