Transnasal Implants as an Alternative to Quadzygoma in the Rehabilitation of Extremely Atrophic Maxillae: Long-Term Results of the Vanderlim Technique Cases Report.

Transnasal Implants® are long implants installed in the residual crest of the maxilla, tangent to the lateral wall of the nasal cavity, and anchored apically to the conchal crest of the maxilla. This procedure is known as the Vanderlim Technique® and provides high-torque anterior maxillary anchorage (in Zone 1), favoring immediate loading. Despite being used clinically since 2016, no publication until now has addressed the long-term results of this technique. Therefore, this multicenter study aimed to investigate the survival rates of Transnasal Implants®. MATERIALS AND METHODS: This non-interventional study included clinical data obtained from 226 Transnasal Implants placed in 121 patients treated in five different clinical centers around the world, with procedure time ranging from 1 to 8 years. In common, the patients had atrophic maxillae and sought immediate loading rehabilitation. All underwent the Transnasal Implants® protocol and then immediate loading. Survival analyses were applied as proposed by Buser et al. (1997) and Cochran et al. (2002). RESULTS: A total of 226 Transnasal Implants® were placed in 121 patients from five different centers. All patients underwent immediate loading procedures. The length range of the Transnasal Implant® was 15 to 25 mm, with a diameter ranging from 3.0 to 4.5 mm. Insertion torque above 35/Ncm was obtained in 94.6% of the implants. No early or late failures were observed. The implants met the survival criteria in their entirety. In this study, the survival rate of the Transnasal Implants® was 100%. CONCLUSIONS: The use of long Transnasal Implants® - Vanderlim Technique® for anterior support of upper full-arch rehabilitations allows: (1) anchorage in good quality bone, with high insertion torque; (2) better anteroposterior distribution of the implants; (3) reduction of indications for QuadZygoma, a more complex and invasive procedure; (4) long-term maintenance of soft and hard tissues. The Vanderlim Technique® provides an anterior anchorage option for atrophic maxillae that, combined with additional implants for posterior anchorage, allows rehabilitation with immediate load. It is a surgical alternative to QuadZygoma, being less complex, with lower associated risk and a more accessible alternative for patients and professionals.