Palatal Positioning of Implants in Severely Atrophic Edentulous Maxillae: Five-Year Cross-Sectional Retrospective Follow-up Study

Purpose: To evaluate the 5-year outcome of a previously reported case series of patients with severely atrophic maxillae treated with palatally positioned implants and fixed full-arch rehabilitations. Materials and Methods: A retrospective cross-sectional clinical study of patients treated between January 2000 and January 2004 with palatally positioned implants was carried out. The parameters evaluated at the 5-year follow-up visit were: implant success rate, peri-implant soft-tissue conditions, biological and prosthetic post-loading complications, radiographic peri-implant marginal bone loss, and patient satisfaction. Results: A total of 33 patients with 151 palatally positioned implants were included in the study; 15 patients had received cemented prostheses and 18 had received screwed full-arch prostheses. The success rate for palatally positioned implants after 5 years was 98.7%. Average peri-implant mucosa retraction was 0.39 ± 0.94 mm and the average probing depth was 2.89 ± 0.77 mm. Plaque Index was 0 in 63.1% of the implants, 1 in 18.8%, 2 in 8.7%, and 3 in 9.4%. The modified Bleeding Index was 0 in 71.1%, 1 in 14.1%, and 2 in 14.8%. Mucositis was found in 5.2% of the implants and none had peri-implantitis. Prosthetic complications occurred in 12.1% of the cases. Average peri-implant marginal bone loss was 1.03 ± 1.28 mm. General patient satisfaction averaged 8.2 ± 1.8 according to a 10-point visual analog scale, and good quality of life was reported by most patients. Conclusions: Palatally positioned implants were found to be an adequate treatment for patients with severely atrophic maxillae. A high implant success rate, good peri-implant soft tissue stability, low marginal bone loss, high patient satisfaction and few complications were registered. Keywords: bone atrophy, full-arch prosthesis, maxillary atrophy, palatal implants