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Introduction Extremely atrophic maxillae can be considered the most important indication for three-dimensional maxillary reconstruction. Different bone-augmentation techniques have been suggested to accomplish this. This article illustrates a minimally invasive approach to rehabilitation of the extremely atrophic maxilla. Material and methods A 63-year-old male patient was referred for restoration of his totally edentulous maxilla with a fixed full-arch implant-prosthetic rehabilitation. Four short implants in the premaxillary region and 2 longer implants in the pterygomaxillary regions were inserted with piezoelectric implant site preparation. Discussion At the 1-year follow-up appointment, no clinical or radiographic changes in the soft-tissue contours or crestal bone levels were observed. Conclusion This surgical approach, based on the combination of short implants in the premaxillary regions and pterygoid implants in the pterygomaxillary regions, represents a way to shorten treatment timing, minimize the risk of surgical complications, and reduce patient discomfort and costs.

This report describes the possibility of treating a patient affected by unilateral cleft palate and an extremely atrophied edentulous maxilla using zygomatic implants inserted in a conventional manner and maxillary implants inserted by means of a computer-assisted surgery. A cross-arch prosthesis supported by 4 maxillary and 2 zygomatic implants may be an ideal mode of prosthetic rehabilitation for these kinds of patients. The use of zygomatic implants is essential to optimize load distribution and to increase prosthesis stability, whereas the use of computer-assisted surgery facilitates surgical procedures and makes it possible to improve patient satisfaction.