Part 2 of our decision tree algorithm for full arch will focus on approaches to ensure success for the FP1 versus FP3 prosthesis Misch classification.
Extramaxillary Approach or Regeneration
The prosthetic planning of the full arch implant therapy patient is dictated next by the availability of the bone height remaining if alveoplasty was necessary due to insufficient prosthetic space or high smile line. If the bone heigh is insufficient, either an extramaxillary approach such as the PATZI protocol ((P)terygoid, (A)nterior (T)ilted (Z)ygomatic (I)mplants.) or bone regeneration (sinus grafts, horizontal (GBR) guided bone regeneration) may be required.
If pterygoid implants are successfully placed, the algorithm next proceeds to achieve anterior support. Anterior prosthetic support may be attained with standard axial, nasopalatine, piriform rim, or transnasal fixtures. If anterior support is achieved, PATZI now proceeds to achieve mid-maxillary support via tilted implants which may be of either traditional or trans-sinus varieties. If pterygoid or mid-maxillary tilted implants are not successful, PATZI calls for placement of a posteroinferior zygomatic implant. Alternatively, failure to achieve placement of an anterior implant necessitates placement of an anterosuperior zygomatic implant.
In part 3 of our blog article, we will discuss putting it all together in the decision tree algorithm for full arch. STAY TUNED
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