[Significance of profile prognosis in implant management of the atrophic maxilla].

Postoperative cosmetic results in soft tissue after combined surgical and prosthetic treatment of the extremely atrophic edentulous maxilla by maxillary advancement, sinus lift, and insertion of enosseous implants are rarely considered during preoperative planning. In a prospective study that began in 1993 in 23 patients, the treatment concept was determined by a medical rapid prototyping model and video imaging to predict the soft tissue profile, taking into consideration the appearance of the front teeth. In eight patients, the surgical and/or the prosthetic concept was modified according to the treatment plan decided on with the patient. All patients were highly satisfied with the aesthetic and functional result achieved. Profile prediction using video imaging is a useful tool in planning rehabilitation of the atrophic maxilla and takes into account the interplay of various factors--the amount of maxillary advancement, the direction of insertion of enosseous implants, and the type of supraconstruction. This procedure shows a very high level of acceptance by patients.