Abstract

IMPLANT-PROSTHETIC REHABILITATION OF THE ATROPHIC POSTERIOR MAXILLA USING “PARA-SINUSAL” IMPLANTS: A CASE SERIES

Benzi Cipelli R.*, Tacchino U., Sencheshen S., Agliardi E.

ABSTRACT

Objective: The rehabilitation of the atrophic posterior maxilla isone of the most complex challenges in implantology, given thereduced amount of available bone due to secondarypneumatization of the maxillary sinus and crestal resorption.Depending on the case, both Major Sinus Lift and zygomaticimplants are definitive and consolidated solutions, but ofteninvasive and not without possible complications. The objectiveof this case series is to illustrate a method for partial and, insome cases, full-arch rehabilitation of the atrophic posteriormaxilla, through the insertion of implants defined as “parasinusal”.This protocol, which involves the use of tiltedimplants positioned parallel to the palatal vault, offers in bothsituations a decidedly minimally invasive therapeutic alternativewith benefits in terms of both time and overall costsfor the realization of both partial and full-arch rehabilitations.Materials and Methods: The study included patients withresidual bone height less than 5 mm, where maxillary sinuspneumatization prevented the insertion of conventional axialimplants wi- thout resorting to “sinus lift” techniques. Tiltedimplants with anchorage in the palatal bone portion of the maxilla were used, thus allowing sufficient primary support for immediate stability. The sur- gical protocol involves the use of guided templates for optimal precision in implant placement and immediate prosthetic management to ensure functionality. Results: During the follow-up period, no implants were lost and patients showed optimal healing without signs of complications. No post-operative infections, nor evidence of peri-implantitis or pathological bone resorption were found. Conclusion: The para-sinusal implant technique represents an innovation in the management of posterior maxillary atrophy, reducing the need for complex and invasive surgical procedures. Within the limitations of this study, the results obtained suggest that this method may represent an effective therapeutic option for the implant-prosthetic rehabilitation of patients with severe bone atrophy.

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