Survival of Immediate-Loaded Pterygoid Implants with Multi-Unit Abutments in the Atrophic Posterior Maxilla

Authors

  • Mohamad Droubi Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Damascus University
  • Mazen Zenati

DOI:

https://doi.org/10.5195/d3000.2025.1063

Keywords:

Prosthodontics, Tooth Loss, Dental Implants

Abstract

Objective: Rehabilitation of the atrophic posterior maxilla is challenging due to insufficient bone quantity and quality. Conventional approaches, such as sinus floor elevation or onlay bone grafting, are associated with higher morbidity, longer treatment times, and increased complications. Pterygoid implants offer a less invasive alternative, utilizing dense cortical bone in the pterygoid apophysis and posterior maxillary tuberosity to provide distal anchorage and full-arch prosthetic support, while avoiding the need for sinus augmentation. Clinical evidence indicates high survival rates, making them a reliable option for posterior maxillary rehabilitation. Materials and Methods: This prospective clinical study included 15 patients (aged 49–78 years) with unilateral posterior maxillary tooth loss that was unsuitable for conventional implants. Each patient received one pterygoid implant and two compressive implants. Preoperative planning included CBCT scans. Surgical procedures involved flap elevation, precise drilling, and manual insertion with high insertion torque. Immediate prosthetic loading was performed within seven days. Postoperative care included antibiotics, analgesics, chlorhexidine mouthwash, and oral hygiene instructions. Implant failure was defined as detectable mobility or conditions requiring removal. Results: All 45 implants (15 pterygoid and 30 compressive) survived over the 12-month follow-up, with no failures observed at 3, 6, or 12 months. Survival rates were 100% for both implant types, and no differences were noted across follow-up periods. Conclusions: Pterygoid implants demonstrate high survival rates and represent a predictable, minimally invasive option for posterior maxillary rehabilitation. Proper preoperative planning and surgical expertise are essential, and further long-term studies are recommended to confirm standardized protocols and durability.

Downloads

Published

2025-11-04

Issue

Vol. 13 No. 1 (2025)

Section

Mechanisms of Oral Disease

License

Copyright (c) 2025 Mohamad Droubi, Mazen Zenati

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
    with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
  4. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
  5. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
  6. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
  7. The Author represents and warrants that:
    1. the Work is the Author’s original work;
    2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
    3. the Work is not pending review or under consideration by another publisher;
    4. the Work has not previously been published;
    5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
    6. the Work contains no libel, invasion of privacy, or other unlawful matter.
  8. The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Revised 7/16/2018. Revision Description: Removed outdated link.