Implant Placement in the Palatal Root Socket of Maxillary Molars to Avoid Posterior Cantilevers in All-on-X Treatments

The treatment of the maxillary arch for an All-on-X approach can be challenging due to sinus enlargement, necessitating the use of pterygoid implants to avoid the creation of a cantilever on the prosthesis. Posterior prosthesis cantilevers may lead to problems such as screw loosening or fracture, as well as bone loss on the anterior implants due to the posterior loads on the cantilever. When maxillary molars are present and would be extracted as part of the All-on-X approach, utilizing the palatal extraction socket for immediate implant placement allows for the avoidance of sinus augmentation and potential complications associated with the surgical placement and restoration of pterygoid implants, while also eliminating the prosthetic cantilever. This report of two cases examines the issues related to prosthetic cantilevers and describes the surgical process of immediate implant placement using maxillary molar palatal root extraction sockets.