A Systematic Approach to Restoring Full Arch Length with Maxillary Fixed Implant Reconstruction: The PATZi Protocol

The traditional configuration of four maxillary implants to restore full-arch maxillary fixed implant prostheses is not without pitfalls. Intraoperative variability, such as bone quality and quantity, may lead to unexpected intraoperative challenges that may not allow for execution of the original treatment plan. Additionally, extensive maxillary sinus pneumatization may inhibit posterior spread and lead to a shortened dental arch or excessive cantilever forces. The PATZi protocol is a systematized algorithm for maxillary full-arch implant treatment planning that addresses such intraoperative surprises and achieves full arch length in the planned prosthesis. PATZi also assigns a numbering classification to each implant configuration, which leads to uniform communication and grading of surgical difficulty, as well as predictable planning for developing future salvage plans. By using the PATZi protocol as a guideline, the surgeon may improve composite torque value and anteroposterior (AP) spread, eliminate distal cantilever forces, and ultimately improve the predictability of the prosthetic treatment plan.