Pereira, JorgeTrivoli, Carlo Antonio2026-04-152026-04-152025-07-24http://hdl.handle.net/10284/15301The “palatal approach” is a surgical technique that positions implants into the residual palatal bone of a thin maxillary ridge, avoiding bone grafting. Severely atrophic maxillae have always been a challenge for rehabilitation. Numerous techniques have been applied to solve this problem, from preparatory grafts to techniques that use the basal bone, such as the All-on-Four, Zygomatic, Trans nasal, Trans sinus, pterygoid and sub periosteal implants. Faced with a jawbone that has lost a lot of thickness, the only way to install a conventional implant would be to use the palatal approach in the region where the bone is slightly thicker, at the base of the jaw together with the cortical bone. This solution has been used by surgeons for some time and has proved to be very effective. Implants installed using the palatal approach technique have shown high success rates and have been similar to conventional implants totally immersed in the bone crest for the rehabilitation of atrophic jaws. Objective: This study aimed to review and analyze recent evidence (last 10 years) on full-arch implant rehabilitation in severely atrophic maxillae using the palatal approach. Methods: : This study was registred on the PROSPERO (CRD 420251024269) the aim of this work is also to carry out a systematic review of the available literature, taking into account the effectiveness and indications of the technique, answering the following question: Is this technique durable in the long term ten years? PECO will be: Population (P): adult population with full arch rehabilitation. Exposure to risk factor (E): implants installed in thin ridge. Comparison (C): Implants installed in non-atrophic ridge compared to atrophic ridge. Results (O): Long-term functional rehabilitation (10 years).The databases used will be Pubmed, ScienceDirect and LILACS following the guidelines of PRISMA. A literature search identified clinical studies and case series, focused on palatally positioned implants for atrophic maxillae. Key outcomes (implant survival/success, peri-implant health, patient-reported outcomes) were extracted. Each included study was critically appraised with the appropriate Joanna Briggs Institute (JBI) checklist (by study design), assigning domain-level risk-of-bias judgments. Results: Three relevant publications met the eligibility criteria: three primary studies (one retrospective case series, one retrospective controlled cohort, and one cross-sectional comparative study on patient satisfaction). All reported high implant survival rates (≥96%) with the palatal approach over ~5 years, comparable to conventional implant placement. Conclusions: The palatal approach appears to be a viable and effective option for full-arch rehabilitation in severely atrophic maxillae, achieving high implant success rates with minimal adverse impact on patient outcomes.engPalatal approachAtrophic maxillaDental implantsFull-arch rehabilitationmaster thesis