Pterygoid Implant-Based “VIV” Design for Rehabilitation of Extreme Maxillary Atrophy

Rehabilitation of severe maxillary atrophy using implant-supported fixed prostheses is challenging due to limited bone volume. Although the all-on-4 concept offers a potential treatment option, sufficient residual bone in the anterior region remains a prerequisite for these prostheses. Pterygoid implants have been used in conjunction with the all-on-4 technique to eliminate the cantilevered prosthetic design, with good long-term results reported. However, when the bone volume in the anterior region is limited or the bucco-palatal dimension is insufficient, use of the traditional all-on-4 approach is problematic. This article describes the clinical management and good short-term success achieved in the treatment of severe maxillary atrophy with a novel ‘‘VIV’’ design, using a combination of 3 anterior and 2 pterygoid implants.