Rehabilitation with Five Osseointegrated Implants in an Atrophic Maxilla: A Case Report

Main Article Content

Bárbara Nathalia Marques de Lima
Maria Taywri Almeida Costa
Vilmar Santos de Almeida
https://orcid.org/0009-0006-9557-1990
Raphael Carvalho e Silva
Mauro Luiz Travessa de Barros
Francisco Amadis Batista Ferreira
https://orcid.org/0000-0002-7444-6510
José da Silva Junior

Abstract

Tooth loss is a public health issue in Brazil, impacting nutrition, speech, aesthetics, and self-esteem. Implant-supported prostheses are considered the gold standard for replacing missing teeth. Bone resorption, a consequence of tooth loss, can lead to an atrophic ridge, making implant treatment more challenging. This paper reports a case of rehabilitation with a fixed full-arch prosthesis supported by five implants in an atrophic maxilla. The patient sought care at the RC Institute of Postgraduate Dentistry to replace her removable maxillary prosthesis with a fixed, implant-supported one. Imaging exams revealed an atrophic maxilla with reduced bone width and limited height in the posterior region due to maxillary sinus pneumatization. Surgery for the placement of five implants was performed with proper distribution and angulation. Three months after surgery, with the implants osseointegrated, the prosthetic phase began, and treatment was completed with the installation of a porcelain fixed full-arch prosthesis. The use of angled implants proved to be an excellent alternative, allowing the placement of long implants, reducing the distal cantilever, and avoiding invasive procedures. This resulted in lower morbidity, shorter treatment time, and reduced costs.

Article Details

How to Cite
Lima, B. N. M. de, Costa, M. T. A., Almeida, V. S. de, Carvalho e Silva, R., Barros, M. L. T. de, Ferreira, F. A. B., & Silva Junior, J. da. (2025). Rehabilitation with Five Osseointegrated Implants in an Atrophic Maxilla: A Case Report. Brazilian Journal of Case Reports, 5(1), bjcr84. https://doi.org/10.52600/2763-583X.bjcr.2025.5.1.bjcr84
Section
Clinical Case Reports
Author Biographies

Bárbara Nathalia Marques de Lima, Faculty FAIPE

Faculty FAIPE, Cuiabá, Mato Grosso, Brazil.

Maria Taywri Almeida Costa, University of the Amazon – UNAMA

University of the Amazon – UNAMA, Ananindeua, Pará, Brazil.

Vilmar Santos de Almeida, State University of Amazonas

State University of Amazonas, Manaus, Amazonas, Brazil.

Raphael Carvalho e Silva, School of Dentistry of Ribeirão Preto, University of São Paulo

School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Mauro Luiz Travessa de Barros, State University of Amazonas

State University of Amazonas, Manaus, Amazonas, Brazil.

Francisco Amadis Batista Ferreira, Federal University of Amazonas

Federal University of Amazonas, Manaus, Amazonas, Brazil.

José da Silva Junior, São Leopoldo Mandic College

São Leopoldo Mandic College, São Paulo, São Paulo, Brazil.

References

Silva ET, Oliveira RT, Leles CR. Fatores associados ao edentulismo funcional em idosos brasileiros. Comun Ciênc Saúde. 2016;27(2):129-138.

Cardoso M, et al. Edentulism in Brazil: trends, projections and expectations until 2040. Cien Saude Colet. 2016;21(4):1239-1245.

Rocha SS, et al. Próteses Totais Fixas Tipo Protocolo Bimaxilares: relato de caso. Rev Odontol Bras Central. 2013;21(60):21-27.

Cunha G, et al. Atrophic maxilla reconstruction with autogenous iliac graft and guided dental implants. J Craniofac Surg. 2018 Nov;29(8):2218-2219.

Sierra-Sanchez J, et al. Predictability of short implants (<10 mm) as a treatment option for the rehabilitation of atrophic maxilla: a systematic review. Med Oral Patol Oral Cir Bucal. 2016;21(3):e392-e402.

Mittal Y, Jindal G, Garg S. Bone manipulation procedures in dental implants. Indian J Dent. 2016;7(2):86-94.

Agliardi EL, et al. Immediate full-arch rehabilitation of the severely atrophic maxilla supported by zygomatic implants: a prospective clinical study with minimum follow-up of 6 years. Int J Oral Maxillofac Surg. 2017;46(12):1592-1599.

Spencer KR. Implant-based rehabilitation options for the atrophic edentulous jaw. Aust Dent J. 2018;63(1):100-107.

Misch CM. Maxillary autogenous bone grafting. Oral Maxillofac Surg Clin North Am. 2011;23(2):229-238.

Peñarrocha-Oltra D, et al. Rehabilitation of the atrophic maxilla with tilted implants: review of the literature. J Oral Implantol. 2013;39(5):625-632.

Zanettini LMS, et al. Use of recombinant human bone morphogenetic protein-2 associated with lyophilized bovine bone in reconstruction of atrophic maxilla. J Craniofac Surg. 2018;29(7):1934-1938.

Durkan R, Oyar P, Deste G. Maxillary and mandibular all-on-four implant designs: a review. Niger J Clin Pract. 2019;22:1033-1040.

Corbella S, Taschieri S, Del Fabbro M. Long-term outcomes for the treatment of atrophic posterior maxilla: a systematic review of literature. Clin Implant Dent Relat Res. 2013;17(1):12-132.

Monje A, et al. Influence of atrophic posterior maxilla ridge height on bone density and microarchitecture. Clin Implant Dent Relat Res. 2013;17(1):111-119.

Mertens C, et al. Reconstruction of the severely atrophic edentulous maxillae with calvarial bone grafts. Clin Oral Implants Res. 2016;28(6):749-756.

Sayed S, Hassan M, Emarah M. All-on-4 versus all-on-6 implant concepts for rehabilitation of edentulous maxilla: short-term randomized clinical and radiographic study. Egypt Dent J. 2020;66:659-670.

Chaware SH, et al. The rehabilitation of posterior atrophic maxilla by using the graftless option of short implant versus conventional long implant with sinus graft: a systematic review and meta-analysis of randomized controlled clinical trial. J Indian Prosthodont Soc. 2021;21:28-44.

Esposito M, et al. Immediately loaded zygomatic implant vs. conventional dental implant in augmented atrophic maxilla: 4 months post loading result from multicentre randomized controlled trial. Eur J Oral Implantol. 2018;11:11-28.

Kern JS, et al. A systematic review and meta-analysis of removable and fixed implant-supported prostheses in edentulous jaws: post-loading implant loss. Clin Oral Implants Res. 2015;:1-22.

Misch CM. Maxillary autogenous bone grafting. Oral Maxillofac Surg Clin North Am. 2011;23(2):229-238.

Rocha SS, et al. Próteses Totais Fixas Tipo Protocolo Bimaxilares: relato de caso. Rev Odontol Bras Central. 2013;21(60):21-27.

Mertens C, et al. Reconstruction of the severely atrophic edentulous maxillae with calvarial bone grafts. Clin Oral Implants Res. 2016;28(6):749-756.

Mehta SP, et al. Clinical success between tilted and axial implants in edentulous maxilla: a systematic review and me-ta-analysis. J Indian Prosthodont Soc. 2021;21:217-228.

Maló P, et al. All-on-4® treatment concept for the rehabilitation of the completely edentulous mandible: a 7-year clinical and 5-year radiographic retrospective case series with risk assessment for implant failure and marginal bone level. Clin Implant Dent Relat Res. 2014;17:531-541.

Zincir OO, Parlar A. Comparison of stresses in monoblock tilted implants and conventional angled multiunit abut-ment-implant connection systems in the all-on-four procedure. BMC Oral Health. 2021;21(646):1-13.

Asawa N, et al. Angulated implants: an alternative to bone augmentation and sinus lift procedure: systematic review. J Clin Diagn Res. 2015;9(3):10-13.

Tischler M, Patch C, Bidra AS. Rehabilitation of edentulous jaws with zirconia complete-arch fixed implant-supported prostheses: an up to 4-year retrospective clinical study. J Prosthet Dent. 2018;120(2):204-209.

Moraes MM, de Oliveira M, Silva J, et al. The role of urban green spaces in the context of the COVID-19 pandemic: a case study of the city of São Paulo, Brazil. Sustain Cities Soc. 2020;61:102338. doi:10.1016/j.scs.2020.102338.

Kondo Y, Sakai K, Minakuchi H, Horimai T, Kuboki T; JSOI Clinical Guideline Working Group collaborators. Im-plant-supported fixed prostheses with cantilever: a systematic review and meta-analysis. Int J Implant Dent. 2024;10:57. doi:10.1186/s40729-024-00573-8.

Most read articles by the same author(s)