Clinical and radiographic outcomes of non-axial implants in partial rehabilitation of the atrophic posterior maxilla: a retrospective case series and narrative review
Authors
Raffaele Vinci, Antonio Ligabue, Alfredo De Rosa, Michele Manacorda, Gian Luca Pancrazi, Sofia Rastelli
Abstract
Rehabilitation of the atrophic posterior maxilla is challenging because alveolar resorption and maxillary sinus pneumatization may limit the native bone available for implant placement. Graftless strategies seek to use residual bone while reducing the morbidity, treatment time and biological burden associated with augmentation procedures.
This retrospective single-centre case series assessed the clinical and qualitative radiographic outcomes of fixed implant-supported rehabilitation of the atrophic posterior maxilla performed without sinus floor elevation or bone grafting. Implant survival, prosthesis-level survival, biological and technical complications, and qualitative peri-implant radiographic findings were evaluated. A narrative review was used to contextualise the clinical findings.
Eighteen patients received 20 partial rehabilitations supported by 44 implants placed in native bone. At a mean follow-up of 4.7 years, 42 of 44 implants remained in function, corresponding to an implant survival rate of 95.45%. All implants were functional at 12 months. Two late implant losses occurred: one following peri-implantitis three years after loading and one after an irretrievable fracture of a Multi-Unit Abutment screw. No prosthesis-level failures were recorded. Qualitative radiographic assessment showed no peri-implant radiolucency or evident progressive pathological bone loss around the surviving implants.
Within the limitations of a small retrospective case series and non-standardised radiographic follow-up, graftless rehabilitation using native bone appears to be a feasible option for selected patients with posterior maxillary atrophy. Prospective comparative studies with standardised clinical and radiographic outcomes are required.
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