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 Accuracy of digital planning in zygomatic implants

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
B. Xing Gao ◽  
O. Iglesias-Velázquez ◽  
F. G.F. Tresguerres ◽  
A. Rodríguez González Cortes ◽  
I. F. Tresguerres ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Angular Deviation ◽  
Surgical Experience ◽  
Proper Position ◽  
Zygomatic Implants ◽  
Digital Planning ◽  
Key Factor ◽  
Implant Length ◽  
Zygomatic Implant ◽  
Maxillary Atrophy

Abstract Background Zygomatic implants have been described as a therapeutic alternative for patients with severe maxillary atrophy in order to avoid bone augmentation procedures. Taking that into account, in these treatments, the key factor is the position of the implant, the virtual surgical planning (VSP) is widespread among most clinicians before surgery on the patient. However, there are no studies which evaluate the clinical relevance of these VSP. The aim of this study is to determine whether digital planning on zygomatic implants has any influence on the implant dimensions and position, even when performing conventional surgery afterwards. Results Fourteen zygomatic implants were placed in four patients. Pre-operative and post-operative helicoidal computed tomography were performed to each patient to allow the comparison between the digital planning and the final position of implants. Tridimensional deviation (TD), mesio-distal deviation (MDD), bucco-palatine deviation (BPD), and apico-coronal deviation (ACD) were evaluated as well as angular deviation (AD). Significative differences in apical TD were observed with a mean of 6.114 ± 4.28 mm (p < 0.05). Regarding implant position, only implants placed in the area of the first right molar reported significant differences (p < 0.05) for ACD. Also, implant length larger than 45 mm showed BPD significative differences (p < 0.05). Conclusions Zygomatic implant surgery is a complex surgical procedure, and although VSP is a useful tool which helps the clinician determine the number and the length of zygomatic implants as well as its proper position, surgical experience is still mandatory.

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.

scholarly journals Maxillary Incisive Canal Characteristics: A Radiographic Study Using Cone Beam Computerized Tomography

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Penala Soumya ◽  
Pradeep Koppolu ◽  
Krishnajaneya Reddy Pathakota ◽  
Vani Chappidi
Keyword(s):  
Central Incisor ◽  
Anatomic Structure ◽  
Incisive Canal ◽  
Maxillary Central Incisor ◽  
Implant Placement ◽  
Mean Width ◽  
Immediate Implant ◽  
Thin Bone ◽  
Incisive Foramen ◽  
The Mean

Background. The incisive canal located at the midline, posterior to the central incisor, is an important anatomic structure of this area to be considered while planning for immediate implant placement in maxillary central incisor region. The purpose of the present study is to assess incisive canal characteristics using CBCT sections. Materials and Methods. CBCT scans of 79 systemically healthy patients, with intact maxillary incisors, were evaluated by two calibrated and independent examiners. Assessments included (1) mesiodistal diameter, (2) labiopalatal diameter, (3) length of the incisive canal, (4) shape of incisive canal, and (5) width of the bone anterior to the incisive foramen. Results. The mean width of the foramen labiopalatally and mesiodistally was 3.12 ± 0.94 mm and 3.23 ± 0.98 mm, respectively. Mean canal length was 18.63 ± 2.35 mm and males have significantly longer incisive canal than females. The mean width of bone anterior to the incisive canal was 6.32 ± 1.43 mm. As age of the subjects increased, incisive foramen diameter and incisive canal length were found to be increased. Cylindrical shaped incisive canals were seen in most of the individuals followed by funnel shaped and hour-glass shaped canals, and banana-like canal is least prevalent type. Conclusion. The findings from the present study suggest that the diameter and length of incisive canal vary among different individuals and presence of very thin bone anterior to the canal would suggest that a pretreatment CBCT scan is a valuable tool to evaluate anatomic variations, morphology, and dimensions of incisive foramen before immediate implant placement in maxillary central incisor region.

scholarly journals Using Resonance Frequency Analysis to Compare Delayed and Immediate Progressive Loading for Implants Placed in the Posterior Maxilla: A Pilot Study

2018 ◽  
Vol 12 (1) ◽  
pp. 801-810
Author(s):  
Mohammed Jasim AL Juboori ◽  
Mohammed Ahmed AL Attas ◽  
Raquel Zita Gomes ◽  
Basma Fathi Alanbari
Keyword(s):  
Pilot Study ◽  
Bone Quality ◽  
Frequency Analysis ◽  
Resonance Frequency Analysis ◽  
Implant Stability ◽  
Implant Placement ◽  
Immediate Implant ◽  
The Mean ◽  
Implant Loading ◽  
Progressive Loading

Objective: Implants placed in the posterior region of the maxilla have a high incidence of implant failure due to poor bone quality, especially when immediate implant loading is needed. Immediate Progressive Loading (IPL) can enhance bone quality and may offer an alternative solution when Immediate Implant loading is needed. Methods: Six patients (one male and five females; 34-62 years old) were included in this study. Twelve implants were inserted in the posterior region of the maxilla. Resonance Frequency Analysis (RFA) was performed at the time of implant placement and after 1, 2, 3 and 6 months. ISQ (Implant Stability Quotient) values were compared between the Delayed Loading (DL) group after 2 months and the Progressive Loading (PL) group and between different time points for each group. Results: At implant placement, the mean ISQ values for PL and DL implants were 63 and 57, respectively. One month after implant placement, the mean ISQ value for PL implants was 73. Two months after implant placement, the mean ISQ value for PL implants was 75. Three months after implant placement, the mean ISQ values for PL and DL implants were 76 and 69, respectively. Six months after implant placement, the mean ISQ values for PL and DL implants were 79 and 76, respectively. Conclusion: Despite its limitations, this pilot study indicated that compared to DL, PL can enhance bone density and implant stability, resulting in greater early functionality and fewer surgery sessions.

scholarly journals Molar Septum Expansion with Osseodensification for Immediate Implant Placement, Retrospective Multicenter Study with Up-to-5-Year Follow-Up, Introducing a New Molar Socket Classification

2021 ◽  
Vol 12 (4) ◽  
pp. 66
Author(s):  
Samvel Bleyan ◽  
João Gaspar ◽  
Salah Huwais ◽  
Charles Schwimer ◽  
Ziv Mazor ◽  
...  
Keyword(s):  
Survival Rate ◽  
Site Preparation ◽  
Insertion Torque ◽  
Implant Survival ◽  
Implant Placement ◽  
Implant Survival Rate ◽  
Immediate Implants ◽  
Immediate Implant ◽  
The Mean ◽  
Molar Extraction

The ideal positioning of immediate implants in molar extraction sockets often requires the osteotomy to be in the interradicular septum, which can be challenging in some cases, with traditional site preparation techniques. Patients who had undergone molar tooth extraction and immediate implant placement at five different centers, and followed up between August 2015 and September 2020, were evaluated. Inclusion criteria were use of the osseodensification technique for implant site preparation. The primary outcome was septum width measurement pre-instrumentation and osteotomy diameter post expansion. Clinical outcomes, such as implant insertion torque (ISQ) and implant survival rate, were also collected. A total of 131 patients, who received 145 immediate implants, were included. The mean overall septum width at baseline was 3.3 mm and the mean osteotomy diameter post instrumentation was 4.65 mm. A total of ten implants failed: seven within the healing period and three after loading; resulting in a cumulative implant survival rate of 93.1%. This retrospective study showed that osseodensification is a predictable method for immediate implant placement with interradicular septum expansion in molar extraction sockets. Furthermore, it allowed the introduction of a new molar socket classification. In the future, well-designed controlled clinical studies are needed to confirm these results and further explore the potential advantages of this technique.

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