Clinical Outcomes and Success Factors of Pterygoid Implants in the Posterior Atrophic Maxilla: A Prospective Study.

Introduction Pterygoid implants serve as an alternative for rehabilitating a posterior atrophic maxilla without requiring extensive bone grafting or sinus augmentation. This study aimed to evaluate the clinical outcomes and success rates of pterygoid implants over a one-year follow-up period and assess the influence of bone quality, complications, and other patient-related factors on implant success. Materials and methods A total of 34 patients with a posterior atrophic maxilla received 35 pterygoid implants. Preoperative cone-beam computed tomography (CBCT) was used to assess bone quality, and the implants were placed using a standardized surgical protocol. Clinical parameters, including primary stability, marginal bone loss, postoperative complications, and patient-reported outcomes, were recorded. Implant success was defined as the absence of pain, mobility, radiographic bone loss beyond 1.5 mm during one-year follow-up, or infection. Patient-reported outcomes were evaluated using the Oral Health Impact Profile (OHIP-14). Statistical analysis was conducted to determine the correlation between implant success and influencing factors such as bone density, complications, smoking history, age, and implant length. Results The overall success rate was 31 (88.57%) pterygoid implants within the one-year follow-up period. Bone quality significantly affected implant success, with D3 showing a higher failure rate than D2 (p = 0.029). Complications, including implant fracture, prosthetic failure, and nerve injury, were significantly associated with implant failure (p = 0.001). Marginal bone loss was higher in the failed implants, supporting its role as a predictive factor of long-term success. Patient age, sex, smoking history, and implant length did not significantly influence outcomes. OHIP-14 scores indicated that patients with successful implants reported improved function and quality of life. Conclusion The pterygoid implants demonstrated a high success rate and served as a viable treatment for posterior maxillary rehabilitation. Bone quality and complications were the key determinants of implant success, whereas age, sex, smoking history, and implant length had no significant impact. Marginal bone loss has emerged as a crucial factor for implant failure, highlighting the importance of postoperative monitoring.