Innovative landing zones for one-piece, rigidly fixated patient-specific subperiosteal implants in dental rehabilitation of severe maxillary and midfacial defects
Year: 2025
Type: article
Abstract: PURPOSE OF THE STUDY: Preprosthetic) with innovative design variations that anchor to the skull base from below and laterally, extending beyond traditional implants to provide enhanced stability in cases of significant bone loss. METHODS: Patients with significant maxillary and midfacial bone loss due to postablative defects were included in our case series, with or without irradiation. From 100 patients, 13 required design modifications based on FEM analysis, involving implant anchorage to the lateral skull base and/or pterygoid process. Eight patients received single-sided lateral skull base extensions; one posttraumatic case required bilateral extensions. In five of 13 cases, additional extensions to the pterygoid process were implemented. One case needed both bilateral skull base and pterygoid extensions, while two had bilateral pterygoid and a single-sided skull base extension. Outcomes assessed included primary stability, prosthodontic restoration, complications, and soft tissue management. RESULTS: No implant failures occurred during follow-up, with functional stability established immediately post-insertion. Prosthodontic restoration succeeded in all cases, with no stability loss or periimplantitis. Mucositis was noted around posterior posts in some instances, and one bar required trimming due to soft tissue changes, without affecting implant function. One implant had to be removed, due to chronic pain. CONCLUSIONS: Preprosthetic with design extensions provide a biologically suitable solution for stable dental rehabilitation in severe maxillary and midfacial structure loss, without biomechanical limitations. Achieving rigid fixation distant from the soft tissue transition is crucial for success.
Source: Head & Face Medicine
Institution: Medizinische Hochschule Hannover
Language: English
Subfield: Oral Surgery
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,890
OpenAlex ID: W4417446849