Pterygoid extension with palatal struts

Early one-piece pterygoid extension implant. The patient's denture (1) was uncomfortable. She desired a lighter, more secure restoration. A trough (2) was made anteriorly to accept the struts crossing from the anterior alveolus to the labial face of the ridge to eliminate the labial undercuts. An impression was taken of the arch: hamular notch, hard palate, palatal surface of the ridge, and bucco-palatal surface of the ridge—including the trenches. The implant (4), the posterior portions of which fit into the hamular notch area, is fitted. Note that the labial ex-tensions fit into their troughs (5), and that the palatal portion extends across a large portion of the hard palate. After the tissues healed (6,7), a palateless restoration is seated (8), and the occlusion carefully checked (9,10). It is important that nowhere does a strut cross the buccal plate of bone flaking the sinus or the inferior alveolus below the sinus.

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