Angled dental implant placement into the vomer/nasal crest of atrophic maxillae for All-on-Four immediate function: a 2-year clinical study of 100 consecutive patients.

PURPOSE: To report on the use of angled implants placed into the vomer/nasal crest to support a complete-arch maxillary prosthesis. MATERIALS AND METHODS: Consecutive patients were treated with the All-on-Four concept to restore the maxillary dentition. When bone volume in the subnasal region was inadequate, angled implants were placed into the vomer/nasal crest area to support the restoration. All implants were loaded immediately. RESULTS: One hundred consecutive maxillary All-on-Four patients were treated over a period of 2 years. Four hundred six implants were placed; 12 were inserted into the vomer/nasal crest area. One year later, at definitive restoration, the 12 vomer implants were found to be osseointegrated without bone loss or instability. CONCLUSIONS: Midline maxillary bone volume at the nasal crest appeared to be a viable alternative to the lateral nasal rim when subnasal bone was deficient. Vomer implants allowed for immediate function or were sometimes used as a rescue implant when an anterior implant failed.