Alternative techniques for treating maxillo-mandibular atrophy
Maxillary and mandibular bone atrophy presents a challenge for implants. Traditionally, bone grafting has been the dentist’s primary tool when facing severe atrophy.
A more recent approach is to forego grafting with the use of zygomatic implants or short large-diameter implants.
While these techniques require a greater level of surgical skill than oral rehabilitation and traditional implants, similar results can be achieved at a lower cost with more immediate results.
Potential pitfalls of bone grafting
Bone grafts present risks that may lead to the eventual failure of implants, including:
- A lack of high quality soft tissue to cover the graft
- Poor patient health leading to improper healing
- Lack of patient cooperation
- Graft contamination
Any of these issues can lead to the full or partial loss of a graft. Even in the case of a successful graft, the long-term viability of the implant is less certain than with patients not suffering from atrophy.
Zygomatic implants as an alternative for an atrophic maxilla
In many cases, zygomatic implants have shown to provide sufficient stability for immediate loading of a full arch implant-supported prosthesis on the maxilla.
While this technique is not simple, it does present a legitimate alternative to bone reconstructive procedures.
A different approach for mandibular atrophy
For the mandible, shorter implants with a wider diameter can increase posterior occlusal stability. This technique allows for a more uniform distribution of occlusal charges during chewing.
The one downside of using larger diameter implants is that more bone will be replaced with titanium, potentially leading to further bone loss surrounding the implant. Depending on the crown, implant ratio and occlusal table width, short implants can achieve longevity.
Clinical studies show positive results
A combination of zygomatic and short implants can replace traditional bone grafting in patients with extremely low bone availability. These techniques allow oral surgeons to avoid more invasive procedures such as bone grafts.