Trans-nasal dental implants are used only in situations where the upper jaw bone is REALLY dissolved, soft and hollow. A trans-nasal dental implant is placed through the mouth just like any other dental implant, but it anchors in a little tiny corner of bone where the upper jaw meets the outermost portion of the nose called the inferior concha/turbinate.
These are used for patients with not enough bone in the upper jaw. Trans-nasal dental implants are used for All on 4/on X type full arch replacement bridges. The final bridge is usually made of zirconia.
Advantages of Trans-nasal dental implants
A Trans-nasal dental implant is primarily used to avoid a quad zygoma where four zygomatic implants are placed in the upper jaw. A quadruple zygomatic implant case is only done for the most extreme cases where there is very little bone under the nose. The goal is to use 1 or 2 Trans-nasal dental implants in the front part of the mouth to avoid using 4 zygomatic implants.
I have trained many dentists in the United States (and some in Europe) in the zygomatic/nasal/pterygoid techniques. I always instruct my students to look at all possible options before jumping straight to a quad zygoma case. Luckily most patients do not even need any of these specialized implants and can just be treated with regular dental implants.
Even though it sounds a bit strange to have implants placed from the mouth into the nasal bones, it is actually more beneficial because they have very strong anchorage and lower risks than that of quadruple zygomatic cases! Most of the time there is barely enough room for four zygomatic implants, making the Trans-nasal option very beneficial.
Special anatomy to safely place Trans-nasal dental implants
It is important that Trans-nasal dental implants are only placed by a dental implant specialist who is very familiar (and has a lot of experience) with these types of remote anchorage implants. They will allow you to get teeth right away in a very safe manner. The alternative to a Trans-nasal dental implant is either a quad zygomatic upper jaw or trying to build back bone in the front of the mouth using block bone grafting.
Very few patients actually have the proper anatomy to safely place Trans-nasal dental implants. Unfortunately most patients do not qualify for this beautiful implant position.
There has to be enough space between a special duct that drains into your nose (called the nasal lacrimal duct). If there is enough room as is, it is often the preferred technique that I will use.
Keep in mind that I have been anchoring implants into the base of the nose for at least two decades! It is almost always recommended to anchor upper front implants for full arch replacement into the base of the nasal bone (piriform rim). This gives a lot torque (stability tightness) and limits movement of the implants, making it great for me to place teeth right away using facial scanning technologies and techniques like photogrammetry/IOS to get beautiful teeth right away in a very safe manner.
The Trans-nasal implant is a fairly new technique. Dental implants in the zygomatic bones have been around since 1988, but the true Trans-nasal specialized technique has only been around for about 3-4 years. Placing implants into the base of the nose has been a greatly studied technique for at least 25 years. Trans-nasal dental implants are kind of a hybrid of nasal base implants and zygomatic dental implants.
What are the risks?
The risks are similar to any other dental implant in the upper jaw, such as bleeding, swelling or infection. The most important thing is measuring the bottom of the tear duct as it enters into the nose.
Conceivably the bottom of that duct could get pinched, making for a chronic watery eye on that side. There are no known complications like this that have occurred. I have never personally experienced that either, but it is something to discuss.
In my opinion, the Trans-nasal dental implant case would probably fare better over time than a quadruple zygomatic dental implant case. Trans-nasal dental implants can also be combined with pterygoids to eliminate all of the extra bite forces we call “cantilever.” Trans-nasal implants also make for an excellent layout of the implants where they are spaced apart a lot.
Just to reiterate, these types of implants are only used in 1% or less of cases. My practice is a bit unique in that I treat patients with failed dental implant cases with very severe bone loss.
Hi. I have been in treatment now for 2 years and I still do not have teeth. I had bone grafting and implants placed . Now I’m in the final steps where I should be getting my denture placed . The restorative dentist was attempting to attach a bar to my posts. My understanding is the denture would then be attached to this bat. However, when he tried to screw the bar into my posts one of the screws would not screw in . He tried for an hour. He then informed me that he will have a jig made to better align the bar so it would be able to be screwed in. I am still waiting after another 3 weeks have passed. I am a loss and feel it is time to seek help from another source. That being said , it appears you are an expert in fixing , repairing or resolving issues with dental implants. Can you be of help to me ?
Yes happy to help but I would need to see you in person. It sounds like there are fitting issues with how that digital scans are being taken. It would be best to just call my office and schedule an appointment with the number is 818-846-3203
I believe your the implant Specialist I need. I have bone loss at the top. Due to a kick in my mouth.
I can help. Just call the office. 818-846-3203
Upper dental implant to all teeth,should you feel a bit of screw under nose .
Do you have complete upper implants or just one ?