Pterygomaxillary Region in Implantology: A Topographic andRadiological Study

Implant rehabilitation of the atrophic posterior maxilla remains challenging due to sinus pneumatization and poor bone density. Pterygo-maxillary implants represent an anatomically feasible option for posterior maxillary rehabilitation; however, this study evaluates their virtual planning characteristics only, without assessing clinical outcomes.This study aimed to assess the three-dimensional characteristics of the pterygomaxillary region relevant for implant placement, and propose a standardized CBCT-based diagnostic protocol to optimize individualized implant planning.Twenty CBCT scans were evaluated bilaterally (40 potential implant sites). Bone density, anatomical dimensions, implant angulations, and virtual implant positioning were analyzed. A novel proposed reference plane, the Maxillary Plane, was developed to provide a consistent virtual framework for analyzing implant trajectories, but does notassess clinical performance.34 virtual pterygo-maxillary implants were successfully planned. Implant lengths ranged between 11–15 mm and diameters between 3.3–3.8 mm. Bone density was consistently higher in the pterygoid lamina compared to the maxillary tuberosity. Implant angulation showed substantial interindividual variability.The anatomical variability of the pterygomaxillary region requires individualized CBCT analysis. The proposed Maxillary Plane is a theoretically applicable methodological innovation for standardized implant angulation assessment. Pterygomaxillary implants represent a predictable and minimally invasive alternative for posterior maxillary rehabilitation in cases of severe atrophy.