**3. Therapeutic options: bone grafting versus buttress implant concept**

There are different surgical techniques used in the rehabilitation of atrophic jaws that are divided into two large groups: Non-grafted versus Grafted treatments. Graft procedures include: bone regeneration with bone substitutes with or without the use of membranes, maxillary sinus lift and platelet-rich plasma [18, 19].

Procedures that do not use grafts, use skeletal anchors with long and conventional implants in the different anatomical points of the facial bones.

For both techniques there is a high success rate of 90–95% at 5 years with no statistically significant difference in implant survival [20].

Currently there are multiple classifications with diagnostic and therapeutic criteria in rehabilitation with dental implants. However, there is no classification that unites all implant alternatives with diagnostic, surgical and implant criteria.

The buttress implant concept is a classification that I have designed and is based on the bony buttresses of the face. These areas offer adequate quality and quantity of bone where the placement and functional load of osseointegrated implants is feasible.

The classification for the patient with jaws atrophy is divided into 6 zones: Zone I/maxillary alveolar buttress, Zone II/nasomaxillary buttress, Zone III/zygomaticomaxillary buttress, Zone IV/pterygomaxillary buttress, Zone V/mandibular alveolar buttress and Zone VI mandibular/basal buttress (**Figure 2**).


*A Review of Current Concepts in Full Arch Rehabilitation with Dental Implants DOI: http://dx.doi.org/10.5772/intechopen.99704*

#### **Figure 2.**

*Buttress implant concept and classification for the patient with jaws atrophy: Zone I/maxillary alveolar buttress, zone II/nasomaxillary buttress, zone III/zygomaticomaxillary buttress, zone IV/pterygomaxillary buttress, zone V/ mandibular alveolar buttress and zone VI mandibular/basal buttress.*


In general, full arch rehabilitation treatments with osseointegrated implants combine multiple techniques; regenerative and skeletal anchoring. The advantage of using skeletal anchors is that it allows a greater probability of immediate loading, a lower biological cost by not performing multiple regenerative procedures, less time in the treatment phases with a comparable global cost. The main disadvantages of using skeletal anchors include a higher learning curve, need for sedation or general anesthesia, and special surgical equipment that in most cases is available from commercial companies.
