Download or read book Implant Placement in the Nasopalatine Canal for the Rehabilitation of Severely Atrophic Maxillae- Case Series with 1 to 5 Years Follow-up written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background:Rehabilitation of atrophic maxilla with implant-supported prosthesis is a major surgical challenge due to alveolar bone resorption, pneumatization of the maxillary sinus and poor bone quality. There are several techniques described in the literature for the treatment of these cases. Anchorage of implants in the nasopalatine canal may represent an alternative to bone grafting procedures that provides additional anterior support to improve the biomechanics of the implant-supported prostheses.Aim/Hypothesis: To assess the outcome of implants placed in the nasopalatine canal for the rehabilitation of severely atrophic maxillae in terms of implant survival, neurosensory status of the anterior palate and satisfaction of the patients, after a follow-up of 1 to 5 years. Materials and Methods:Five patients (three women and two men; age range 48 to 72) with severely atrophic maxillae were included. A preoperative CBCT of all patients was obtained and all surgeries were performed by the same surgeon. The assessed parameters were: implant survival rate, neurosensory status of the anterior palate and patient satisfaction with the prosthetic treatment. In all patients, the nasopalatine neurovascular bundle was removed with curettes and implant site preparation was then performed. All implants placed in the nasopalatine canal were 5,2 x 8 mm. The insertion torque at the time of placement was measured using the surgical unit. In total, one patient (woman) received 4 implants; two patients (one woman and one man) received 5 implants and two patients (one woman and one man) received 6 implants. A screw-retained immediately loaded prosthesis was placed in the patients who received 6 implants. Three months after implant placement, impression was taken for final restorations.Results: All implants placed in the nasopalatine canal had insertion torque values ≥45 N cm at the time of placement. No implant failed during osseointegration period nor after prosthetic loading, with a cumulative survival rate of 100% after a mean follow-up of 3,2 years (range 1 to 5 years). Digital intraoral radiographs were taken in the annual control visits and showed stable marginal bone levels around the implants. No patient reported any type of loss or decrease in sensitivity in the anterior palate after surgery. Patient satisfaction with the prosthetic restoration was generally high in terms of esthetics, comfort, function and ease of speech.Conclusions and clinical implications: Even in patients with severe resorption and maxillary atrophy, residual bone is associated with the nasopalatine canal. The results of this case series with 1 to 5 years follow-up presented promising results confirming that the placement of one implant in the nasopalatine canal can offer a viable treatment approach for the rehabilitation of severely atrophic maxillae with great satisfaction of the patients.