Intraorbital hemorrhage following a secondary intervention at integrated zygomatic implants: A case report

Camp, Philippe Van; Vrielinck, Luc; Gemels, Bert; Politis, Constantinus

doi:10.1016/j.ijscr.2018.01.007

Cited by 12 publications

(12 citation statements)

References 8 publications

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“…In fact, different anatomical structures adjacent to the zygomatic bone, such as the orbit, can be damaged during zygomatic implant placement [ 21 ]. Severe pain of the eye and diffused swelling of the upper and lower eyelid were reported by Van Camp et al [ 25 ].…”

Section: Discussionmentioning

confidence: 98%

Zygomatic implant penetration to the central portion of orbit: a case report

et al. 2021

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Background Zygomatic implants have been proposed in literature for atrophic maxillary fixed oral rehabilitations. The aim of the present research was to evaluate, by a clinical and tomography assessment, a surgical complication of a zygomatic implant penetration to the orbit. Case presentation A 56 year-old female patient was visited for pain and swelling in the left orbit after a zygomatic implant protocol. The orbit invasion of the zygomatic implant screw was confirmed by the CBCT scan. The patient was treated for surgical implant removal and the peri- and post-operative symptoms were assessed. No neurological complications were reported at the follow-up. The ocular motility and the visual acuity were well maintained. No purulent secretion or inflammatory evidence were reported in the post-operative healing phases. Conclusion The penetration of the orbit during a zygomatic implant positioning is a surgical complication that could compromise the sight and movements of the eye. In the present case report, a zygomatic implant removal resulted in an uneventful healing phase with recovery of the eye functions.

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Section: Discussionmentioning

confidence: 98%

Zygomatic implant penetration to the central portion of orbit: a case report

et al. 2021

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“…After implant placement, the apex is located between the orbit anteriorly and the dermis of the face laterally. These two areas are susceptible to different complications such as orbit invasion, although very rare, has been described by various authors [ 25 , 26 ], or dermis perforation, which could cause cutaneous fistulas [ 27 ]. For these reasons, the posterior area was where we observed most of the variations, because it is the zone that offers more manoeuvring possibilities.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of digital planning in zygomatic implants

et al. 2021

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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.

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“…In the absence of bone tissue in zones 1, 2 and 3 of the maxilla, the placement of 4 zygomatic implants is performed [ 10 ]. In spite of being a safe technique and well documented in the literature, it requires more experience of the surgeon, with increase in surgical risks [ 1 , 4 , 5 ]. An experienced surgeon perforated the orbital cavity in an attempt to place the second zygomatic implant, and reported only a hematoma in the orbit in the post-operative period [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…In spite the technique being a predictable and well documented in the literature, in the above-mentioned cases, a higher degree of experience of the surgeon is demanded. Moreover, there is increased surgical risk due to the apex of the second zygomatic implant being anchored close to the orbit [ [3] , [4] , [5] ]. Indication of the placement of 4 zygomatic implants also has limitation when the infraorbital foramen is within the trajectory of the zygomatic implant, dimension of the zygomatic bone is insufficient for anchorage of 2 zygomatic implants, and there is accentuated facial concavity of the patient between the zygomatic bone, maxillary sinus and alveolar ridge (ZAGA 3 e 4), making it unfeasible to place a zygomatic implant, due to the risk of dehiscense of the tissue and exposure of the implant body [ [6] , [7] , [8] ].…”

Section: Introductionmentioning

confidence: 99%

Extra-long transnasal implants as alternative for Quad Zygoma: Case report

Almeida

Cacciacane

Arcazas

2021

Annals of Medicine &Amp; Surgery

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Introduction and importance The aim of this case report is to present a technical report for rehabilitation of patients with atrophic maxilla with the use of extra-long transnasal implants associated with unilateral zygomatic implants. Case presentation The indications, contraindications, planning and surgical procedure are described in order to give surgeons confidence in the management of this surgical approach to how to increase the range of rehabilitative options available to surgeons and patients. Clinical discussion Maxillary bone atrophy is a challenge demanding a high degree of experience of dental surgeons who trains themselves to rehabilitate these patients, whose treatment options range from bone grafts through to zygomatic implants. Extensive regions of atrophy require the use of 4 zygomatic implants which, in spite of offering predictability of the treatment, increase the surgical risk, require zygomatic bone with volume for anchoring 2 zygomatic implants. Generally, this bone density is reduced in elderly patients, making apical anchorage of the implants unfeasible. Conclusion The case report presented is a feasible alternative for replacing the placement of a second zygomatic implant, thereby diminishing the surgical risk, and making it possible for the technique to be more extensively used and performed by a larger number of surgeons.

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Intraorbital hemorrhage following a secondary intervention at integrated zygomatic implants: A case report

Abstract: HighlightsZygomatic implant placement may have severe complications.Case reports about a complication during secondary, corrective surgery.Intraorbital hemorrhage caused an orbital compression syndrome.Emergency surgery was necessary to resolve the compression.

Cited by 12 publications

References 8 publications

Zygomatic implant penetration to the central portion of orbit: a case report

Zygomatic implant penetration to the central portion of orbit: a case report

Accuracy of digital planning in zygomatic implants

Extra-long transnasal implants as alternative for Quad Zygoma: Case report

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