The Nasopalatine Canal as an Anatomic Buttress for Implant Placement in the Severely Atrophic Maxilla: A Pilot Study

Purpose: The aim of this study was to present an alternative treatment concept for the rehabilitation of the atrophic maxilla that used the nasopalatine canal as an anatomic buttress for dental implant insertion and to assess patient satisfaction with this treatment. Materials and Methods: The inclusion criterion for the study consisted of the presence of severe resorption of the edentulous maxilla (Class V according to the Cawood and Howell classification). In each patient, one implant was positioned in the nasopalatine canal. Additional implants were also placed in the remaining maxillary bone. The patients were followed for a minimum of 2 years after prosthesis connection. Satisfaction with the prosthesis was evaluated after 12 months using a visual analog scale. Results: Seven patients with severely resorbed edentulous maxillae received a total of seven implants in the nasopalatine buttress and 29 implants posterior to this structure. One of the seven implants in the nasopalatine canal was lost during the osseointegration phase. All patients had stable prostheses at the end of the observation period. Patients were satisfied with comfort and stability, ability to speak, ease of cleaning, and esthetics and function of the prosthesis. Five patients experienced minor sensory alterations during the first weeks after surgery. At the final examination, which took place after a mean of 5 years (range, 3 to 7 years), all patients expressed the presence of normal sensation. Conclusions: It appears that implants in the nasopalatine canal may be a viable treatment approach for the rehabilitation of the severely atrophied maxilla. Patients were satisfied with a prosthesis supported by implants in the nasopalatine canal. Keywords: anatomic buttress, dental implants, maxillary atrophy, nasopalatine canal