Prosthetic Screw Loosening After Immediate Loading of One-Piece Pterygoid Implants with Multi-Unit Abutments in the Atrophic Posterior Maxilla: A Clinical Study

Introduction: Implant-supported fixed prostheses are the preferred treatment for restoring missing teeth in the posterior maxilla. In cases of severe atrophy, conventional implant placement becomes difficult, and alternative approaches such as pterygoid implants may be necessary.

Aim of Study: This study aimed to evaluate prosthetic screw loosening and postoperative pain after immediate loading of single-piece pterygoid implants combined with multi-unit abutments in the posterior atrophic maxilla.

Methodology: A prospective, single-group clinical study was conducted on 15 patients (8 males and 7 females; mean age 60.07 years) who received three implants: one pterygoid implant and two compressive implants. All implants were immediately restored with screw-retained prostheses using multi-unit abutments. Postoperative care included antibiotics, analgesics, and chlorhexidine rinses. Follow-up was performed for three months to assess prosthetic complications.

Results: Out of 15 patients, 12 (80%) experienced no complications, while 3 patients (20%) presented with prosthetic screw loosening after three months. The issue was resolved by re-tightening the screws with a torque of 30 N·cm, and no recurrence was observed.

Conclusion: Within the limitations of this study, immediate loading of single-piece pterygoid implants with multi-unit abutments appears to be a reliable option for rehabilitation of the atrophic posterior maxilla. Prosthetic screw loosening may occur as a short-term complication but can be successfully managed with proper torque protocols.