Managing the severely atrophic maxilla: farewell to zygomatic implants and extensive augmentations?

Edentulous patients with an atrophic maxilla associated with lip-palate fissures have unpredictable results after undergoing grafting procedures. In situations where the atrophic maxilla does not adequately allow reconstruction, the use of zygomatic implants has been indicated, and probably these implants can be indicated for the rehabilitation of patients with lip-palate fissures. This case report describes the oral rehabilitation treatment of a patient with a lip-palate cleft treated with zygomatic implants and implant-supported fixed prosthesis with two years of follow-up. A 65-year-old female patient had a lip-palate cleft and previously underwent surgery to close the cleft. The patient had a severely atrophic maxilla and had difficulty adapting to a removable total prosthesis. Due to the small amount of bone remaining and extensive fibrous tissue in the palate region, a rehabilitation with conventional implants associated with zygomatic implants was chosen. Two zygomatic implants and a conventional implant were placed on the right side, and a zygomatic implant and conventional implant were placed on the left side; these implants were later activated by a protocol-type prosthesis. The zygomatic implants provided an adequate aesthetic and functional outcome of the prosthesis in a patient with cleft palate.

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Multiple Zygomatic Implants as an Alternative for Rehabilitation of the Extremely Atrophic Maxilla: A Case Letter With 55 Months of Follow-Up

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-12-00212 ◽

2015 ◽

Vol 41 (1) ◽

pp. 97-100 ◽

Cited By ~ 4

Author(s):

Luis Eduardo Marques Padovan ◽

Paulo Domingos Ribeiro-Júnior ◽

Ivete Aparecida de Mattias Sartori ◽

Geninho Thomé ◽

Elisa Mattias Sartori ◽

...

Keyword(s):

Atrophic Maxilla ◽

Zygomatic Implants

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Zygomatic Implants: The Impact of Zygoma Bone Support on Biomechanics

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00245 ◽

2014 ◽

Vol 40 (3) ◽

pp. 231-237 ◽

Cited By ~ 4

Author(s):

Shihab A. Romeed ◽

Raheel Malik ◽

Stephen M. Dunne

Keyword(s):

Element Analysis ◽

3 Dimensional ◽

Zygomatic Bone ◽

Support Level ◽

Atrophic Maxilla ◽

Zygomatic Implants ◽

Dimensional Finite Element ◽

And Function ◽

The Impact ◽

Abutment Screw

Maxillectomy and severely resorbed maxilla are challenging to restore with provision of removable prostheses. Dental implants are essential to restore esthetics and function and subsequently quality of life in such group of patients. Zygomatic implants reduce the complications associated with bone grafting procedures and simplify the rehabilitation of atrophic maxilla and maxillectomy. The purpose of this study was to compare, by means of 3-dimensional finite element analysis, the impact of different zygomatic bone support (10, 15, and 20 mm) on the biomechanics of zygomatic implants. Results indicated that maximum stresses within the fixture were increased by 3 times when bone support decreased from 20 to 10 mm and were concentrated at the fixture/bone interface. However, stresses within the abutment screw and the abutment itself were not significantly different regardless of the bone support level. Supporting bone at 10 mm sustained double the stresses of 15 and 20 mm. Fixture's deflection was decreased by 2 to 3 times when bone support level increased to 15 mm and 20 mm, respectively. It was concluded that zygomatic bone support should not be less than 15 mm, and abutment screw is not at risk of fracture regardless of the zygomatic bone support.

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Simplifying the Treatment of Bone Atrophy in the Posterior Regions: Combination of Zygomatic and Wide-Short Implants—A Case Report with 2 Years of Follow-Up

Case Reports in Dentistry ◽

10.1155/2016/5328598 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7

Author(s):

Fernanda Faot ◽

Geninho Thomé ◽

Amália Machado Bielemann ◽

Caio Hermann ◽

Ana Cláudia Moreira Melo ◽

...

Keyword(s):

Case Report ◽

Large Diameter ◽

Immediate Loading ◽

Oral Rehabilitation ◽

Short Implants ◽

Atrophic Maxilla ◽

Zygomatic Implants ◽

Bone Atrophy ◽

The Face ◽

Maxilla And Mandible

The rehabilitation of maxillary and mandibular bone atrophy represents one of the main challenges of modern oral implantology because it requires a variety of procedures, which not only differ technically, but also differ in their results. In the face of limitations such as deficiencies in the height and thickness of the alveolar structure, prosthetic rehabilitation has sought to avoid large bone reconstruction through bone grafting; this clinical behavior has become a treatment system based on evidence from clinical scientific research. In the treatment of atrophic maxilla, the use of zygomatic implants has been safely applied as a result of extreme technical rigor and mastery of this surgical skill. For cases of posterior mandibular atrophy, short implants with a large diameter and a combination of short and long implants have been recommended to improve biomechanical resistance. These surgical alternatives have demonstrated a success rate similar to that of oral rehabilitation with the placing of conventional implants, allowing the adoption of immediate loading protocol, a decrease in morbidity, simplification and speed of the treatment, and cost reduction. This case report presents complete oral rehabilitation in a patient with bilateral bone atrophy in the posterior regions of the maxilla and mandible with the goal of developing and increasing posterior occlusal stability during immediate loading.

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Zygomatic Implant: State of the Art

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt2137 ◽

2021 ◽

pp. 42-49

Author(s):

Henrique Esteves Magalhães ◽

Priscilla Janaína de Lima Borelli Bovo ◽

Luciano Rodrigues Neves ◽

Marcelo Henrique Batista Santos ◽

Rogério Luiz de Araújo Vian ◽

...

Keyword(s):

Systematic Review ◽

Bone Graft ◽

Dental Implant ◽

State Of The Art ◽

Therapeutic Option ◽

Cochrane Library ◽

Promising Alternative ◽

Atrophic Maxilla ◽

Zygomatic Implants ◽

Zygomatic Implant

Introduction: In the dental implant scenario, the rehabilitation of the maxilla severely reabsorbed with endosseous implants remains a challenge. There are less aggressive alternatives, including short implants, inclined implants, and especially zygomatic (ZI) implants. In cases where the height and width of the residual bone do not allow the placement of conventional dental implants, the ZI can be considered. Objective: Conducted a concise systematic review to analyze the main literary findings on the use of the zygomatic implant as an important alternative for a dental implant, to present the state of the art to the dental community. Methods: The present study followed a concise systematic review model. The search was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: Zygomatic implants appear to be a consolidated therapeutic option for significantly atrophic maxilla, offering a promising alternative to costly heavy bone graft techniques, fewer complications, less time for rehabilitation, less required prosthodontic work, and significantly higher survival rates. Thus, the zygomatic implant is revolutionizing the implant procedure in the posterior atrophic maxilla, eliminating the complications of bone augmentation and sinus elevation, with delayed healing, showing better clinical results compared to the bone graft, pointing to a possible gold standard for a dental implant.

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Zygomatic Implants for Restoration of Complex Nasal Defects – A Case Report and Outcome

Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology ◽

10.23999/j.dtomp.2020.9.2 ◽

2020 ◽

Vol 4 (9) ◽

pp. 152-161

Keyword(s):

Limiting Factor ◽

Prosthetic Rehabilitation ◽

Edentulous Patient ◽

Osseointegrated Implants ◽

Ablative Surgery ◽

Atrophic Maxilla ◽

Zygomatic Implants ◽

Excellent Cosmetic Result ◽

Lip Defect ◽

Nasal Defects

Total rhinectomy defects pose a challenge for the reconstructive surgeon, but since the introduction of osseointegrated implants, maxillofacial implant–retained prosthetic rehabilitation has provided the patient with an alternative option that has an excellent cosmetic result. Traditionally, zygomatic implants are used for prosthodontic restoration in patients with severely atrophic maxilla or to retain an obturator after tumor ablative surgery. More recently, the nonconventional use of zygomatic implants for retention of a nasal prosthesis has been reported in cases involving rhinectomy defects where the length of conventional dental implants is a limiting factor. In this article, we describe the use and value of transversely-oriented zygomatic implants in combination with an acrylic keeper and maxillary denture to optimize retention of a complex, multi-unit prosthesis in an edentulous patient with a total rhinectomy and upper lip defect.

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Full mouth implant rehabilitation of patients with severely atrophic maxilla: Quad zygomatic implants approach

Journal of Dental Implants ◽

10.4103/0974-6781.140907 ◽

2014 ◽

Vol 4 (2) ◽

pp. 182

Author(s):

Gowri Natarajarathinam ◽

Gunaseelan Rajan ◽

M Saravanakumar ◽

Yashoda Ashok

Keyword(s):

Atrophic Maxilla ◽

Zygomatic Implants

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