Observational Study of Pterygoid, Zygomatic and Subperiosteal Implants: Treatment Strategies, Clinical Outcomes, and Complications for Severe Maxillary and Mandibular Atrophy

• Abdulmajid Elshawesh

  Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Misrata University, Libya

  المؤلف

• Tarek Esmail

  Faculty of Medicine, Alrazi University, Misrata, Libya

  المؤلف

• Khaled Ben Salah

  Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Misrata University, Libya

  المؤلف

• Kamal Elsebsi

  Alkamal Dental Hospital, Misrata, Libya

  المؤلف

• Abduladim Affat

  Department of Health Services, Misrata, Libya

  المؤلف

Rehabilitation of edentulous atrophic jaws remains a significant clinical challenge. Conventional bone grafting with implant placement often results in extended treatment times, increased morbidity, and higher costs. Graft-less implant rehabilitation, using pterygoid, zygomatic, and subperiosteal implants, offers a minimally invasive alternative for patients with severe maxillary or mandibular atrophy. This study aimed to compare the clinical outcomes, complications, and treatment strategies of pterygoid, zygomatic, and subperiosteal implants in the graft-less rehabilitation of severely atrophic jaws. A total of 15 partially and fully edentulous Libyan patients (age range: 39–63 years) with severe maxillary and mandibular atrophy were treated using a graft-less approach. Implants included 11 zygomatic, 7 pterygoids, and 6 subperiosteal systems. Demographic, surgical, and follow-up data were analyzed. Clinical success, osseointegration, and postoperative complications were evaluated over follow-up periods of 1–25 months. All implant types demonstrated high success rates with no cases of implant loss or persistent infection. Minor complications included transient oral–antral communication in one zygomatic case and small plate exposure in one subperiosteal case. Patient satisfaction was universally high regarding function, comfort, and esthetics. Immediate or early loading was feasible in selected cases with adequate primary stability. Pterygoid, zygomatic, and subperiosteal implants represent reliable, minimally invasive, and cost-effective options for the rehabilitation of edentulous atrophic jaws without the need for bone grafting. Selection of the optimal implant type should be guided by anatomical limitations, bone availability, and patient-specific factors.

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