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To report retrospectively on the 12-years follow-up results of the treatment and rehabilitation of edentulous maxillae, applying extra-sinus zygomatic implants alone or in combination with intra-sinus zygomatic implants. We recruited 22 Patients with 35 zygomatic Brånemark System Implants; 24 implants in the standard Brånemark protocol through the sinus and 11 extra - sinus implants outside the sinus. Additionally, 147 regular implants were placed (Brånemark System, Straumann, Nobel Replace, SternGold). The minimum follow-up period was from 50 months to a maximum of 152 months. The Zygoma survival rate after 12 years was 97.15%. Chronic sinusitis occurred in 11.42% of patients. We lost 1 (2.85%) zygomatic implant placed through the sinus and none of those in the extra - sinus position. The survival rate of the regular implants was 93.87%. Chronic sinusitis occurred in 4 patients (11.42%) who received Zygomatic implants using the standard protocol through the sinus. None of the extra - sinus zygoma patients developed sinusitis. Peri - implantitis was detected with only three zygomatic implants. In the original P-I Brånemark zygoma protocol (Brånemark System, Sweden) the implants were passing through the sinus which resulted in chronic sinusitis in some patients and malposition of the prosthetic platform towards the palate. These complications can be avoided by the extra - sinus placement of zygoma implants as demonstrated in this study.

Evaluation of periodontal and peri-implant tissue condition is mainly based on clinical examination and imaging diagnostics. Some data imply that Metalloproteinase-8 (MMP-8) level examination in peri-implant sulcular fluid (PISF) might be useful for evaluating the condition of peri-implant tissues and monitoring a development of peri-implant inflammation, including both mucositis and peri-implantitis. Hence, in this study, we decided to evaluate the level of MMP-8 in PISF obtained from patients without clinical symptoms of mucositis or peri-implantitis and compare it with MMP-8 level in gingival crevicular fluid (GCF) obtained from patients with healthy periodontium and those with varying severity of periodontitis. A total of 189 subjects were included in the study, and GCF/PISF samples were analysed for MMP-8 level by ELISA test. We documented that MMP-8 level in PISF obtained from patients without symptoms of mucositis or peri-implantitis was significantly higher not only than in GCF of periodontally healthy patients but also, which seems to be very interesting, than in GCF of patients with varying degrees of periodontal inflammation, consistent with earlier studies. Our observation might imply that monitoring of MMP-8 level in PISF could help to diagnose mucositis/peri-implantitis in an early stage, prior to clinical manifestations, which may allow for quick start of appropriate therapy.

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Background Our study aimed to assess the level of IL-1β, CXCL8, and TNF-α in peri-implant sulcular fluid (PISF) collected from patients with no clinical symptoms of mucositis or peri-implantitis and compare them with cytokine concentration in gingival crevicular fluid (GCF) acquired from patients with healthy periodontium and those with varying severity of periodontitis. Methods A total of 189 subjects were included in the study, and GCF/PISF samples were checked for IL-1β, CXCL8, and TNF-α levels using an ELISA test. Results The IL-1β level in PISF in patients with implants was significantly lower than in GCF in patients with mild, moderate, or severe periodontitis. The CXCL8 level in PISF was considerably lower than in patients with moderate periodontitis. The TNF-α level in PISF in patients with implants was markedly higher compared to subjects with healthy periodontium or patients with mild periodontitis. Conclusion Analysis of cytokine levels may help describe the pathogenesis and early diagnosis of peri-implantitis and prevision in high-risk patients.