Implants in the pterygoid region: An updated systematic review of modern roughened surface implants

Abstract

Purpose To determine the survival rates of modern roughened surface dental implants in the pterygoid region. Methods This systematic review was an update from a previously published systematic review in 2011, which largely reported data on older machined surface dental implants. An electronic search for articles in the English language literature published from January 1, 2010 to December 8, 2021 was performed using PubMed, Scopus, and CENTRAL search engines. After applying a systematic search process in three stages, the final list of selected articles on roughened surface pterygoid implants was obtained. Data from the selected articles were collated with data from pertinent articles on roughened implant surface from the previous systematic review. The combined data were then used for calculating the interval survival rate and cumulative survival rate (CSR) of pterygoid implants. Results The initial electronic search resulted in 1263 titles. The systematic search process eventually resulted in 10 clinical studies reporting on modern roughened surface pterygoid implants. These 10 studies reported on a total of 911 pterygoid implants with 39 reported failures over a 6‐year period. The majority of failures (37) were reported during the first year time interval and a majority of them (30) occurred before loading of the pterygoid implants. Only two late failures were reported after loading, during the sixth‐year time interval. The majority of implants were used for rehabilitation of full‐arch fixed implant‐supported prosthesis. At the maximum follow‐up interval of 6 years, the CSR of pterygoid implants with roughened surfaces was 95.5%, which was 5% higher than reported in the previous systematic review which combined machined and roughed surface pterygoid implants. Conclusions The survival rate of modern roughened surface dental implants in the pterygoid region is favorable at 95.5% over a 6‐year period, and comparable to the existing evidence on survival of implants in other regions of the maxilla and mandible.

A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept

“…A previous systematic review on the placement of dental implants in the maxillary tuberosity estimated a 94.6% implant cumulative survival rate with a follow-up up to 14 years [21]. A recent systematic review assessing the outcome of implants in the pterygoid region estimated a 95.5% implant cumulative survival rate at 6 years of follow-up [22]. As illustrated by the results, both these treatment modalities are viable with predictable outcomes, offering the surgical advantage of a virtual impossibility of implant insertion in the posterior region of the maxilla.…”

Finite Element Analysis (FEA) of a Premaxillary Device: A New Type of Subperiosteal Implant to Treat Severe Atrophy of the Maxilla

“…In another systematic review on 1983 PIs in 634 patients, a mean survival rate of 94.87% was reported [ 42 ]. Bidra et al [ 9 ] reported a 95.5% cumulative survival rate of PIs after 6 years. Recently, a FEA study on PIs was also published [ 43 ].…”

“…Additionally, there are no guarantees of complete healing and predictable recovery of the alveolar bone, and complications have also been reported, primarily including sinusitis. Alternatively, several surgical and reconstructive techniques have been proposed, such as inlay/onlay grafts and dental implants, guided bone regeneration (GBR), distraction osteogenesis, splitting of the alveolar ridge, Lefort I interpositional grafts, use of inclined implants, zygomatic implants, and pterygoid implants [ 7 , 8 , 9 , 10 , 11 , 12 ].…”

“…Although most of these clinical approaches have been reported to have very high success rates, complications can occur, and sometimes they can be very serious [ 8 , 10 ]. Among the various mentioned techniques, zygomatic implants (ZIs) offer a valid alternative to more invasive methods, providing safe, reliable, and predictable results [ 7 , 8 , 9 , 10 , 11 ]. ZIs offer several advantages over other techniques, including lower costs; apparently fewer complications; often mild, easy-to-manage, and shorter time required for prosthetic rehabilitation; and fewer prosthetic needs [ 7 ].…”

“…However, it is important to note that some complications associated with ZIs may be underestimated, and they encompass various issues, such as sinusitis, intraoral soft-tissue infection, oro-antral fistula, facial–periosteal hematoma, gingival hyperplasia, infraorbital paresthesia, penetration and perforation of the orbital cavity, prosthetic fit problems, temporary sensory nerve deficits, moderate nosebleeds, subcutaneous malar emphysema, and peri-implant soft tissue infection [ 8 ]. Pterygoid implants (PIs) have also been used successfully for treating extreme jaw atrophy [ 9 ]. These implants are generally stable and enable the anchorage of the atrophied or resorbed posterior maxilla without the need for sinus lift or bone grafts, resulting in long-term stability.…”