Integration of orthognathic surgery, implantology and prosthetics in the functional and aesthetic restoration of patients with severe maxillofacial atrophy

Severe maxillofacial atrophy, resulting from trauma, congenital defects, or prolonged edentulism, presents significant challenges in functional and aesthetic rehabilitation. The loss of alveolar bone and supporting structures often hinders traditional implant placement due to insufficient bone height and volume. Traditional methods, such as bone grafting and sinus lifting, have limitations, including prolonged treatment times and varying success rates. The integration of orthognathic surgery, implantology (particularly zygomatic implants), and prosthetics offers innovative solutions, addressing both functional and aesthetic needs in patients with severe maxillary atrophy. This narrative review adopts an integrative and thematic approach to evaluate the combination of orthognathic surgery, implantology, and prosthetics in managing severe maxillofacial atrophy. A systematic search of databases, including PubMed, ScienceDirect, and Google Scholar, was conducted for studies published between 2010 and 2024. The search included terms such as “severe maxillary atrophy,” “orthognathic surgery,” and “implant-supported prosthetics.” Studies were selected based on clinical, functional, and aesthetic outcomes from both surgical and prosthetic interventions. The review identified key studies demonstrating the effectiveness of combining orthognathic surgery with advanced implantology and prosthetics. Zygomatic implants, in particular, showed a high survival rate (96.3%), while subperiosteal implants provided enhanced soft tissue stability. Orthodontic interventions were also crucial, facilitating successful prosthetic outcomes. Prosthetic rehabilitation yielded immediate functional and aesthetic improvements with temporary screw-retained acrylic bridges, with minimal complications. The integration of orthognathic surgery, implantology, and prosthetics offers a promising approach for rehabilitating patients with severe maxillofacial atrophy. Further studies with larger sample sizes and extended follow-up periods are needed to solidify long-term outcomes and refine treatment protocols.