03/10/2026
Engaging the palatal cortical plate is a critical prerequisite for predictable immediate loading. By obtaining anchorage within the dense palatal cortical bone, sufficient primary stability can be achieved despite the presence of relatively low-density cancellous bone surrounding the extraction sockets. This cortical engagement enhances insertion torque and reduces micromotion during the critical early healing phase.
The anterior implants were oriented toward the nasal crest, a dense osseous structure extending in an anteroposterior direction posterior to the anterior nasal spine. Utilizing this anatomical landmark provides additional cortical stabilization and contributes to improved biomechanical support of the prosthesis.
The posterior implants were intentionally tilted medially and facially. This angulation facilitates avoidance of the maxillary sinus while maximizing engagement of the facial cortical plate, thereby increasing bone-to-implant contact within higher-density bone.
Multi-unit abutments (MUAs) were employed to correct implant angulation and to optimize the trajectory of screw access channels, ensuring prosthetically favorable positioning and improved restorative outcomes.
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