Implants placed in the nasopalatine canal to rehabilitate severely atrophic maxillae: A retrospective study with long follow-up

To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients withatrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell’s class V)rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. Apreoperative computed tomography scan was obtained of all patients and all surgeries were performed by thesame surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using thepointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al;patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a meanage of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatinecanal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 inother locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, whichdisappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures(after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with theprosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease ofcleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy.This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patientsusing implant-supported prostheses