The patient denied cocaine history.
This patient was intubated and given local anesthesia. A crestal incision was made with a full-thickness flap. Nasal mucosa was reflected off the nasal fossa, the inferior turbinate bone was exposed. 4.2x22mm Noris Tuff implants were placed into the nasal turbinate bones bilaterally and extended into the mouth in lateral incisor positions. A thin layer of Augma was placed on the exposed implant in the nasal fossa, to hopefully re-establish a periosteal attachment of nasal mucosa. From here, 35mm zygomatic implants were placed in an inferior position, and 20mm Pteryfit implants were placed into the pyramidal process of the palatine bone. Composite torque exceeded 400NCm, so immediate loading took place.
Postoperatively the patient denies paresthesia and epiphora and is still in function today.