CME Journal of Clinical Case Reports
ISSN: 3067-7998 | DOI: 10.64030/3067-7998
Javiera Cerpa, Agustin Diaz, Dusan Marinkovic, Francisca Collao and Claudio Miranda
Background Severe premaxillary atrophy poses a substantial challenge for implant-supported rehabilitation, often requiring invasive grafting procedures. Although traditionally considered a limiting anatomical structure, the nasopalatine canal (NPC) has emerged as a potential alternative site for implant placement in selected cases.
Case Presentation A 71-year-old female presented with a failed maxillary full-arch prosthesis and severe anterior ridge resorption that precluded conventional implant placement. CBCT analysis revealed marked horizontal and vertical atrophy but a favorable NPC morphology, offering sufficient intra-canal osseous volume for implant insertion. Following careful curettage of the neurovascular contents and controlled osteotomy preparation under low-speed irrigation, a 5 × 8.5 mm implant was placed within the canal, achieving high primary stability. Soft-tissue healing was uneventful, and resonance frequency analysis at 3 months demonstrated adequate stability (ISQ 73). The implant was successfully integrated into a new full-arch prosthetic reconstruction supported by pre-existing posterior implants. At 6 months, clinical and radiographic evaluations confirmed stable peri-implant tissues, preserved crestal bone, and absence of neurosensory disturbances.
Discussion This case illustrates that, in highly selected scenarios of severe premaxillary atrophy, the NPC can serve as a viable anatomic site for implant anchorage, potentially avoiding extensive augmentation. The approach aligns with minimally invasive treatment principles and may reduce morbidity and treatment duration.
Conclusion Implant placement within the NPC may represent a feasible alternative in cases of pronounced anterior maxillary atrophy when conventional sites are inadequate. While short-term outcomes appear favorable, broader clinical adoption requires cautious case selection and further evidence from controlled studies.