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KHAIRNAR'S Pterygoid Classification: Pterygo-Maxillary Anatomical Variation-Guided Approach for Placement of
Mayur Khairnar1, A Raam Prasath1,2, Tejasvi Seth1
1Implantology, Precigem Dental World, Private Practice, Mumbai, Maharashtra, India.
Background:
Implant placement in the pterygoid region has been a complex challenge due to anatomical variability and limited bone availability. Khairnar's Collectives introduces a novel clinical classification system to streamline predictable pterygoid implant placement, addressing the unique anatomical considerations for successful outcomes.
Materials And Methods:
This retrospective study analyzed 597 pterygoid implants placed over 6 years. Implants were classified into six types (1-6) with each subtype A and B based on Khairnar's pterygoid bone classification, which assesses bone in the pterygomaxillary junction (PMJ) by evaluating bone availability in the junction of the maxillary tuberosity, pyramidal process of Palatine bone, and Pterygoid process of the sphenoid bone. Classification helps the clinician gauge vertical and horizontal direction to engage implants in the PMJ. Implant success and failure rates were correlated with anatomical variations for each classification type.
Results:
The study revealed a significant correlation between anatomical variations and implant success rates. Type 1 and type 2 junctions, with incidences of 36% and 24%, respectively, exhibited a 100% success rate, indicating optimal bone volume and stability for implant placement. Type 3, with an 8% incidence, had one placement failure and two post-placement failures, slightly reducing its success rate. Types 4 and 5, with incidences of 20% and 10%, respectively, faced increased challenges, reporting two and three placement failures respectively, alongside additional post-placement failures. Type 6, the least common at 2%, had the highest failure rates, with two placement failures and one post-placement failure. Overall, anatomical types with adequate bone volume (types 1-3 junction) showed minimal failures, while inadequate bone volume (types 4-6 junction) posed greater difficulties, emphasizing the need for careful preoperative assessment and planning.
Conclusion:
Khairnar's pterygoid bone classification provides a comprehensive framework for assessing the anatomical feasibility of implant placement in the pterygoid region. Types 1, 2, and 3 offer predictable outcomes with minimal failures, whereas types 4, 5, and 6 require advanced planning and techniques due to higher failure rates.
