D A Diniz, P H H Sales, P G B Silva, I Giovannacci, P Vescovi, J C Leão
The aim of this systematic review was to determine the clinical effectiveness of pterygoid dental implants in the rehabilitation of the atrophic maxilla. Database searches were performed up to April 2026 to identify randomized, non-randomized, and observational human studies comparing pterygoid implants to conventional implants for full maxillary rehabilitation. Outcomes were implant survival and marginal bone loss (MBL). The meta-analysis was conducted using RevMan 5.4. Risk of bias was assessed using the Newcastle-Ottawa Scale. Overall, 466 articles were identified, of which six were included. These studies encompassed 466 participants and 3844 implants (904 pterygoid, 2940 conventional). The implant survival rate was 95.25% for pterygoid implants and 97.88% for conventional implants. The risk of implant loss was significantly higher for pterygoid implants when compared to conventional implants (risk ratio 1.54, 95% confidence interval 1.05-2.24, P = 0.030; no significant heterogeneity, I² = 13%). Only one study assessed MBL, finding similar values for pterygoid implants (0.64-0.68 mm) and conventional implants (0.61-0.62 mm). Immediate loading was reported in one study, but details were insufficient to compare implant survival rates. Three studies presented a low risk of bias and three a high risk of bias. Pterygoid implants may be considered a potential treatment approach for rehabilitation of the atrophic maxilla, showing relatively high implant survival rates. However, the slightly lower survival compared to conventional implants and the methodological limitations of the included studies highlight the need for further high-quality controlled trials.