Initial implant restorative approaches for the fully edentulous maxilla concentrated on implant placement in the anterior- region, simllar to the edentulous mandible. However, the resulting prosthesis was often unsatisfactonry, If adequate space was allowed for proper hygiene,
phonetics and esthetics were severely compromised, If the prosthesis was developed in such a way as to eliminate these, problems, hygiene became virtually impossi- ‘ble. The cantilever effect of this type of prosthesis on
implants placed w thin the compromised bone of the maxilla also resulted in increased failures. If implants are ‘placed bilaterally in the posterior maxilla, a prosthesis , ‘ wlthldeal esthetics, phonetics, and hygiene access can be , -created.: However, the ‘bone overlying the sinus is frequently
inadeq ate to place the implant and to allow , .suitable bony support. In these situations the sinus floor may be, grafted to. increase the quantity of bone for implant placement. , . Some patients are unwilling to wait the time required for sinus lift’ consolidation or are unwilling to undergo grafting.,A relatively new technique that places very long implants into the. body of the zygoma (Zygomaticus system), ‘along with short anterior implants, is an effective way to support a maxillary overdenture without need for sinus lift surge~ (Fig. 14-67).