Palatal positioning of implants in severely resorbed edentulous maxillae

The aim of this study was to evaluate implant-supported restorations supported by palatally positioned implants as an alternative treatment for rehabilitation of the atrophic maxilla and to assess the satisfaction of patients with the results.

A retrospective case study was conducted on completely edentulous subjects who received palatally positioned implants (placed and loaded) between January 2000 and January 2004. Inclusion criteria were patients with severely resorbed edentulous maxillae (Class IV or V maxillary atrophy, according to the Cawood and Howell classification) who requested implant-supported restorations and had a follow-up period of at least 24 months after implant loading. Panoramic radiographs and maxillary computerized tomograms had been made for all patients prior to treatment. Mesial and distal implant bone loss was measured on panoramic radiographs, and the largest value was designated as the bone loss for the implant in question. Subjects indicated their degree of satisfaction with the new prosthesis after 12 months on a visual analogue scale.

Sixty-nine patients with severely resorbed edentulous maxillae were included in the study. Four hundred and ninety implants (six to eight in each patient) were placed to support 69 fixed prostheses; 330 were in palatal positions and 160 were in molar positions (84 over the crest in the first molar position and 76 in anatomic buttresses). The success rate of palatally positioned implants was 97.8% (323/330). The mean bone loss of implants with palatal anchorage after 2 years of loading was 0.61 mm (range, 0 to 3.10 mm). All patients had stable prostheses at the end of the observation period. Patients were satisfied with comfort and stability, ability to speak, ease of cleaning, esthetics, and function of the prosthesis.

Implants placed in a palatal position may be a viable alternative for rehabilitation of the atrophied maxilla.