Management of the Posterior Maxilla in the Compromised Patient: Historical, Current, and Future Perspectives CONTINUED (Page 11) FIGURES (Page 1 of 2) Thomas J. Balshi & Glenn J. Wolfinger Periodontology 2000, Vol 33, 2003, 67-81.

Figure 1 (a) Panoramic and periapical radiographs of maxillary fixed detachable prosthesis with cantilever illustrating advanced bone loss on posterior fixture. (b) Transition from fixed detachable prosthesis to maxillary implant overdenture one five implants after removal of three posterior implants with advanced bone loss. Note the bone loss on the remaining implants as well.

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Figure 2a Unilateral maxillary posterior implant reconstruction showing advanced bone loss around distal fixture and subsequent implant fracture.

Figure 1c Additional fixtures placed in the pterygoid region for extension of the overdenture bar for better stability.

Figure 2b Replacement of fixed prosthesis without cantilever after distal implant was resurfaced.

Figure 2c Additional implants placed for better stability of unilateral maxillary posterior prosthesis.

Figure 3a Preoperative panoramic view of advanced bone loss in maxillary posterior region.

Figure 3b Caldwel-luc procedure in fracturing buccal plate of bone and placement of three fixtures to support and elevate the bone plate and sinus membrane.

Figure 3c Placement of 50/50 mixture of autogenous bone and Bio-Oss bovine bone material for sinus grafting.

Figure 3d Placement of a Bio-Gide resorbable membrane with the use of four titanium tacks.

Figure 3e Postoperative panoramic radiograph showing the placement of three implants in the grafted area and a pterygoid fixture for posterior support.

Figure 3f Clinical view five months postop showing complete bone fill.

Figure 3g Panoramic view of final prosthesis in place.

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Figure 3h Periapical views showing final prosthesis in place and bone graft one year after surgery.

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Figure 4b After loss of one of the anterior implants, implants were placed in the pterygoid maxillary region to support a full arch maxillary fixed detachable porcelain fused to gold prosthesis.

Figure 4a Five implants to support a mandibular implant overdenture in the anterior region.

Figure 5c Panoramic view thirteen years later showing the response of the restoration of an implant in the pterygomaxillary region connected to a natural tooth.

Figure 5b Placement of one fixture in the pterygomaxillary region and restoration in connection to the natural tooth.

Figure 5a Panoramic view showing advanced bone loss in maxillary posterior region.

Second Page of Figures View Management of Posterior Article: Introduction -- Page 1 Standard Implant Placement --Page 2 Hard Tissue Grafting -- Page 3 Tuberosity and Pterygoid Implants -- Page 4 Treatment Planning, Clinical Results -- Page 5 Zygoma Fixtures -- Page 6 Compromised Patients, Contraindications -- Page 7 Future Considerations -- Page 8 Conclusion -- Page 9 References -- Page 10 Figures and Graphics -- Page 11 Figures and Graphics -- Page 12 PDF Format Home | Write Us to Request Information or Ask a Dental Question To make an appointment for an evaluation, call: 1-800-PI-TEAM-5 1-800-748-3265 All information is intended for your general knowledge only and is not a substitute for dental or medical advice or treatment for specific dental or medical conditions. You should seek prompt dental and medical care for any specific health issues. See disclaimer. Copyright 2009 Pi Dental Center (Prosthodontics Intermedica).