Refinements using optimized planning concepts and tools: The value of planning for final results before treatment initiation
Recent advances in digital applications have focused on the integration of the diagnostic phase, surgical implant placement and prosthetic reconstruction. 3D radiographic data sets, collected prior to treatment initiation, can be fused with digital data sets representing the intra-oral situation and the desired final prosthetic reconstruction. Thus, crucial information is available to assist with a correct diagnosis, formulation of a treatment plan and surgical and and prosthetic execution.
The quad-zygoma experience
In this presentation the current “state-of-the-art” of this technique will be reviewed in-depth: indications, long-term results, complications, level of evidence, limits, refinements, and future directions for research. Classical pre-prosthetic surgical techniques for the totally-extremely resorbed maxilla have mainly tried to augment the available bone (different grafting procedures). Nevertheless the frequent need to use delayed loading protocols, and the demands on considerable patient compliance, have often precluded a high patient acceptance rate for these techniques, especially when a previous therapy has failed. The successful outcome of four well-distributed Brånemark System® Zygoma implants (two on each zygoma bone) which permits the immediate loading of a fixed prosthesis (zygoma quad concept) has been validated.

1. Gain more diagnostic information through the integration of CBCT scans and 3D surface model scans versus traditional 2D radiographs;
2. Reduce the possibility of adverse patient outcomes and mitigate risk through CAD surgical templates for precise implant placement versus traditional freehand techniques;
3. Increase patient acceptance and generate higher conversion rates through the use of digital consultation tools to more effectively communicate treatment plans;
4. Understand treatment planning with NobelClinician software when dealing with edentulous patients;
5. Review surgical techniques and immediate loading protocol with Brånemark System Zygoma and new zygoma implant solutions; and
6. Achieve long-term outcome using the zygoma quad concept.