Peri-implant orthodontic correction on long-term implant stability in posterior maxillofacial regions with severe bone loss: a literature review

Abstract

The posterior maxilla presents significant challenges for implant-supported rehabilitation due to severe alveolar bone loss, low bone density, and proximity to the maxillary sinus. Traditional implant placement often necessitates bone augmentation, while the application of orthodontic forces in such regions remains controversial due to the risks of implant destabilization.  This literature review aims to evaluate the effectiveness and safety of peri-implant orthodontic correction techniques in severely atrophic posterior maxillary regions, with a focus on long-term implant stability and peri-implant health. A systematic search of PubMed, Scopus, Google Scholar, and ScienceDirect was conducted, including studies from 2005 to 2024. Sixteen relevant clinical trials, cohort studies, and case series were analyzed. Key themes included sinus augmentation methods, orthodontic force application, and implant outcomes in compromised bone.  Sinus lift procedures—both lateral and osteotome techniques—showed >90% implant survival with <1 mm marginal bone loss. Concentrated growth factor (CGF)-assisted OSFE provided up to 9.2 mm bone gain and 100% implant survival. Implants used as orthodontic anchorage-maintained peri-implant health under forces of 50–200 g. Controlled orthodontic tooth movement through the sinus was also successful in selected cases, promoting bone remodeling without grafts.  Peri-implant orthodontic correction, when integrated with advanced surgical protocols, can yield predictable and stable outcomes in the atrophic posterior maxilla. However, further long-term trials are essential to standardize clinical guidelines and force parameters for these complex interventions.