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.

(1) Background: The main disadvantage of rigid fracture fixation is remain material after healing period. Implementation of resorbable plates prevents issues resulting from left plates. The aim of this study is to compare the usage of bioresorbable and titanium “A” shape condyle plate in condylar fractures. (2) Methods: Thickness of 1.0 mm, height of 31 mm, and width of 19 mm polylactic acid (PLLA) and titanium “A” shape plate with 2.0 mm-wide connecting bar and 9 holes were tested with finite element analysis in high right condylar neck fracture. (3) Results: On bone surface the highest stress is on the anterior bridge around first hole (approx. 100 MPa). The highest stress on screws is located in the first screw around plate in the anterior bridge and is greater in titanium (150 MPa) than PLLA (114 MPa). (4) Conclusion: Pressure on bone in PLLA osteosynthesis is two times higher than in titanium fixation. On small areas where pressure on bone is too high it causes local bone degradation around the fracture and may delay the healing process or make it impossible. Fixation by PLLA is such flexible that bone edges slide and twist what may lead to degradation of callus.

Background: There has been no direct comparison of all existing plates dedicated for fracture osteosynthesis of mandibular condyle base until now. The aim of the study was to test mechanically all available designs of titanium plates on the market on polyurethane mandibles using an individually designed clamping system. Methods: Forces required for a 1 mm displacement of fixed fracture and incidents of screw loosening were recorded. Results indicated the best mechanical plates among all existing designs available. Results: It has occured that some of osseofixation plates should not be used any more, whereas some shape of the single plates are similar shape to two single plates shape are regarded as the best osseofixation method for condyle base fracture. Conclusion: General observation is the bigger plate and more screws, the better rigid stable osteosynthesis of mandibular condyle base. 4 plates of current designs of total 30 tested series can be recommended for open rigid internal fixation of fractures of the base of the mandibular condyle. The rest of 26 existing plates should not be used in condylar base fractures.

Background: In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis. Methods: The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system. Results: Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle (p < 0.001). Conclusions: It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates.

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.