<p>Immediate fixed full arch rehabilitation of the severely atrophic maxilla eliminates the use of a tissue supported prosthesis during the healing phase and maximises patient comfort and quality of life.<o:p></o:p></p> <p>The surgical treatment options available for immediate rehabilitation of the severely atrophic maxilla are dependent on the location and availability of the residual alveolar ridge. When bone is only available in the inter canine region, a graftless approach using tilted distal implants may not provide adequate distance between implants for favourable biomechanics. Subsequently, zygomatic implants are the alternative to provide adequate posterior occlusal support. &nbsp;<o:p></o:p></p> <p>The use of extended length sub crestal angulated implants offers an additional implant option for the clinician to restore the severely atrophic maxilla immediately. The treatment protocol involves anchorage of the implant fixture to the lateral wall of the nasal bone. The distally tilted implant transverses an augmented sinus cavity and extends to the site of the first permanent molar.&nbsp;The novel implant sub crestal angulation and use of a multi-unit abutment promotes passivity of fit of a full arch fixed immediate prosthesis.<o:p></o:p></p> <p>Five clinical case reports from private practice&nbsp;are presented which outline the clinical value of the novel implant design in the rehabilitation&nbsp;the severely&nbsp;atrophic maxilla. In each case, the use of zygomatic implants would&nbsp;conventionally have been prescribed due to the absence&nbsp;of residual alveolar bone in the maxilla&nbsp;premolar and molar regions. Alternatively,&nbsp;the use of extended length subcrestally angulated implants with straight of angulated multi-unit abutments have successfully restored the arch immediately.<o:p></o:p></p>

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