Outcomes suggested that all the analyzed connections resulted contaminated after 5 years of functional loading. However, the connection design might influence bacterial activity levels qualitatively and quantitatively, especially inside the implant connection.

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The purpose of this article is to review the literature published and to assess the success of treatment of patients with atrophic posterior maxilla with pterygoid implants. Studies from 1992 to 2009 on patients with atrophic posterior maxilla rehabilitated with pterygoid implants were reviewed. Those reporting clinical series of at least 5 patients with atrophic posterior maxilla (Class IV and V of Cawood and Howell), rehabilitated with pterygoid implants and fixed prosthesis, and with 12 months minimum follow-up were included. In each study the following were assessed: number of patients, number of implants, surgical technique, prosthetic rehabilitation, success rate, bone loss, complications and patient satisfaction. Thirteen articles were included, reporting a total of 1053 pterygoid implants in 676 patients. The weighted average success of pterygoid implants was 90.7%; bone loss evaluated radiographically ranged between 0 and 4.5 mm. No additional complications compared with conventional implants were found, and patient satisfaction level with the prosthesis was high. Pterygoid implants have high success rates, similar bone loss levels to those of conventional implants, minimal complications and good acceptance by patients, being therefore an alternative to treat patients with atrophic posterior maxilla. Two anatomical locations in which implants are placed in the retromolar area can be distinguished: the pterygoid process and the pterygomaxillary region. Implant lengths and angulations vary between these two techniques.

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To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients with atrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between 2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell's class V) rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. A preoperative computed tomography scan was obtained of all patients and all surgeries were performed by the same surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using the pointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al; patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a mean age of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatine canal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 in other locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, which disappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures (after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of 84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with the prosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease of cleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy. This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patients using implant-supported prostheses.

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Trigeminal neuropathies (TNs) are well recognized disorders characterized and manifesting as skin and mucosal numbness in the region innervated by the trigeminal nerve. Facial numbness indicates trigeminal sensory alteration affecting the trigeminal system. TNs always pose differential location difficulties as multiple diseases are capable of producing them: they can be the result of traumatism, tumors, or diseases of the connective tissue, infectious or demyelinating diseases, or may be of idiopathic origin. Their importance is explained by the fact that TN may represent the first manifestation of tumor disease, or of relapse in patients with prior neoplastic processes. As such, these manifestations are ominous, and patient life expectancy is often short. The clinical exploration reveals a loss of sensitivity in the cutaneous territory corresponding to the affected nerve, which can be partial (hypoesthesia) or complete (anesthesia). The sensory defect is occasionally associated with hyperesthesia (i.e., the patient suffers a decrease in sensory perception, but when sensation is perceived, it may cause considerable discomfort). Complementary studies are needed to establish the etiologic diagnosis, with laboratory tests to discard the possible causative diseases underlying the trigeminal neuropathy, and the opportune radiographic examinations in the form of plain X‐rays or a routine cranial computed tomography scan.

Introduction. Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery. Material and methods. A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months. Results. Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not affected in three cases, while mild alterations were recorded in 25 subjects and severe alterations in 8. Partial or complete recovery was observed in 25 cases after 6 months, and in 32 after one year. There were few recoveries after this period of time. Recovery proved faster in the youngest patients, who moreover were the individuals with the least pain. Conclusion. Our patients with trigeminal neuropathy recovered particularly in the first 6 months and up to one year after injury. The older patients more often suffered pain associated to the sensory defect. On the other hand, their discomfort was more intense, and the patients with most pain and the poorest clinical scores also showed a comparatively poorer course. Key words:Post-traumatic trigeminal neuropathy.