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.
(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.
Unilateral maxillary posterior implant reconstruction showing advanced bone loss around distal fixture and subsequent implant fracture.
Additional fixtures placed in the pterygoid region for extension of the overdenture bar for better stability.
Replacement of fixed prosthesis without cantilever after distal implant was resurfaced.
Additional implants placed for better stability of unilateral maxillary posterior prosthesis.
Preoperative panoramic view of advanced bone loss in maxillary posterior region.
Caldwel-luc procedure in fracturing buccal plate of bone and placement of three fixtures to support and elevate the bone plate and sinus membrane.
Placement of 50/50 mixture of autogenous bone and Bio-Oss bovine bone material for sinus grafting.
Placement of a Bio-Gide resorbable membrane with the use of four titanium tacks.
Postoperative panoramic radiograph showing the placement of three implants in the grafted area and a pterygoid fixture for posterior support.
Clinical view five months postop showing complete bone fill.
Panoramic view of final prosthesis in place.
Periapical views showing final prosthesis in place and bone graft one year after surgery.
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.
Five implants to support a mandibular implant overdenture in the anterior region.
Panoramic view thirteen years later showing the response of the restoration of an implant in the pterygomaxillary region connected to a natural tooth.