Tuberopterygoid implants are dental implants placed in the upper jaw in the second molar area that anchor in the dense cortical bone of the pterygoid plates, avoiding the need for invasive sinus lift surgery. They allow for immediate loading and replacement of teeth up to the second molars. Key advantages include eliminating sinus grafting, replacing all teeth without cantilevers, using strong single-piece implants in rigid cortical bone, and enabling immediate loading with permanent crowns in just 3 days with a flapless technique.

1. Tuberopterygoid Implants
What are Tuberopterygoid Implants?
Tuberopterygoid implants are implants located in 2nd molar area of
upper jaw. They allow the prosthetic rehabilitation on dental implants in
upper jaw. The applied forces go to the pterygomaxillary buttress area
allowing immediate loading of the implants. The white arrows show
tuberopterygoid implant, this avoided invasive Sinus lift Surgery and
saved time period of 6-8 months post sinus lift surgery.We were in
position to deliver fixed teeeth in period of just 3 days even in such an
atrophied situation.

2. Introduction
If you have been told that there is less bone in your upper jaw for dental
implants, do not worry. The best solution for cases with severe bone
resorption in upper jaw is pterygoid implant. Tubero pterygoid
implants are the best solution for patients requiring dental implants
for upper jaw.
Such patients were going for sinus lift or bone grafts as per old
techniques. In a single procedure we place pterygoid implant and place
the permanent crown in 3 days. As we use single piece implants the
procedure is flapless and done under local anesthesia.

3. Current definitions for pterygoid implants
Throughout literature, several terms are being used to describe
pterygoid implants. The terms "pterygoid implants", "pterygomaxillary
implants" and "tuberosity implants" are used interchangeably.
"Pterygoid implants" have been defined by the Glossary of Oral and
Maxillofacial Implants (GOMI) as "implant placement through the
maxillary tuberosity and into the pterygoid plate".
• There are significant differences between pterygoid and tuberosity
implants including the following:
• pterygoid implants originate in the tuberosity and engage in the
dense bone of the pterygoid plates and palatine bone
• tuberosity implants originate in the maxillary alveolar process and
can occasionally anchor in the pyramidal process. The bone quality
in this region is mainly composed of type III or IV cancellous bone
Indications
• In the edentulous upper jaw the placement of implants can be
challenging due to limited bone quantity and the presence of the
maxillary sinus. Pterygoid implants have high success rates, similar
bone loss levels to those of conventional implants, minimal
complications and good acceptance by patients, being an
alternative to treat patients with highly atrophic maxillae and
avoiding the need for extensive augmentation procedures.
• However, at present, pterygoid implants have mainly been studied
in partial edentulism as a very attractive treatment alternative to
sinus lift procedures.

4. Procedure
When the upper grinding teeth are lost and are not replaced on time, it
leads to drooping of the sinus there by resulting in bone resorption
making it difficult for tooth replacement, Some conventional
implantologists suggest Sinus lift procedure, which is a complex
traumatic surgical approach, that is totally unpredictable and takes
approximately 6 to 8 months to heal.All the patients interested in
getting the upper full arch replaced on implants are suitable candidates
for this as pterygoid bone is present in all the patients. Pterygoid bone
is present distal to the second molar region in the upper jaw and is the
only option available if you want to avoid cantilevers, but it requires a
very experienced hand with an in depth knowledge of Anatomy of the
surrounding areas.
The option of fixed teeth on dental implants in upper jaw
• Cantilever bridges: It devised to avoid the expensive and aggressive
bone grafting by placing just 4 or 6 implants in the front part of the
jaw. Then placing a set of just 10/12 teeth. As 1st molar crowns are
placed as cantilevers but there is no need to replace 2nd molars at
all.

5. • Occasionally, only 10 teeth are placed. The permanent ceramic
bridges are fixed after 3-6 months which is another disadvantage of
cantilevers.
Clinical recommendations
The pterygoid implant is placed in the region of the former first or
second maxillary molars and follows a diagonal direction posteriorly
towards the pyramidal process. The implant ultimately anchors in the
pterygoid fossa of the sphenoid bone. The angulation of pterygoid
implants ranges from 45°-50° towards the maxillary plane.
Before and After of Tubero-pterygoid implants
• In clinical reality, whenever pterygoid implants are described those
are in reality tuberosity implants with an anchorage in the
pterygoid plate and thus the treatment difficulties are very limited.
As with every implant surgery the preparation of the implant bed is
of high importance and treatment planning should be performed
with great attention to the anatomical structures and bone
availability/quality.

6. • Due to the presence of type III or IV cancellous bone in this region,
a preferred choice of implant type is the NobelActive implant given
its high primary stability in soft bone
Advantages of Tubero pterygoid Implants
• Eliminates the need of sinus grafting.
• No cantilevers from front teeth or implants.
• Efficient chewing is possible as teeth upto second molars are
replaced. In cantilevers implant cases or in all-on -4 and all – on – 6
techniques 2nd molars are not replaced. If replaced then they are
made as cantilevers which make the last implant weak and the
bridge susceptible to fracture in the long run.
• Bone in pterygoid area is cortical in nature, and hence very strong
and rigid allowing Immediate loading with permanent crown in 3
days.
• Single piece implants are used which are strong in comparison to
conventional dental implants.
• All patients who want dental implants in upper jaw are good
candidates as bone is always available in pterygoid area.
• Flapless technique is used, as such patients have no swelling or
bleeding and patients need not stop blood thinners, if they are
taking any.
• With Tuberopterygoid Implant - No More Sinus Lift No More Bone
graft.
• Strong single piece implants are being used in strong cortical bone.
• 100% success rate.

7. If you want to know more details about
Tubero-pterygoid Implants,
contact us:
Dr Motiwala
2nd Floor, Park View Building, Road No. 1, Near KBR Park, Beside CVR
Health & News Building, Jubilee Hills Navanirman Nagar Colony, Jubilee
Hills Hyderabad, Telangana 500033.
Email : info@drmotiwala.com
Mobile: +91 73374 49900
http://thesinuslift.com/tuberopterygoid-implants