International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 11 , ISSUE 3 ( July-September, 2021 ) > List of Articles

CASE REPORT

Alternative Treatment Option for Sinus Lifts in Partially Edentulous Posterior Maxilla Using TTPHIL ALL TILT® Technique: A Case Report on Implants with Palatonasal Angulation

P Venkat Ratna Nag, Puppala Sarika, Smitha Daniel

Keywords : Immediate function, Implant with palatonasal angulation, Lateral wall of nose, Medial wall of maxillary sinus, Sinus lifts, Sinus pneumatization, Tilted implant

Citation Information : Nag PV, Sarika P, Daniel S. Alternative Treatment Option for Sinus Lifts in Partially Edentulous Posterior Maxilla Using TTPHIL ALL TILT® Technique: A Case Report on Implants with Palatonasal Angulation. Int J Prosthodont Restor Dent 2021; 11 (3):146-150.

DOI: 10.5005/jp-journals-10019-1329

License: CC BY-NC 4.0

Published Online: 01-02-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Rehabilitation of the atrophic posterior maxilla is complicated owing to poor bone quality, non-optimal quantity, and sinus pneumatization. Such clinical situations demand extensive bone augmentations and sinus lifts which prolong treatment time and increase morbidity. Using preexisting anatomic features for implant placement in patients indicated for extensive augmentation surgeries is an alternative treatment possibility. TTPHIL ALL TILT® technique for partial or complete edentulous atrophic maxilla is an immediate function protocol in this direction. In clinical situations depicting severe anterior pneumatization of the maxillary sinus, placement of implants with palatonasal angulation using TTPHIL ALL TILT® immediate function technique that anchor the lateral wall of nose/medial wall of the maxillary sinus by angulating implants in palatal direction present a minimally invasive treatment option for rehabilitation. The purpose of this clinical report was to present implants with palatonasal angulation as a non-surgical treatment option for the rehabilitation of partially edentulous posterior maxilla using the TTPHIL ALL TILT® technique. Follow-up of 3 years showed stable marginal bone levels without any biological or prosthetic complications. The patient showed a high level of satisfaction with the prosthesis and reduced patient morbidity and costs, thus, it is a viable treatment alternative to sinus lift surgeries for oral rehabilitation of maxillary posterior partially edentulous sites.


HTML PDF Share
  1. Lozano-Carrascal N, Anglada-Bosqued A, Salomó-Coll O, et al. Short implants (<8 mm) versus longer implants (≥8 mm) with lateral sinus floor augmentation in posterior atrophic maxilla: a meta-analysis of RCT's in humans. Med Oral Patol Oral Cir Bucal 2020;25(2):e168–e179. DOI: 10.4317/medoral.23248.
  2. Ferrigno N, Laureti M, Fanali S. Dental implants placement in conjunction with osteotome sinus floor elevation: a 12-year life-table analysis from a prospective study on 588 ITI implants. Clin Oral Implants Res 2006;17(2):194–205. DOI: 10.1111/j.1600-0501.2005.01192.x.
  3. Misch CE. Contemporary. Implant Dentistry. 2nd ed., St Louis, MO: Mosby Inc; 1999. vol. 469-470 pp. 477–484.
  4. Atamni F, Atamni M, Atamna M. Palatal positioning of implants in severely resorbed posterior maxillae. Romanian J Oral Rehabil 2011;3(1):34–39.
  5. Mattsson T, Köndell PÅ, Gynther GW, et al. Implant treatment without bone grafting in severely resorbed edentulous maxillae. J Oral Maxillofacial Surg 1999;57(3):281. DOI: 10.1016/s0278-2391(99)90673-0.
  6. Nag PVR, Dhara V, Puppala S, et al. Treatment of the complete edentulous atrophic maxilla: the tall tilted pin hole placement immediate loading (TTPHIL)-ALL TILT™ implant option. J Contemp Dent Pract 2019;20(6):754–763. DOI: 10.5005/jp-journals-10024-2592.
  7. Pietrokovski J, Massler M. Alveolar ridge resorption following tooth extraction. J Prosthet Dent 1967(1):21–27. DOI: 10.1016/0022-3913(67)90046-7.
  8. Al-Faraje L. Surgical and radiologic anatomy for oral implantology. Illinois: Quintessence; 2013. pp. 57–65.
  9. Romanos GE, Cionei G, Jucan A, et al. In vitro assessment of primary stability of Straumann® implant designs. Clin Implant Dent Relat Res 2014;16(1):89–95. DOI: 10.1111/j.1708-8208.2012.00464.x.
  10. Grandi T, Faustini F, Casotto F, et al. Immediate fixed rehabilitation of severe maxillary atrophies using trans-sinus tilted implants with or without sinus bone grafting: one-year results from a randomised controlled trial. Int J Oral Implantol 2019;12(2):141–152.
  11. Rosen A, Gynther G. Implant treatment without bone grafting in edentulous severely resorbed maxillas: a long-term followup study. J Oral Maxillofac Surg 2007;65(5):1010–1016. DOI: 10.1016/j.joms.2006.11.023.
  12. Branemark PI, Adell R, Albrektsson T, et al. An experimental and clinical study of osseointegrated implants penetrating the nasal cavity and maxillary sinus. J Oral Maxillofac Surg 1984;42(8):497–505. DOI: 10.1016/0278-2391(84)90008-9.
  13. Peñarrocha M, Carrillo C, Boronat A, et al. Palatal positioning of implants in severely resorbed edentulous maxillae. Int J Oral Maxillofac Implants 2009;24(3):527–533.
  14. Malo P, Rangert B, Nobre M. All-on-4 immediate-function concept with branemark system implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Dent Relat Res 2005;7(s1):S88–S94. DOI: 10.1111/j.1708-8208.2005.tb00080.x.
  15. Lin CC, Wu CZ, Huang MS, et al. Fully digital workflow for planning static guided implant surgery: a prospective accuracy study. J Clin Med 2020;9(4):980. DOI: 10.3390/jcm9040980.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.