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Subperiosteal Surgical Implantology.

I present to you the technique of immediate load dental implantology for patients categorically devoid of maxillary bone, as we carry out within our clinic in Padua these extremely complex but extremely precise and fast interventions to solve the extremely severe, unmanageable and unrehabilitatable atrophy with no other technique with fixed, solid, definitive, beautiful and immediate teeth for our patients’ atrophies. When a patient presents severe atrophy of the maxillary bone, with an extremely severe level of resorption that makes the use of zygomatic implants or the Galileus cerclage sinus technique impossible, one wonders if dentures are the only solution.

Absolutely not!

I present to you the technique of immediate load dental implantology for patients categorically lacking maxillary bone, as we carry out within our clinic in Padua these extremely complex but precise and rapid interventions to address severe, unmanageable atrophy that cannot be rehabilitated with any other technique, providing patients with immediate fixed, solid, definitive, beautiful, and immediate teeth. Even though we just mentioned that this is one of the most severe cases encountered so far, patients with extremely complex cases who come to our clinic are rehabilitated with this technique. This treatment is performed at our immediate load implantology center without bone, which exploits the cortical basal bones. Now, I’ll explain in detail how this special technique works at our Padua center.

The subperiosteal grid implantology technique is performed when a patient presents with severe atrophy of the maxillary bone, making the use of other techniques such as quad zygomatic implantology or pterigoidea zygomatic implantology impossible. In this case, dentures are not an acceptable option, so this extremely innovative and effective technique, practiced at our specialized implantology center in Italy, Padua, is employed.

The procedure begins with a thorough evaluation of the patient, including a panoramic and Cone Beam Computed Tomography (CBCT) scan to obtain a detailed view of the jawbone structure. During the CBCT scan, the patient wears a provisional prosthetic denture with triangulated reference points fixed inside to create a three-dimensional image of the jaw. This image is sent to a specialized laboratory for the creation of the surgical grid.

Meanwhile, the patient undergoes a pre-intervention, during which two special dental implants are inserted into the cortical basal bones of the maxillary bone, specifically into the pterigoideal basal bone. These implants are strategically placed and left dormant under the periosteum.

Next, the CBCT data and files are sent to the laboratory, where a three-dimensional CAD/CAM model of the bone structure and provisional dental prosthesis is created. This model is then used to guide a fusion laser, which creates the titanium surgical grid.

On the day of the surgery, the patient is anesthetized, and the surgeon proceeds to open the gum and skeletonize the maxillary bone. The grid is then placed and manually fixed onto the skeletonized maxillary bone, using small osteosynthesis screws to ensure stability. Once fixed, the grid is covered again by the gum, and the patient immediately receives a fixed dental prosthesis.

After about six months, during which the grid and implants undergo osseointegration, the patient undergoes surgery for the exposure of the pterigoideal implants. Finally, after a month, the final replacement phase is carried out with the creation of a definitive dental prosthesis in zirconia ceramic or composite, completing the rehabilitation process.

This technique allows the patient to obtain a fixed and complete dentition, enabling them to return to chewing, smiling, and living with confidence and security.

If you want to view the latest surgery we performed with this technique on one of our patients who gave us authorization for scientific dissemination of her clinical case, thus giving other patients in her same condition the opportunity to benefit from hope of a technique that could avoid dentures, you can watch it on the YouTube video or go to YouTube and watch the surgical intervention of this technique:

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