Background/Objectives: Severe maxillary atrophy presents challenges in maxillofacial rehabilitation. This study compares the clinical outcomes of zygomatic and subperiosteal implants, focusing on implant survival, soft tissue management, and postoperative complications over a five-year follow-up. Methods: A retrospective cohort study analyzed 150 patients divided into two groups based on the type of implant. Zygomatic implants were assessed for immediate functional loading, procedural efficiency, and complications such as sinus-related issues and orbital damage. Subperiosteal implants were evaluated for their customized design, keratinized mucosa integration, and adaptation to severe anatomical limitations. Statistical analyses, including Chi-square tests, were used to determine significant differences (p < 0.05). Results: This study demonstrated differences in complication rates (sinus-related complications: 12.4% for zygomatic implants; peri-implantitis: 5.6% for subperiosteal implants). Implant survival rates were comparable (zygomatic: 96.3%, subperiosteal: 97.1%, p = 0.278). Zygomatic implants demonstrated higher incidences of sinus-related complications (12.4%) and risks of orbital damage. Subperiosteal implants exhibited superior soft tissue stability with fewer cases of peri-implantitis (5.6%, p < 0.05). Procedural duration was shorter for zygomatic implants (177 min vs. 123 min); however, subperiosteal implants allowed for re-implantation after failure, providing flexibility that was unavailable with zygomatic implants. Conclusions: Zygomatic implants excel in immediate functional loading and reduced procedural time but require advanced surgical expertise to mitigate anatomical risks. Subperiosteal implants offer a safer, customizable solution, particularly in anatomically complex cases. These findings emphasize the importance of individualized treatment planning and technological advancements in implant design to optimize clinical outcomes for patients with severe maxillary atrophy.

The MaI Implants^® method offers a modern treatment option for specific patients who lack sufficient bone for traditional screw-based implants. The aim of the article is to use Finite Element Analysis (FEA) to examine the behavior of a subperiosteal implant under actual conditions within the oral cavity and to assess the impact of various mechanical factors on the durability of the MaI Implants^®. A strength analysis was conducted using Finite Element Analysis for two models. The first was a single subperiosteal implant, while the second was a model of an arch consisting of two single subperiosteal implants connected by a bar. Based on the obtained results, it can be observed that the increase in load from 100 N to 800 N leads to an increase in displacements throughout the implant. Changing the angle from 90 to 30 degrees resulted in a 576% increase in the average displacement value across all multi-units. Stresses in the multi-units range from 23.7 MPa to 268.5 MPa. The lack of proper stabilization of the implant has the greatest impact on the results of displacements. Such displacements are significant for the later positioning of the implant compared to the initial conditions.

The study involved numerical FEA (finite element analysis) of dental implants. Based on this, fatigue tests were conducted according to the PN-EN 14801 standard required for the certification of dental products. Thanks to the research methodology developed by the authors, it was possible to conduct a thorough analysis of the impact of external and internal factors such as material, geometry, loading, and assembly of the dental system on the achieved value of fatigue strength limit in the examined object. For this purpose, FEM studies were based on identifying potential sites of fatigue crack initiation in reference to the results of the test conducted on a real model. The actions described in the study helped in the final evaluation of the dental system design process named by the manufacturer as INTEGRA OPTIMA 3.35. The objective of the research was to identify potential sites for fatigue crack initiation in a selected dental system built on the INTEGRA OPTIMA 3.35 set. The material used in the research was titanium grade 4. A map of reduced von Mises stresses was used to search for potential fatigue crack areas. The research [loading] was conducted on two mutually perpendicular planes positioned in such a way that the edge intersecting the planes coincided with the axis of the system. The research indicated that the connecting screw showed the least sensitivity (stress change) to the change in the loading plane, while the value of preload has a significant impact on the achieved fatigue strength of the system. In contrast, the endosteal implant (root) and the prosthetic connector showed the greatest sensitivity to the change in the loading plane. The method of mounting [securing] the endosteal implant using a holder, despite meeting the standards, may contribute to generating excessive stress concentration in the threaded part. Observation of the prosthetic connector in the Optima 3.35 system, cyclically loaded with a force of F ≈ 300 N in the area of the upper hexagonal peg, revealed a fatigue fracture. The observed change in stress peak in the dental connector for two different force application surfaces shows that the positioning of the dental system (setting of the socket in relation to the force action plane) is significantly decisive in estimating the limited fatigue strength.

This study evaluated the bone-to-implant contact (BIC) of various surface-treated dental implants using high-resolution micro-CT in rabbit bone, focusing on the effects of different treatments on osseointegration and implant stability before and after bone demineralization. Six male New Zealand White rabbits were used. Four implant types were tested: machined surface with anodizing, only etching, sandblasting with Al₂O₃ + etching, and sandblasting with TiO₂ + etching. Implants were scanned with high-resolution micro-CT before and after demineralization. Parameters like implant volume, surface area, and BIC were determined using specific software tools. During demineralization, the BIC changed about 6% for machined surface with anodizing, 5% for only etching, 4% for sandblasting with Al₂O₃ + etching, and 10% for sandblasting with TiO₂ + etching. Demineralization reduced BIC percentages, notably in the machined surface with anodizing and sandblasting with TiO₂ + etching groups. Etching and sandblasting combined with etching showed higher initial BIC compared to anodizing alone. Demineralization negatively impacted the BIC across all treatments. This study underscores the importance of surface modification in implant integration, especially in compromised bone. Further research with larger sample sizes and advanced techniques is recommended.

The newest technology allows the medical industry to manufacture innovative products such as milled titanium prosthodontic parts in an implant for a screw-retained suprastructure. In the literature, there are some articles on the clinical usage of subperiosteal implants, but none of these publications, either in PubMed or Google Scholar, thoroughly describe the workflow for the design and manufacture of individual implants for maxillofacial surgery with milled threads for a screw-retained prosthodontic bridge. The aim of the article is to present a step-by-step method of producing personalized implants, from the first steps of production to the implantation of the final product. The article includes information on patient qualification for surgery, computational preparation and skull printing, planning of Mai Implants^®, meshing, 3D printing and milling, cleaning, rinsing, anodizing, and laser marking, as well as the cleaning and sterilization process in a hospital or dental clinic. A detailed description of implant production allows for the analysis of each step and the development of technology. The production of implants is an expensive procedure, but considering all the advantages of the Mai Implants^® treatment and the disadvantages of alternatives, the product is worth the price.

Background: One of the most critical complications that can occur after placing zygomatic implants is the accidental penetration of the patient's eye socket by a drill or implant. This article aims to find some relationships between the anatomical features of the lower orbital wall, different configuration of zygomatic implants, and other factors when planning the placement of zygomatic implants. Methods: A total of 81 patients underwent zygomatic implant procedures, receiving different combinations of implants. These included four zygomatic implants along with one or two conventional implants (Group I), four zygomatic implants alone (Group II), two zygomatic implants paired with four conventional implants (Group III), or three zygomatic implants alongside one or two conventional implants (Group IV). The aim of the study was to describe the complications and clinical outcomes of treatment in 81 patients who received zygomatic implants. Results: The following parameters were statistically significant between all four groups of patients: height and distance of two zygomatic implants in the zygomatic bone; surgery type and duration; the distance between zygomatic implants in the zygomatic bone; and zygomatic orbital floor (ZOF) classification at the left side showed significant differences; intramaxillary insertion of zygomatic implants reduced the rupture of Schneiderian’s membrane; the average of zygomatic implants’ length in all groups was 42.8 mm. Conclusions: Not damaging the ZOF is profoundly important for preventing orbital damage during osteotomy for zygomatic implants and should be measured before every surgery.