Indications for implant-supported rehabilitation of the posterior atrophic maxilla: A multidisciplinary consensus among experts in the field utilising the modified Delphi method

Tiziano Testori, Tommaso Clauser, Antonio Rapani, Zvi Artzi, Gustavo Avila-Ortiz, Shayan Barootchi, Eriberto Bressan, Matteo Chiapasco, Luca Cordaro, Ann Decker, Luca De Stavola, Danilo Alessio Di Stefano, Pietro Felice, Filippo Fontana, Maria Gabriella Grusovin, Ole T. Jensen, Bach T. Le, Teresa Lombardi, Craig Misch, Michael PikosRoberto Pistilli, Marco Ronda, Muhammad H. Saleh, Devorah Schwarz-Arad, Massimo Simion, Silvio Taschieri, Michael Toffler, Tolga F. Tozum, Pascal Valentini, Raffaele Vinci, Stephen S. Wallace, Hom Lay Wang, Shih Cheng Wen, Shi Yin, Giovanni Zucchelli, Francesco Zuffetti, Claudio Stacchi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

PURPOSE: To establish consensus-driven guidelines that could support the clinical decision-making process for implant-supported rehabilitation of the posterior atrophic maxilla and ultimately improve long-term treatment outcomes and patient satisfaction. MATERIALS AND METHODS: A total of 33 participants were enrolled (18 active members of the Italian Academy of Osseointegration and 15 international experts). Based on the available evidence, the development group discussed and proposed an initial list of 20 statements, which were later evalu-ated by all participants. After the forms were completed, the responses were sent for blinded ana-lysis. In most cases, when a consensus was not reached, the statements were rephrased and sent to the participants for another round of evaluation. Three rounds were planned. RESULTS: After the first round of voting, participants came close to reaching a consensus on six statements, but no consensus was achieved for the other fourteen. Following this, nineteen statements were rephrased and sent to participants again for the second round of voting, after which a consensus was reached for six statements and almost reached for three statements, but no consensus was achieved for the other ten. All 13 statements upon which no consensus was reached were rephrased and included in the third round. After this round, a consensus was achieved for an additional nine statements and almost achieved for three statements, but no consensus was reached for the remaining statement. CONCLUSION: This Delphi consensus highlights the importance of accurate preoperative planning, taking into consideration the maxillomandibular relationship to meet the functional and aesthetic requirements of the final restoration. Emphasis is placed on the role played by the sinus bony walls and floor in providing essential elements for bone formation, and on evaluation of bucco-palatal sinus width for choosing between lateral and transcrestal sinus floor elevation. Tilted and trans-sinus implants are considered viable options, whereas caution is advised when placing pterygoid implants. Zygomatic implants are seen as a potential option in specific cases, such as for completely edentulous elderly or oncological patients, for whom conventional alternatives are unsuitable.

Original languageEnglish
Pages (from-to)89-100
Number of pages12
JournalInternational Journal of Oral Implantology
Volume17
Issue number1
StatePublished - 19 Mar 2024

Keywords

  • diagnostic procedure
  • implant dentistry
  • lateral window technique
  • pterygoid implants
  • sinus floor elevation
  • transcrestal sinus floor elevation
  • zygomatic implants

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