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In edentulism, maxillary resorption is often in three vectors: superiorly, medially, and posteriorly, leading to a prosthetically unfavorable pseudo\u2010class III ridge relationship. Longstanding edentulism, especially in the context of ill\u2010fitting dentures, can result in severe maxillary atrophy. Rehabilitation of the severely atrophic maxilla remains a challenge, frequently requiring extensive bone grafting procedures in combination with endosseous dental implants. Graftless options, using longer endosseous and\/or tilted dental implants placed into the nasal, pyriform rim, pterygoid process, and zygomatic bone, have been developed to solve this treatment dilemma. These options have specific patient anatomy limitations, can be technique sensitive, and can result in increased patient morbidity. 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Long\u2010term follow\u2010up for the use of this technique in fixed definitive restorations is not available at this time.<\/jats:p>","DOI":"10.1111\/jopr.70071","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T04:53:35Z","timestamp":1764651215000},"page":"235-242","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A digitally designed fixed subperiosteal implant solution for the treatment of the severely atrophic full\u2010arch with an immediate\u2010load protocol"],"prefix":"10.1111","volume":"35","author":[{"given":"Peter","family":"Rekawek","sequence":"first","affiliation":[{"name":"Department of Dentistry, Division of Oral and Maxillofacial Surgery New York University Langone Medical Center and Bellevue Hospital Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Etessami","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Division of Graduate Prosthodontics New York Harbor Veterans Affairs Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-7017","authenticated-orcid":false,"given":"Frank","family":"Tuminelli","sequence":"additional","affiliation":[{"name":"Department of Dentistry Division of Graduate Prosthodontics, New York Harbor Veterans Affairs Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukasz","family":"Skomial","sequence":"additional","affiliation":[{"name":"Department of Dentistry New York Harbor Veterans Affairs Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3461-1753","authenticated-orcid":false,"given":"Gary","family":"Orentlicher","sequence":"additional","affiliation":[{"name":"Department of Dentistry Division of Oral and Maxillofacial Surgery New York Harbor Veterans Affairs Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729-016-0057-z"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/652936"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2015.04.012"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdsr.2021.09.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2020.103373"},{"key":"e_1_2_6_7_1","first-page":"1051","article-title":"Decreasing residual height in complete denture wearers. 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