Multiple pterygoid approach: A novel technique with single-piece implants.

Area of Science:

• Dental Implantology
• Maxillofacial Surgery
• Biomaterials Engineering

Background:

• Pterygoid implants are crucial for distal maxillary support in dental restorations.
• Current literature often mislabels these implants, leading to confusion in terminology and application.
• Understanding the precise anatomical targets and implant designs is essential for successful outcomes.

Purpose of the Study:

• To clarify the correct terminology and anatomical engagement of pterygoid implants.
• To differentiate between true pterygoid implants and tubero-pterygoid implants based on their support mechanisms.
• To highlight the biomechanical advantages and limitations of tubero-pterygoid implants in the posterior maxilla.

Main Methods:

• Review of anatomical literature concerning the pterygoid apophysis and maxillary tuberosity.
• Analysis of implant design characteristics, focusing on root form screw implants.
• Comparative assessment of support engagement in pterygoid vs. tubero-pterygoid implant placement.

Main Results:

• Pterygoid implants engage the pterygoid apophysis without initial tuberosity support, sometimes using a transsinus approach.
• Tubero-pterygoid implants are root form screw implants that gain primary support from the maxillary tuberosity and engage the pterygoid pillar apically.
• Tubero-pterygoid implants maximize bone-to-implant contact but are limited by tuberosity atrophy.

Conclusions:

• The term 'tubero-pterygoid implant' accurately describes implants engaging both the tuberosity and pterygoid pillar.
• This precise terminology aids in understanding implant biomechanics and surgical planning.
• Tubero-pterygoid implants offer significant advantages but require adequate tuberosity bone stock for optimal support.