Case 3 | Prosthodontic Award 2015 | Italy
Dr. Andrea Tedesco
“ The zygomatic implants in the treatment of atrophic maxilla “
Patients with severe bone atrophy cannot be rehabilitated by using standard implants without resorting to bone reconstruction.
For this reason, a series of bone graft techniques have been proposed that make the treatment too long, expansive and inconvenient for the patient.
Zygomatic bone, with a optimal volume and stable density, represents a valid solution.
By using zygomatic implants, we can treat patients who requires prosthetic implant rehabilitation of posterior maxilla in the presence of an inadeguate amount of bone for implant placing without recurring to bone grafting.
The severe bone loss to improve the patients life quality and provide mastication, phonation, comfort, communication and social interaction.
Zygoma implants are excellent alternative to the rehabilitation of the edentulous patients.
We can solve estreme cases fixed in very few hours.
This approach with is to insert long implants ( 30-52,5 mm ) bilaterally in the posterior region of the maxilla to have anchorage in both crestal bone of the residual maxilla and the dense bone of the zygomatic arch.
A zygomatic implant insert in the zygomatic bone, extends along the interior aspect of the lateral wall of the maxillary sinus, and emerges at the palatal aspect of the second premolar region.
The aim of this work is to evaluate some surgeries using zygomatic implants with a software and stereolithographic model.
A total of 42 conventional implants were placed together with 40 zygomatic implants. The patients, 12 male and 8 female, no smokers, in good health, with a removable prosthesis, were followed up 24 months. After Tc Cone Beam and software planning design, each surgery was performed placing for each patient two or four straight implants ( NobelBiocare Active )in the frontal area and two zygomatic implants ( NobelBiocare Branemark System Zygoma ) in the zygomatic bone. Some cases have been treated with 4 zygomatic implants. Only one surgery was performed placing a oncology zygomatic implants ( Southern Implants )
After planning the surgery a stereolithographic model was created for each patient, and
some surgeries were performed with Nobel Clinicians software template.
The insertion torque was over 35 Nc. The surgeries was performed under general anesthesia.
No zygomatic implants was lost during the observation period.
The survival rate for the zygomatic implants was 100% over an average of 24 months observation period.
Two conventional implants were lost and there were no significant complications.
The zygomatic implants are a valid alternative to grafting procedure for the rehabilitation of the atrophic maxilla, in many cases using a classical two-stage technique or immediate function protocols in others.
The zygomatic implants were placed intra and outside the sinus and anchored in the maxillary alveolar process and in the zygomatic cortical bone.