Management of the atrophic maxilla using remote anchorage with zygomatic and short Implants

a 4-year follow-up case report

Abstract

This case report presents a rehabilitation of atrophic maxilla employing remote anchorage with zygomatic and short implants in the premaxilla, including a nasopalatine approach. A 47-year-old female patient presented with advanced posterior bone resorption and bilateral sinus pneumatization. Two zygomatic implants were placed for posterior support, and three short implants were positioned in the premaxilla, achieving sufficient primary stability to allow immediate prosthetic loading. The patient was followed at 1, 6, and 12 months postoperatively, with annual monitoring. Satisfactory function and preservation of peri-implant mucosal health were observed throughout the observation period. Radiographic evaluation revealed stable bone levels. No mechanical or biological complications occurred during the 4-year follow-up period. Remote anchorage using zygomatic implants combined with short implants in the premaxilla represents a reliable and graftless approach for the rehabilitation of atrophic maxilla, optimizing anterior–posterior spread, reducing cantilever extension, and promoting biomechanical stability.