BackgroundThe use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants.Material and MethodsAn electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications.ResultsOut of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted.ConclusionsThe analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed. Key words:Implant, zygomatic implant, surgery, complications.

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.

Determine whether the implant loading time influences the marginal bone loss (MBL) that occurs in the different restorations on dental implants.Background: Different concepts of prosthetic loading have been proposed in literature. While the conventional loading (CL) protocol dictates to wait for a period of osseointegration of 3-4 to 6-8 months before loading the implant, the immediate loading (IL) protocol proposes to perform the implant loading within a period of no more than 1 week after its placement. Although there are several parameters to evaluate implant success, the evaluation of the radiographic changes of the MBL with standardized intraoral radiographic is the most used method in the literature to evaluate the success of the implant over time.Methods: A comprehensive search of the literature was conducted in the PubMed/MEDLINE (National Library of Medicine), Cochrane Library, Scopus and Web of Science electronic databases. The search strategy was done using the following terms: "dental implants", "loading protocols", "MBL".Conclusions: MBL is similar in both protocols, with no significant differences found in most published studies. IL has certain advantages such as reduced treatment time. However, good primary stability is needed to perform it. More studies are needed to establish clear conclusions.

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