Pterygoid Implants To Avoid Zygomatic Implants And Sinus Lifting

Pterygoid implants are often used along with zygomatic or other implants (to learn more about this particular type of implant, visit my webpage here).  They can be extremely useful to allow you to get teeth quickly and safely for the upper jaw “all on 4/6 dental implants.” 

These are very specialized implants that are only placed by a handful of dentists on a regular basis.  They require an immense skillset since they are placed with a “blind” technique. Additionally, they are placed completely by feel (between the medial and lateral pterygoid bone plates).

In this case I used pterygoid implants to avoid zygomatic implants and to avoid needing a sinus lift bone graft.

This case is unique because zygomatic implants could not be placed. 

The patient has cosmetic cheekbone implants that were used to reconstruct the face after a car accident.  In rare instances these cosmetic cheekbone implants can be removed and zygomatic implants placed. 

But most of the time people do not want to remove the cosmetic implant to make room for a zygomatic dental implant.  I had a patient who removed them because it was more important that she had teeth rather than cosmetically-enhanced cheeks.

Sinus lift bone grafts are very predictable and safe.  The problem is they do not allow the patient to have teeth quickly.   Usually, the patient has to be without teeth for several months or, worse yet, wear a partial or complete upper denture.  This is because the bone has to heal for several months before the implants can be put in.

Pterygoid dental implants allow the teeth to be attached to the implant right away.  This is because they are engaged into very solid bone that is called “cortex.”

Only in some situations can the pterygoid implant be used when a zygomatic or sinus lift cannot. This case happens to be one of them.  Generally speaking, I would prefer more support in the middle of the bridge and not a long span without an implant.  In this case I made up for the long span by increasing the height dimension of the bridge for strength.

In other words, it takes a lot of planning!

Problems with pterygoid dental implants

Problems with pterygoid dental implants generally revolve around not having enough space to use them to make teeth since they go so far back (almost in the upper wisdom tooth area).  This requires a lot of “interarch space” to have enough room for the porcelain zirconia bridge. 

The other problem is usually a lack of experience with pterygoid implant placement, leading to low stability and early failure.  They are not easy to place!  They are best placed while you are intravenously sedated for comfort.

A success story!

Through a digital workflow and no real molds, this patient was completed in just 24 hours!  There was one single surgery, and the very next day computer fabricated teeth were connected to the implants… even in these very difficult situations!

Pterygoid implants can offer some very versatile solutions for very difficult dental implant situations, especially with the all-on-4 types of procedures.