"13-23-30" Anatomic Approach for Maxillary Full-Arch Implant Reconstruction: A Case Report and Surgical-Prosthetic Considerations

For the past 30 years, implant treatment has been advocated for partially and fully edentulous patients to improve function, esthetics, phonetics, and comfort. Patients can now benefit from removable and fixed implant-retained and implant-supported prostheses using the bone-anchoring techniques of endosseous osseointegrated implants. Much research has been done on complete maxillary implant reconstruction because of the large number of patients with edentulous maxillas and an enormous armamentarium of surgical-prosthetic implant techniques used in these cases. In the present article, one more technique is recommended, an anatomically based surgical-prosthetic approach-"13-23-30"-that should help a clinician with the initial selection of implant sites when contemplating an implant treatment of edentulous maxilla with a fixed 6-implant-supported hybrid prosthesis. This technique is based on the anatomy and function of mastication of natural dentition. The rationale behind this anatomic concept of treatment is discussed, and a case report is presented. (C) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:818-824, 2010