When pterygoid implants are planned in addition to zygomatic ones, it is recommended to start the procedure with pterygoid implants placement in order to use the implants as anchor pin, in addition to the screw fixation.

The pterygoid osteotomy was performed by a long 2.8 mm diameter drill, used with a reduction spoon placed in a long sleeve defining the planned drilling direction. The marks on the drills were used to check the drilling depth (Figure 9).

The first step was the pterygoid implant preparation, performed with the aid of a reduction spoon and a calibrated drill.

The implant was seated by a driver through the guide (Figure 10) until the driver stopped on the sleeve. The planned orientation of the implant was achieved by aligning the hex of the driver with the hex of the sleeve (Figure 11).

The placement of the pterygoid implant increased the guide’s stability for the following zygomatic implant site preparations.

Pterygoid implant was placed by an implant mount that allow to position the implant as planned.

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