Rehabilitation of Atrophied Maxillary Bones With Short-Splinted Implants in a Periodontitis Patient: A Six-Year Follow-Up Case Report

Abstract

This case report aims to report the successful use of a short-splinted implant in a patient with a history of periodontal disease. Two implants were used to rehabilitate severe atrophied alveolar ridge with fixed prosthesis. Despite the left posterior ridge being weakened by maxillary sinus pneumatization and bone remodeling after tooth extraction, no bone grafts nor sinus osteotomy procedures were needed for the rehabilitation surgery. The report examines the use of Roxolid® SLActive® surface implants (Straumann Group, Basel, Switzerland) for the restoration of missing posterior teeth in the atrophied alveolar ridge. These implants offer improved mechanical properties that enhance their durability and dependability, which increase their survival rate. This case report demonstrates that the use of short-splinted implants can effectively reduce morbidity rates and the risk of implant failure. Additionally, the simplified rehabilitation surgery involving a short implant, when combined with proper surgical and prosthetic management, appears to be a viable treatment option that is both cost-effective and less time-consuming for rehabilitating atrophied maxillary ridges. It is important to emphasize that rigorous periodontal maintenance, which includes regular professional follow-ups and effective oral hygiene practices, is essential for achieving optimal health of both soft and hard oral tissues around dental implants.

Keywords: atrophied maxillary ridge; maxillary sinus pneumatization; roxolid® dental implant; short dental implant; slactive® surface implant; splinted dental implant.

Figure 1. (A, B) Pre-surgical X-rays and clinical photograph. (C) The maxillary left ridge is severely resorbed, with noticeable pneumatization of the maxillary sinus.

Figure 2. (A) Maxillary cast with a three-unit wax-up fixed partial denture. (B) Customized surgical stent for the maxillary arch, featuring two holes at the planned implant fixture osteotome locations (areas of #24 and #26).

Figure 3. Two implant fixtures made of titanium-zirconium (Roxolid® SLActive®) were surgically placed in the areas of #24 and #26 (𝝓 4.1×10 mm and 𝝓 4.1×8 mm) and covered with screws. Later, the screws were replaced with healing abutments.

Figure 4. (A) Periapical X-ray showing the two implants restored and splinted together with a fixed partial denture (fixed prosthesis). (B, C) Clinical photos taken with an intraoral camera (Dentsply Sirona’s intraoral scanner (York, USA)) for the fixed partial denture.

Figure 5. Follow-up images

(A) The 2021 X-ray shows the two implants in the areas of #24 and #26. (B) The 2023 X-ray of the same implants. (C, D) The 2024 X-rays were taken for the #24 and #26 implants and prostheses. (E, F) Clinical photographs taken with an intra-oral camera in 2024, showing the same prosthesis after six years (E: Buccal view, F: Occlusal view).