Cone-Beam Computed Tomography–Based Assessment of Virtual Pterygoid Implant Placement in Vietnamese Population

Pterygoid implants provide a graftless solution for atrophic posterior maxillae but require precise planning. Cone-beam computed tomography (CBCT) enables accurate assessment of implant length, apical engagement, and angulation. Population-specific data for Vietnamese patients remain limited. The study aimed to evaluate virtual pterygoid implant parameters in Vietnamese patients with atrophic maxillae. A cross-sectional study analyzed 110 CBCT scans of patients with residual ridge height <3 mm. Virtual implants were placed following a standardized protocol. Measurements included implant length, apex engagement, and buccopalatal angulation. Descriptive statistics, analysis of variance (ANOVA), Pearson's correlations, and intraclass correlation coefficients (ICCs) were performed. Mean implant length was 16.8 ± 2.1 mm (range: 12–23 mm), with most between 15 and 18 mm. Apex engagement averaged 4.1 ± 1.4 mm, mainly 2 to 6 mm (85.4%). Mean angulation was 12.0 ± 4.6 degrees, clustering at 10 to 15 degrees. ANOVA showed no age-related differences. A moderate correlation existed between implant length and apex engagement (r = 0.53, p < 0.001), but not with angulation or age. Outliers (≥21-mm length, >7-mm engagement, >25-degree angulation) underscored anatomical variability. ICC values demonstrated excellent reliability (>0.90). In Vietnamese patients, virtual pterygoid implants of 16- to 18-mm length, 3- to 5-mm apical engagement, and 10- to 15-degree angulation appear most predictable. These ethnicity-specific reference values support individualized CBCT-based planning to optimize stability and minimize risk.