Implant-supported fixed full-arch rehabilitation without bone grafting in severely atrophic maxillae: A 10- to 12-year retro spective follow-up study

The objective of this article is to assess the clinical, radiographic and patient-related outcomes of patients with severe atrophy of the maxilla (Cawood and Howell Class V) rehabilitated with fixed full-arch prostheses on dental implants placed in anatomical buttresses and remnant bone. An observational retrospective clinical study was performed with a minimum follow-up period of 10 years. An analysis of the following parameters was performed: (a) periimplant parameters (plaque index, modified gingival index, probing pocket depth and keratinized mucosa width); (b) marginal bone loss; (c) implant survival rate; and (d) patient satisfaction based on a visual analog scale (VAS). Ten patients and 71 dental implants were studied, with a mean follow-up period of 126 months (range: 120–144). The mean plaque index was 1.0 ± 0.5, with a mean probing pocket depth of 2.3 mm (range: 1.0–4.0 mm). Sixty-one percent and 39% of the implants presented a modified gingival index of 1 and 2, respectively, and the mean keratinized mucosa width was 5.8 mm (range: 4.0–10.0 mm). The mean marginal bone loss of the implants was 0.7 ± 0.4 mm (range: 0.0–5.0 mm). The implant survival rate was 97.2%, and the overall mean patient satisfaction score was 90 (range: 0–100). Prosthesis cleaning ease scored lowest on the VAS. In our limited sample of patients with severe maxillary atrophy (Cawood and Howell Class V), the placement of dental implants in anatomical buttresses and remnant bone, associated with rehabilitation with fixed full-arch prostheses, was found to be an adequate treatment option in the long term regarding implant survival, marginal bone loss, periimplant clinical parameters and patient satisfaction. Keywords Dental implants; atrophic maxilla; fixed prosthesis; full arch; long-term; graftless.

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