title: A retrospective comparison of implants in the pterygomaxillary region: implant placement with two-stage, single-stage, and guided surgery protocols.
abstract: OBJECTIVE
  Implants placed into the pterygomaxillary region allow for increased posterior support and a full complement of teeth without the need for distal cantilevers. With advancements in research and technology, implant delivery has evolved from the traditional two-stage procedure to immediate loading freehand and guided surgical template protocols. The purpose of this retrospective study is to determine if there is a significant difference in implant survival rates between these protocols.
  
  
  METHODS
  All pterygomaxillary implants placed in a single private practice from September 1985 to July 2011 were categorized into three separate classifications (two-stage freehand, single-stage freehand, or single-stage guided) by retrospective chart review. Life tables were constructed to determine the cumulative survival rates (CSR), and ANOVA was used to identify statistical significance.
  
  
  RESULTS
  A total of 981 patients comprising 371 males and 610 females were included in the study. Of all pterygomaxillary implants, 1,460 of 1,608 implants osseointegrated for a CSR of 90.80%. Seven hundred nine of the 825 two-stage, 624 of the 647 single-stage, and 127 of the 136 guided surgery implants osseointegrated for CSRs of 85.94%, 96.45%, and 93.38%, respectively. The comparison between two-stage and single-stage protocols was statistically significant, (P < .05) while the difference between single-stage guided versus freehand protocols was found to be statistically insignificant (P > .05).
  
  
  CONCLUSIONS
  The results from this retrospective study reinforce that immediate loading of pterygomaxillary implants with a provisional prosthesis is beneficial to both doctor and patient. The lower CSR for the guided surgery protocol compared with the single-stage freehand procedure is statistically insignificant, suggesting guided surgery is still a viable and recommended option for qualified patients.
authors: PI Dental Center at Institute for Facial Esthetics, Fort Washington, PA 19034, USA. balshi2@aol.com
authors: Thomas J
authors: TJ
authors: Balshi
authors: Glenn J
authors: GJ
authors: Wolfinger
authors: Robert W
authors: RW
authors: Slauch
authors: Stephen F
authors: SF
authors: Balshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003758:Dental Implantation, Endosseous / Q000379:methods* / Q000706:statistics & numerical data; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure / Q000706:statistics & numerical data*; D003794:Dental Restoration, Temporary / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading / Q000706:statistics & numerical data; D015993:Life Tables; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D016348:Osseointegration; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015921:Dental Implants