Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study

Abstract

The main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients who had received 182 zygomatic implants. Patients were fully edentulous (62.2%), partially edentulous (22.0%), or had failing dentition (15.9%). Most patients (87.5%) did not have previous sinusitis and 11.3% had been previously treated for it. Additionally, about half of the patients (53.8%) did not present periodontal pathology, and one-third (36.3%) did, but were subsequently treated. Most implants (93.8%) were loaded immediately, i.e., within 48 h of placement. Implants were followed for 10.5 ± 7.2 months, and all were recorded as surviving and stable at last follow-up. Post-operative complications were infrequent and included sinusitis (10.1%) and peri-implant hyperplasia (0.8%). The low complication rate and 100% implant survival and stability indicate that zygomatic implants offer a viable treatment option when performing graftless restoration of severely resorbed maxilla, including immediate loading protocols.

Survival Rate and Prosthetic and Sinus Complications of Zygomatic Dental Implants for the Rehabilitation of the Atrophic Edentulous Maxilla: A Systematic Review and Meta-Analysis

“…Of the 46 articles included, 4 were randomized clinical trials [19][20][21][22], 19 were nonrandomized clinical trials [10,11,14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], 20 were retrospective studies [7,8,13,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54], and 3 were case series [55][56][57]. In addition, 31 articles compared the success rate of conventional and zygomatic dental implants [7][8][9]11,13,…”

“…The results of the methodological quality assessment using the Jadad scale were performed by one author (A.Z.-M.) and are shown in Table 2. The Jadad scale returned 23 articles as "not applicable", because 20 were retrospective [7,8,13,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52]] and 3 were case series [53][54][55], and the authors of these articles did not blind or randomize the studies. Two articles [17,20] obtained scores of five, indicating high methodological quality.…”

“…The follow-up time of the studies selected was 3-163 months. Thirty-one studies [7][8][9]11,13,17,19,[21][22][23][24][25][26][27][28][29][32][33][34]36,38,[41][42][43][44]46,48,[53][54][55] that compared the incidence of dental implant failure between conventional and zygomatic dental implants were included in the meta-analysis and combined using a random effects model with the Mantel-Haenszel method. The effect size measure used was the Odds Ratio, which was estimated at 1.33 with a 95% confidence interval between 0.79 and 2.23 (z-test = 1.09; p-value = 0.278).…”

“…Thirty-two studies [7,11,13,20,21,[23][24][25][26][27]29,[32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][48]50,52,54,55] with a total of 1119 patients, combined using a random effects model (inverse variance method), obtained an estimate of the incidence of sinusitis of 4.7% with a 95% confidence interval between 2.8% and 6.5% of patients with zygomatic implants. The meta-analysis detected moderate heterogeneity between the combined studies (Q test = 75.3; p-value < 0.0001; I 2 = 58.8%) (Figure 4).…”

Effect of Maxillary Implants Region and Loading Condition in the Stress Distribution of Implant-Supported Full-Arch Prosthesis: 3D-FEA

“…Thus, there are two alternatives that can provide the necessary anchorage in these areas: bone grafting or the use of long implants in the posterior region with anchorage in other portions of the bone tissue [3]. It is important to emphasize that the use of long implants with zygomatic anchorage, in addition to being invasive and requiring hospitalization, usually has a high cost to the patient [4].…”