Pterygoid implant insertion is an alternative to avoid sinus-lifting or other grafting procedures to treat the posterior maxilla.They are especially used in partial edentulism in order to avoid distal cantilevers. The placement of a pterygoid implant requires surgical experience and expertise in the field of implantology. Pterygoid implants have high success rates, to those of conventional implants, minimal complications and a good patient acceptance. Dr Sachdeva's Facial Aesthetic and implant institute is one of the leading clinics in Delhi performing Pterygoid Implants in patients with bone resorption. So hurry up and book an appointment with us at Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments. To book an appointment contact: Dr. Rajat Sachdeva Director & Mentor Dr Sachdeva’s Dental Aesthetic And Implant Institute I 101, Ashok Vihar Phase 1, Delhi- 110052 Contact us at Phone : +919818894041,01142464041 Our Websites: www.sachdevadentalcare.com www.dentalimplantindia.co.in www.dentalclinicindelhi.com www.dentalcoursesdelhi.com Facebook- dentalcoursesdelhi Youtube- drrajatsachdeva Linkedin- drrajatsachdeva Slideshare- Dr Rajat Sachdeva Twitter Page- drrajatsachdeva Instagram page- surgicalmasterrajat

1. EMERGENCE OF
PTERYGOID IMPLANTS

2. NECESSITY OF PTERYGOID
IMPLANTS?
Today, any dentist with proper education and
training routinely places conventional dental
implants in patients with sufficient bone conditions.
They may also perform minor bone augmentation
or sinus augmentation procedures, but they tend
not to treat patients with severe bone loss.

3. These patients, unfortunately, need to rely on
removable dentures or undergo massive
augmentation procedures before conventional
implants can be place.
Pterygoid implants present an alternative option to
use residual bone for implant anchorage and to
overcome the need for augmentation procedures.

4. FAILURE OF CONVENTIONAL
IMPLANTS LEADING TO THE
EVOLUTION OF PTERYGOID
IMPLANTS

5. •Tear of sinus membrane during sinus lift
procedures,
•Seepage of bone grafts into the sinus.
•Loss of bone grafts due to resorption during
bone augmentation procedure.
•High morbidity seen in zygomatic implants.
•Screw loosening or breakage in tilted implants.

6. WHAT IS THE DIFFERENCE BETWEEN
PTERYGOID AND TUBEROSITY IMPLANTS?
There is a significant difference between
pterygoid and tuberosity implants.
Pterygoid implants are engaged in the dense
cortical part of the pterygoid bone and the palatal
bone, while tuberosity implants are directed and
engaged in cancellous maxillary bone of poor
quality.

7. Though the maxillary tuberosity is known to have
the lowest bone density in the oral cavity, it rests
against a denser mass of cortical bone formed by
the pyramidal process of palatine bone and the
pterygoid process of the sphenoid bone.
In 1989 Tulasne identified this anatomic advantage
and first described the use of dental implants in the
pterygomaxillary region.

8. Going by definition, all ‘pterygoid implants’ encompass the
tuberosity region, but all ‘tuberosity implants’ do not
necessarily engage the pterygoid process.

9. WHAT ARE THE ADVANTAGES OF
USING PTERYGOID IMPLANTS?
 Placement of dental implants in the pterygoid
region provides posterior bone support for the
prosthesis, without sinus floor augmentation, and
can achieve better distribution of masticatory
forces in comparison to conventional maxillary
implants.
 This benefit allows rehabilitating patients with
satisfactory full arch fixed maxillary prosthesis,
which usually spanned from second molar to
second molar.

10. FACTS ABOUT PTERYGOID
IMPLANTS
The pterygoid implant is anaxial implant placed
through the maxillary tuberosity with fixation
apically in the pterygoid process of the sphenoid
bone and the pyramidal process of the palatine
bone.
Pterygoid implants were first proposed by Linkow
in 1975 and the method was first described by JF
Tulasne in 1992.

11. Pterygoid implant
passes through the
maxillary tuberosity and
the pyramidal process
of palatine bone to
engage the pterygoid
process of the sphenoid
bone, its length ranges
from 16 to 20 mm, they
have a pointed, self-
tapping apex to ensure
strong anchorage when
inserted.

12. TECHNIQUE OF
PLACEMENT OF
PTERYGOID IMPLANTS

13. The incision design is such that the entire tuberosity,
including its posterior aspect, is uncovered for visualization
and instrumentation

14. The drill entry point is often marked 3-4 mm in front
of the posterior region of the tuberosity.
The drill axis runs towards the palate at about 20-
30° in the horizontal plane and about 45° from the
maxillary plane.
Drilling with a pilot drill continues up to the
pterygopalatine-tuberosity suture, which is the
anchorage region for a pterygoid implant.

15. Three different types of drills are used for insertion.
All preparation is done in an underprepared mode,
at a working speed of 600 rpm or manually.
The implant is then inserted manually using a bone
condensation technique, due to its self-tapping and
compressive characteristics

16. The implant is anchored in the pterygoid plate of the
sphenoid bone, through the maxillary and palatine bones
and with distal angulation between 35° and 55°.

18. COMPLICATIONS

19. Insertion of implants at the level of the pterygoid
plate can be potentially associated with bleedings
(from the pterygoid plexus or the a. maxillaris).
Nevertheless this can be avoided by inserting the
implant just at the level of the tuberosity.
Another complication is lack of primary implant
stability [Candel 2012] which can be solved through
underpreparation drilling protocols and innovative
implant designs (NobelActive).

20. CONCLUSION

21. Pterygoid implants have a
high success rate, minor
and infrequent
complications and similar
bone loss in comparison to
conventional implants.
Pterygoid implants are
considered as a good
alternative for extensive
augmentation procedure in
patients with atrophic
maxilla.

23. CONNECT WITH US AT
@surgicalmasterrajat
@dentalcoursesdelhi
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24. To book an appmt.
contact :
Dr.Rajat Sachdeva
Dr Sachdeva’s Dental
Aesthetic & Implant Institute
I 101, Ashok Vihar Phase 1,
Delhi- 110052

25. THANK
YOU