Reconstruction of the Severely Atrophic Maxilla or Acquired Maxillary Defects Using Zygomatic Implants: Outcome study of 41 implants
Reconstruction of the Severely Atrophic Maxilla or Acquired Maxillary Defects Using Zygomatic Implants: Outcome study of 41 implants
Thursday, September 13, 2012: 9:10 AM
Reconstruction of the Severely Atrophic Maxilla or Acquired Maxillary Defects Using Zygomatic Implants: Outcome study of 41 implants
Kevin Brewer, DDS, MD, Luis Vega DDS, University of Florida, Jacksonville
Dental rehabilitation is the ultimate goal of the reconstruction efforts for the severely atrophic maxilla or acquired maxillary defects. Multiple techniques dealing with these challenging reconstructions have been described in the literature. Most these techniques include bone grafting that has the disadvantage of prolonging the treatment plan, increased costs, and the potential of donor site morbidity. Zygoma implants are a graftless solution for the rehabilitation these patients. The purpose of this study was to evaluate indications, surgical problems and treatment outcomes related to the placement of zygoma implants and their prosthetic rehabilitation.
Forty-one zygoma implants were placed in 11 consecutive patients (8 women, 3 men) between September 2007 and November 2011. The patient age range was 50 to 73 years with a mean age of 61.5 years. Six patients were treated due to severe maxillary atrophy and 5 were due to acquired maxillary defects. Three of the acquired defects were hemimaxillectomies due to cancer ablation, 1 was secondary to a gunshot wound, and 1 was a total maxillectomy secondary to a fungal infection. Three of the acquired maxillary defect patients underwent additional soft tissue reconstruction with a radial forearm free flap. Nine patients were reconstructed with 4 zygomatic implants, 1 was reconstructed with 3 zygomatic implants and 1 had 2 zygoma implants placed. Five patients were reconstructed with a combination of zygomatic and conventional dental implants. A total of 10 dental implants were placed. Outcomes measures were zygomatic and conventional implants survival rates, satisfaction with the prosthetic restoration as well as complications. Follow up ranged from 10 months to 5 years with a mean of 30 months.
No zygomatic implants were lost and minor complications occurred in 3 patients. Complications reported included less than ideal implant position, oral-antral communication and peri-implantitis. Additionally 2 conventional implants were lost in two patients before loading. There were no reported cases of sinusitis, swelling, infection, or nerve damage. All patients were successfully restored with either a fixed or removable prosthesis. All patient reported high level of satisfaction with the reconstruction.
Within the limitations of the present study, the results suggest that reconstruction of the severely atrophic maxilla or acquired maxillary defects with zygomatic implants provides a viable and predictable treatment option with minimal complications.
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