Immediate full-arch rehabilitation of atrophic maxilla using extra-long implants with bicortical anchorage in the canine pillars: a 16-month case report

Abstract

Rehabilitation of atrophic maxilla can be challenging, being used bone augmentation and modified implant designs. Despite many studies on more complex techniques, such as zygomatic implants. There are practically no case reports in literature using extra-long implants with bicortical anchorage in canine pillars for immediate rehabilitation in atrophic maxillae. This clinical report aims to describe a case in which extra-long implants were placed with bicortical anchorage in canine pillars region to allow full-arch immediate rehabilitation of an atrophic maxilla. A 60-year-old male patient, in good general health, was referred to a Dental College (Curitiba, Brazil) with complaints about his upper partial dentures. Patient´s rehabilitation was initiated with lower arch to achieve a full-mouth balanced occlusion. Platform-switched Morse taper connection implants were placed in regions #34, #36, #44, and #46 to support single and multi-unit fixed prostheses. For rehabilitation of maxillary arch, an all-on-four rehabilitation was planned. Guided surgery was performed to place four platform-switched Morse taper connection implants bicortically anchored in the canine pillar´s region, the two distal extra-long implants. Patient was followed for 16 months and presented good clinical and radiographic outcomes, including adequate peri-implant bone level maintenance and soft tissue health. No biological or mechanical complications were reported within this period. Therefore, use of extra-long implants bicortical anchored in canine pillars seems to be a suitable treatment option for rehabilitation of atrophic maxilla, enhancing possibility of obtaining sufficient primary stability, more even distribution of load on the remaining bone, possibility of immediate rehabilitation and maintaining peri-implant tissue health.