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Volume 29 , Issue 1
January/February 2014

Pages e30e35

Angled Dental Implant Placement into the Vomer/Nasal Crest of Atrophic Maxillae for All-on-Four Immediate Function: A 2-Year Clinical Study of 100 Consecutive Patients

Ole T. Jensen, DDS, MS/Jared R. Cottam, DDS, MD/Jason L. Ringeman, DDS, MD/Stuart Graves, DDS, MS/Lucas Beatty, DDS, MD/Mark W. Adams, DDS, MS

PMID: 24451885
DOI: 10.11607/jomi.te39

Purpose: To report on the use of angled implants placed into the vomer/nasal crest to support a complete-arch maxillary prosthesis. Materials and Methods: Consecutive patients were treated with the All-on-Four concept to restore the maxillary dentition. When bone volume in the subnasal region was inadequate, angled implants were placed into the vomer/nasal crest area to support the restoration. All implants were loaded immediately. Results: One hundred consecutive maxillary All-on-Four patients were treated over a period of 2 years. Four hundred six implants were placed; 12 were inserted into the vomer/nasal crest area. One year later, at definitive restoration, the 12 vomer implants were found to be osseointegrated without bone loss or instability. Conclusions: Midline maxillary bone volume at the nasal crest appeared to be a viable alternative to the lateral nasal rim when subnasal bone was deficient. Vomer implants allowed for immediate function or were sometimes used as a rescue implant when an anterior implant failed.

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