Tuberopterygoid Implants

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Tubero pterygoid Implants
http//thesinuslift.com/tuberopterygoid-implants
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What are Tuberopterygoid Implants?

• Tuberopterygoid implants are implants located in
  2nd molar area of upper jaw. They allow the
  prosthetic rehabilitation on dental implants in
  upper jaw. The applied forces go to the
  pterygomaxillary buttress area allowing immediate
  loading of the implants. The white arrows show
  tuberopterygoid implant, this avoided invasive
  Sinus lift Surgery and saved time period of 6-8
  months post sinus lift surgery.We were in
  position to deliver fixed  teeeth in period of
  just 3 days even in such an atrophied situation.

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With Tuberopterygoid Implants No More Sinus Lift
No More Bone graft. 
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Introduction

• If you have been told that there is less bone in
  your upper jaw for dental implants, do not worry.
  The best solution for cases with severe bone
  resorption in upper jaw is pterygoid implant.
  Tubero pterygoid implants  are the best solution
  for patients requiring dental implants for upper
  jaw.

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• Such patients were going for sinus lift or bone
  grafts as per old techniques. In a single
  procedure we place pterygoid implant and place
  the permanent crown in 3 days. As we use single
  piece implants the procedure is flapless and done
  under local anesthesia.

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Current definitions for pterygoid implants

• Throughout literature, several terms are being
  used to describe pterygoid implants. The terms
  "pterygoid implants", "pterygomaxillary implants"
  and "tuberosity implants" are used
  interchangeably. "Pterygoid implants" have been
  defined by the Glossary of Oral and Maxillofacial
  Implants (GOMI) as "implant placement through the
  maxillary tuberosity and into the pterygoid
  plate".

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• There are significant differences between
  pterygoid and tuberosity implants including the
  following
• pterygoid implants originate in the tuberosity
  and engage in the dense bone of the pterygoid
  plates and palatine bone
• tuberosity implants originate in the maxillary
  alveolar process and can occasionally anchor in
  the pyramidal process. The bone quality in this
  region is mainly composed of type III or IV
  cancellous bone

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Indications

• In the edentulous upper jaw the placement of
  implants can be challenging due to limited bone
  quantity and the presence of the maxillary sinus.
  Pterygoid implants have high success rates,
  similar bone loss levels to those of conventional
  implants, minimal complications and good
  acceptance by patients, being an alternative to
  treat patients with highly atrophic maxillae and
  avoiding the need for extensive augmentation
  procedures. 
• However, at present, pterygoid implants have
  mainly been studied in partial edentulism as a
  very attractive treatment alternative to sinus
  lift procedures.

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Procedure

• When the upper grinding teeth are lost and are
  not replaced on time, it leads to drooping of the
  sinus there by resulting in bone resorption
  making it difficult for tooth replacement, Some
  conventional implantologists suggest Sinus lift
  procedure, which is a complex traumatic surgical
  approach, that is totally unpredictable and takes
  approximately 6 to 8 months to heal.All the
  patients interested in getting the upper full
  arch replaced on implants are suitable candidates
  for this as pterygoid bone is present in all the
  patients. Pterygoid bone is present distal to the
  second molar region in the upper jaw and is the
  only option available if you want to avoid
  cantilevers, but it requires a very experienced
  hand with an in depth knowledge of Anatomy of the
  surrounding areas.

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The option of fixed teeth on dental implants in
upper jaw

• Cantilever bridges It devised to avoid the
  expensive and aggressive bone grafting by placing
  just 4 or 6 implants in the front part of the
  jaw. Then placing a set of just 10/12 teeth. As
  1st molar crowns are placed as cantilevers but
  there is no need to replace 2nd molars at all.
• Occasionally, only 10 teeth are placed. The
  permanent ceramic bridges are fixed after 3-6
  months which is another disadvantage of
  cantilevers.

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Clinical recommendations

• The pterygoid implant is placed in the region of
  the former first or second maxillary molars and
  follows a diagonal direction posteriorly towards
  the pyramidal process. The implant ultimately
  anchors in the pterygoid fossa of the sphenoid
  bone. The angulation of pterygoid implants ranges
  from 45-50 towards the maxillary plane.
•  

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Before and After of Tubero-pterygoid implants
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• In clinical reality, whenever pterygoid implants
  are described those are in reality tuberosity
  implants with an anchorage in the pterygoid plate
  and thus the treatment difficulties are very
  limited. As with every implant surgery the
  preparation of the implant bed is of high
  importance and treatment planning should be
  performed with great attention to the anatomical
  structures and bone availability/quality.
• Due to the presence of type III or IV cancellous
  bone in this region, a preferred choice of
  implant type is the NobelActive implant given its
  high primary stability in soft bone

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Efficient chewing is possible as teeth upto
second molars are replaced. In cantilevers and
zygomatic implant cases or in single piece
implants techniques 2nd molars are not replaced.
If replaced then they are made as cantilevers
which make the last implant weak and the bridge
susceptible to fracture in the long run.
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Advantages of Tubero pterygoid Implants

• Eliminates the need of sinus grafting.
• No cantilevers from front teeth or implants.
• Efficient chewing is possible as teeth upto
  second molars are replaced. In cantilevers
  implant cases or in all-on -4 and all on 6
  techniques 2nd molars are not replaced. If
  replaced then they are made as cantilevers which
  make the last implant weak and the bridge
  susceptible to fracture in the long run.
• Bone in pterygoid area is cortical in nature, and
  hence very strong and rigid allowing Immediate
  loading with permanent crown in 3 days.

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• Single piece implants are used which are strong
  in comparison to conventional dental implants.
• All patients who want dental implants in upper
  jaw are good candidates as bone is always
  available in pterygoid area.
• Flapless technique is used, as such patients have
  no swelling or bleeding and patients need not
  stop blood thinners, if they are taking any.
• With Tuberopterygoid Implant - No More Sinus Lift
  No More Bone graft.
• Strong single piece implants are being used in
  strong cortical bone.
• 100 success rate.

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• If you want to know more details about
• Tubero-pterygoid Implants,
• contact us Dr Motiwala2nd Floor, Park View
  Building, Road No. 1, Near KBR Park, Beside CVR
  Health News Building, Jubilee Hills Navanirman
  Nagar Colony, Jubilee Hills Hyderabad, Telangana
  500033?.Email info_at_drmotiwala.comMobile 91
  73374 49900
• http//thesinuslift.com/tuberopterygoid-implants

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• Thank you..