A retrospective comparison of implants in the pterygomaxillary region: implant placement with two-stage, single-stage, and guided surgery protocols

• Published in: The International journal of oral and maxillofacial implants Vol. 28; no. 1; p. 184
• Main Authors: Balshi, Thomas J, Wolfinger, Glenn J, Slauch, Robert W, Balshi, Stephen F
• Format: Journal Article
• Language: English
• Published: United States 01.01.2013
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Dental Implantation, Endosseous - methods; Dental Implantation, Endosseous - statistics & numerical data; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure - statistics & numerical data; Dental Restoration, Temporary - statistics & numerical data; Female; Humans; Immediate Dental Implant Loading - statistics & numerical data; Life Tables; Male; Maxilla; Middle Aged; Osseointegration; Retrospective Studies; Treatment Outcome; Young Adult
• ISSN: 1942-4434
• DOI: 10.11607/jomi.2693

Implants placed into the pterygomaxillary region allow for increased posterior support and a full complement of teeth without the need for distal cantilevers. With advancements in research and technology, implant delivery has evolved from the traditional two-stage procedure to immediate loading freehand and guided surgical template protocols. The purpose of this retrospective study is to determine if there is a significant difference in implant survival rates between these protocols. All pterygomaxillary implants placed in a single private practice from September 1985 to July 2011 were categorized into three separate classifications (two-stage freehand, single-stage freehand, or single-stage guided) by retrospective chart review. Life tables were constructed to determine the cumulative survival rates (CSR), and ANOVA was used to identify statistical significance. A total of 981 patients comprising 371 males and 610 females were included in the study. Of all pterygomaxillary implants, 1,460 of 1,608 implants osseointegrated for a CSR of 90.80%. Seven hundred nine of the 825 two-stage, 624 of the 647 single-stage, and 127 of the 136 guided surgery implants osseointegrated for CSRs of 85.94%, 96.45%, and 93.38%, respectively. The comparison between two-stage and single-stage protocols was statistically significant, (P < .05) while the difference between single-stage guided versus freehand protocols was found to be statistically insignificant (P > .05). The results from this retrospective study reinforce that immediate loading of pterygomaxillary implants with a provisional prosthesis is beneficial to both doctor and patient. The lower CSR for the guided surgery protocol compared with the single-stage freehand procedure is statistically insignificant, suggesting guided surgery is still a viable and recommended option for qualified patients.