scholarly journals Rehabilitation of Maxillary Defect Using Zygomatic Implant Retained Obturator

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mounika Ayinala ◽  
Gautam Shetty
Keyword(s):  
Hard Palate ◽  
Odontogenic Myxoma ◽  
Prosthetic Rehabilitation ◽  
Implant Placement ◽  
Heat Cure ◽  
Maxillary Defect ◽  
Zygomatic Implants ◽  
And Function ◽  
Zygomatic Implant

Tumors involving the hard palate, maxillary sinus, or nasal cavity require maxillectomy based on the extent of the lesion. Lack of these boundaries affects the speech, esthetics, and masticatory function. Prosthetic rehabilitation of these defects can be done utilizing zygomatic implants. This present case describes the use of a zygomatic implant to retain a maxillary obturator in a 22-year-old male patient following partial maxillectomy (Brown’s Class 2b) due to odontogenic myxoma. A surgical obturator was secured in position subsequent to the implant placement. Following the healing period, an interim obturator using heat cure acrylic was fabricated. Mechanical retention for the definitive obturator was obtained through the ball attachment suspended from the multiunit abutment of the zygomatic implant. The case was followed up closely for a year to evaluate the function of the prosthesis. The prosthetic rehabilitation not only promoted esthetics and function but also improved the patient’s quality of life.

PROSTHETIC REHABILITATION OF HARD PALATE - A RECONSTRUCTIVE CASE REPORT.

2021 ◽  
pp. 159-161
Author(s):  
Avinash Sagvekar ◽  
Sachin Fulbel ◽  
Aushili Mahule
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Prosthetic Rehabilitation ◽  
Edentulous Patient ◽  
Anatomical Structures ◽  
Maxillary Defect ◽  
Residual Tissue ◽  
Maxillary Defects ◽  
Important Objective

An important objective of prosthetic rehabilitation is to conserve any residual tissue. Patients undergoing resection of maxilla due to accidental casualties or benign or malignant tumor will have inadequacy in maxillary palatal area. Removable prostheses gets support, stability and retention mainly through anatomical structures such as teeth, alveolar bones and palate. When surgical intervention removes much of these structures, remaining tissue becomes too vulnerable to support the necessary prosthesis. Therefore, important considerations to be undertaken to attain extra support, retention and resistance while planning for obturator of maxillary defects. In this case report we have advocated the application of an obturator that closes the defected cavity and also restores the masticatory functions. This obturator is retained by the stainless steel 19 gauge wire encircling the teeth in neighbouring quadrant, undercuts surrounding the defect. The prosthetic obturator was inserted in a 58-year old partially edentulous patient with an extensive maxillary defect. Subjective and objective evaluations indicated that the functional efcacy of obturator dened the quality of life of the patient. The concept of a obturator is a useful solution for the particular situation created by maxillectomy.

Zygomatic Implants/Fixture: A Systematic Review

2013 ◽  
Vol 39 (2) ◽  
pp. 215-224 ◽  
Author(s):  
Ashu Sharma ◽  
G. R. Rahul
Keyword(s):  
Systematic Review ◽  
Bone Grafting ◽  
Sinus Augmentation ◽  
Le Fort ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Le Fort I ◽  
Implant Treatment ◽  
Zygomatic Implant ◽  
Anatomic Information

Patients with moderate to severe atrophy challenge the surgeon to discover alternative ways to use existing bone or resort to augmenting the patient with autogenous or alloplastic bone materials. Many procedures have been suggested for these atrophied maxillae before implant placement, which include Le Fort I maxillary downfracture, onlay bone grafts and maxillary sinus graft procedures. A zygomatic implant can be an effective device for rehabilitation of the severely resorbed maxilla. If zygomatic implants are used, onlay bone grafting or sinus augmentation would likely not be necessary. The purpose of this article is to review the developments that have taken place in zygomatic implant treatment over years, including anatomic information for installing the zygomatic implants, implant placement techniques, stabilization, and prosthodontic procedures.

scholarly journals Three-Dimensional Radiographic Evaluation of the Malar Bone Engagement Available for Ideal Zygomatic Implant Placement

2020 ◽  
Vol 3 (3) ◽  
pp. 52 ◽  
Author(s):  
Gerardo Pellegrino ◽  
Francesco Grande ◽  
Agnese Ferri ◽  
Paolo Pisi ◽  
Maria Giovanna Gandolfi ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Ct Scans ◽  
Radiographic Evaluation ◽  
Anatomical Landmarks ◽  
Malar Bone ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Edentulous Patients ◽  
Zygomatic Implant ◽  
The Ideal

Zygomatic implant rehabilitation is a challenging procedure that requires an accurate prosthetic and implant plan. The aim of this study was to evaluate the malar bone available for three-dimensional zygomatic implant placement on the possible trajectories exhibiting optimal occlusal emergence. After a preliminary analysis on 30 computed tomography (CT) scans of dentate patients to identify the ideal implant emergencies, we used 80 CT scans of edentulous patients to create two sagittal planes representing the possible trajectories of the anterior and posterior zygomatic implants. These planes were rotated clockwise on the ideal emergence points and three different hypothetical implant trajectories per zygoma were drawn for each slice. Then, the engageable malar bone and intra- and extra-sinus paths were measured. It was possible to identify the ideal implant emergences via anatomical landmarks with a high predictability. Significant differences were evident between males and females, between implants featuring anterior and those featuring posterior emergences, and between the different trajectories. The use of internal trajectories provided better bone engagement but required a higher intra-sinus path. A significant association was found between higher intra-sinus paths and lower crestal bone heights.

scholarly journals Dynamic Navigation for Zygomatic Implants: A Case Report about a Protocol with Intraoral Anchored Reference Tool and an Up-To-Date Review of the Available Protocols

2020 ◽  
Vol 3 (4) ◽  
pp. 75
Author(s):  
Gerardo Pellegrino ◽  
Giuseppe Lizio ◽  
Francesco Basile ◽  
Luigi Vito Stefanelli ◽  
Claudio Marchetti ◽  
...  
Keyword(s):  
Navigation Systems ◽  
Radiological Anatomy ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Dynamic Navigation ◽  
Operative Planning ◽  
Placement Accuracy ◽  
Zygomatic Implant ◽  
Maxillary Atrophy ◽  
Reference Tool

Dynamic Navigation is a computer-aided technology that allows the surgeon to track the grip instruments while preparing the implant site in real time based on radiological anatomy and accurate pre-operative planning. The support of this technology to the zygoma implant placement aims to reduce the risks and the errors associated with this complex surgical and prosthetic treatment. Various navigation systems are available to clinicians currently, distinguished by handling, reliability, and the associated economic and biological benefits and disadvantages. The present paper reports on the different protocols of dynamic navigations following a standard workflow in correlation with zygomatic implant supported rehabilitations and describes a case of maxillary atrophy successfully resolved with this technology. An innovative and minimally invasive dynamic navigation system, with the use of an intraoral anchored trust marker plate and a patient reference tool, has been adopted to support the accurate insertion of four zygomatic implants, which rapidly resolved maxillary atrophy from a 75-year-old male system. This approach provided an optimal implant placement accuracy reducing surgical invasiveness.

scholarly journals Immediate implant-retained prosthetic obturation after maxillectomy based on zygomatic implant placement by 3D-guided surgery: a cadaver study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
N. Vosselman ◽  
H. H. Glas ◽  
S. A. H. J. de Visscher ◽  
J. Kraeima ◽  
B. J. Merema ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Immediate Loading ◽  
Virtual Surgical Planning ◽  
Implant Placement ◽  
Ablative Surgery ◽  
Zygomatic Implants ◽  
Immediate Implant ◽  
The Mean ◽  
Obturator Prosthesis ◽  
Zygomatic Implant

Abstract Background The aim of this study was to introduce a complete 3D workflow for immediate implant retained prosthetic rehabilitation following maxillectomy in cancer surgery. The workflow consists of a 3D virtual surgical planning for tumor resection, zygomatic implant placement, and for an implant-retained prosthetic-obturator to fit the planned outcome situation for immediate loading. Materials and methods In this study, 3D virtual surgical planning and resection of the maxilla, followed by guided placement of 10 zygomatic implants, using custom cutting and drill/placement-guides, was performed on 5 fresh frozen human cadavers. A preoperatively digitally designed and printed obturator prosthesis was placed and connected to the zygomatic implants. The accuracy of the implant positioning was obtained using 3D deviation analysis by merging the pre- and post-operative CT scan datasets. Results The preoperatively designed and manufactured obturator prostheses matched accurately the per-operative implant positions. All five obturators could be placed and fixated for immediate loading. The mean prosthetic point deviation on the cadavers was 1.03 ± 0.85 mm; the mean entry point deviation was 1.20 ± 0.62 mm; and the 3D angle deviation was 2.97 ± 1.44°. Conclusions It is possible to 3D plan and accurately execute the ablative surgery, placement of zygomatic implants, and immediate placement of an implant-retained obturator prosthesis with 3D virtual surgical planning.The next step is to apply the workflow in the operating room in patients planned for maxillectomy.

scholarly journals Rehabilitation of Posterior Maxilla with Obturator3b2:?show $6# Supported by Zygomatic Implants

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Sankalp Mittal ◽  
Manoj Agarwal ◽  
Debopriya Chatterjee
Keyword(s):  
Prosthetic Rehabilitation ◽  
Avant Garde ◽  
Anterior Teeth ◽  
Maxillary Defect ◽  
Single Piece ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Zygomatic Implants ◽  
Tuberculous Osteomyelitis

Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomaticimplant-supportedprosthesis. Zygomatic implants are anavant-gardeto complex andinvasive-freevascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification) maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS).The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with twosingle-piecezygomatic implants. At 1-yearfollow-up,the patient was comfortable with the prosthesis, and no further complaints were recorded.

Accuracy Evaluation of Computed Tomography–Derived Stereolithographic Surgical Guides in Zygomatic Implant Placement in Human Cadavers

2010 ◽  
Vol 36 (5) ◽  
pp. 345-355 ◽  
Author(s):  
Bruno R. Chrcanovic ◽  
Davidson R. Oliveira ◽  
Antônio L. Custódio
Keyword(s):  
Computed Tomography ◽  
Computer Aided Design ◽  
Accuracy Evaluation ◽  
Angular Deviation ◽  
Implant Placement ◽  
Surgical Guides ◽  
Zygomatic Implants ◽  
Computer Aided ◽  
Human Cadavers ◽  
Zygomatic Implant

Abstract Presurgical planning is essential to achieve esthetic and functional implants. For implant planning and placement, the association of computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques furnishes some advantages regarding tridimensional determination of the patient's anatomy and fabrication of both anatomic models and surgical guides. The goal of this clinical study was to determine the angular deviations between planned and placed zygomatic implants using stereolithographic surgical guides in human cadavers. A total of 16 zygomatic implants were placed, 4 in each cadaver, with the use of stereolithographic (SLA) surgical guides generated by computed tomography (CT). A new CT scan was made after implant insertion. The angle between the long axis of the planned and actual implants was calculated. The mean angular deviation of the long axis between the planned and placed implants was 8.06 ± 6.40 (mean ± SD) for the anterior-posterior view, and 11.20 ± 9.75 (mean ± SD) for the caudal-cranial view. Use of the zygomatic implant, in the context of this protocol, should probably be reevaluated because some large deviations were noted. An implant insertion guiding system is needed because this last step is carried out manually. It is recommended that the sinus slot technique should be used together with the CT-based drilling guide to enhance final results. Further research to enhance the precision of zygomatic implant placement should be undertaken.

scholarly journals Are zygomatic implants a simple and reliable technique for the stabilization of obturator prostheses? Case report and review of the literature

2020 ◽  
Vol 26 (2) ◽  
pp. 12
Author(s):  
Benjamin Sender ◽  
Thibault Lacroix ◽  
Philippe Jaby ◽  
Anne-Gaelle Chaux-Bodard
Keyword(s):  
Reliable Technique ◽  
Surgical Closure ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Significant Difference ◽  
Oncologic Patients ◽  
Long Term Follow Up ◽  
Obturator Prosthesis

Zygomatic implants have been used for several years for the treatment of extremely resorbed maxilla. Indications were extended for oral rehabilitations after maxillectomy in oncologic patients. A 24-year old patient with a triple A syndrome who underwent a left maxillectomy due to a spinocellular tumour was addressed for prosthetic rehabilitation. As his obturator prosthesis failed, surgical closure of the defect combined with 2 zygomatic implants to support the prosthesis was proposed. Despite a small persistent oro-antral fistula, the new obturator prosthesis restored the patient's functions and esthetics and improved his quality of life. The literature reports less than 40 cases of maxillectomy patients rehabilitated with zygomatic implants (with or without flap closure of the defect). Regardless of implant placement, there is no significant difference between reconstructive surgery and obturator prosthesis. Thus, zygomatic implants seem to be a reliable method for the stabilization of obturator prosthesis, without complex surgical procedure. Nonetheless, reservations should be expressed given the lack of data in terms of long-term follow up.

scholarly journals A Titanium Cast Hollow Definitive Obturator Prosthesis for a Maxillectomy Patient

2016 ◽  
Vol 6 (3) ◽  
pp. 69-72
Author(s):  
Teny Fernandez ◽  
Sheela V Rodrigues ◽  
KR Vijayanand
Keyword(s):  
Quality Of Life ◽  
Detrimental Effect ◽  
Self Esteem ◽  
Surgical Removal ◽  
Prosthetic Rehabilitation ◽  
Hypernasal Speech ◽  
And Function ◽  
Obturator Prosthesis ◽  
Extent Of Surgical Resection

ABSTRACT Oral cancer necessitates the surgical removal of all or part of the maxilla. The extent of surgical resection is dependent on the size, location, and potential behavior of the tumor. The maxillectomy procedure leaves the patient with a defect that compromises of the integrity and function of the oral cavity, leading to hypernasal speech, fluid regurgitation into the nasal cavity, and impaired masticatory function. Rehabilitation of subtotal and total bilateral maxillectomy surgical defects is a complex challenge to the prosthodontist. Prosthetic rehabilitation of the surgical defect with the help of obturator is very important, because the resulting functional deficiencies have a detrimental effect on the quality of life and self-esteem of the patient. How to cite this article Fernandez T, Rodrigues SV, Vijayanand KR. A Titanium Cast Hollow Definitive Obturator Prosthesis for a Maxillectomy Patient. Int J Prosthodont Restor Dent 2016;6(3):69-72.

Impact of Dental and Zygomatic Implants on Stress Distribution in Maxillary Defects: A 3-Dimensional Finite Element Analysis Study

2012 ◽  
Vol 38 (5) ◽  
pp. 557-567 ◽  
Author(s):  
Fatih Mehmet Korkmaz ◽  
Yavuz Tolga Korkmaz ◽  
Suat Yaluğ ◽  
Turan Korkmaz
Keyword(s):  
Finite Element ◽  
Stress Distribution ◽  
Dental Implants ◽  
Loading Condition ◽  
Element Analysis ◽  
3 Dimensional ◽  
Maxillary Defect ◽  
Zygomatic Implants ◽  
Dimensional Finite Element ◽  
Zygomatic Implant

The aim of this study was to evaluate the stress distribution in the bone around dental and zygomatic implants for 4 different implant-supported obturator prostheses designs in a unilaterally maxillary defect using a 3-dimensional finite element stress analysis. A 3-dimensional finite element model of the human unilateral maxillary defect was constructed. Four different implant-supported obturator prostheses were modeled; model 1 with 2 zygomatic implants and 1 dental implant, model 2 with 2 zygomatic implants and 2 dental implants, model 3 with 2 zygomatic implants and 3 dental implants, and model 4 with 1 zygomatic implant and 3 dental implants. Bar attachments were used as superstructure. A 150-N vertical load was applied in 3 different ways, and von Mises stresses in the cortical bone around implants were evaluated. When the models (model 1–3) were compared in terms of number of implants, all of the models showed similar highest stress values under the first loading condition, and these values were less than under model 4 conditions. The highest stress values of models 1–4 under the first loading condition were 8.56, 8.59, 8.32, and 11.55 Mpa, respectively. The same trend was also observed under the other loading conditions. It may be concluded that the use of a zygomatic implant on the nondefective side decreased the highest stress values, and increasing the number of dental implants between the most distal and most mesial implants on the nondefective side did not decrease the highest stress values.

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