Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review

Sáez-Alcaide, Luis Miguel; Cortés-Bretón-Brinkmann, Jorge; Sánchez-Labrador, Luis; Pérez-González, Fabian; Forteza-López, Alba; Molinero‐Mourelle, Pedro; López-Quiles, Juan

doi:10.1080/00016357.2021.2018494

Cited by 8 publications

(5 citation statements)

References 32 publications

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“…The mean overall score of the OHIP‐14 of 1.3 ± 2.0 indicates that the use of QZP rehabilitation fulfills the functional, esthetic, and expectations of patients in the long‐term. These findings are in agreement with results of a systematic review showing substantial increases in OHRQoL among patients restored with ZI (with scores in terms of general satisfaction, especially in chewing ability and esthetics) after a mean follow‐up time of 46.5 months 49 . Other studies that investigated PROMS using the OHIP‐14 questionnaire in patients rehabilitated with ZIs also reported marked improvements in OHRQoL.…”

Section: Discussionsupporting

confidence: 90%

“…These findings are in agreement with results of a systematic review showing substantial increases in OHR-QoL among patients restored with ZI (with scores in terms of general satisfaction, especially in chewing ability and esthetics) after a mean follow-up time of 46.5 months. 49 Other studies that investigated PROMS using the OHIP-14 questionnaire in patients rehabilitated with ZIs also reported marked improvements in OHRQoL. In a study of 10 patients with maxillary atrophy and 10 oncological patients with bone defects, the quality of life improved by 71.3% in the atrophic group and by 82.9% in the oncologic group, with overall scores decreasing from 30.4 ± 9.5 preoperatively to 6.4 ± 3.8 at 60 months after positioning the ZIs.…”

Section: Ohrqolmentioning

confidence: 99%

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Long‐term survival and complications of Quad Zygoma Protocol with Anatomy‐Guided Approach in severely atrophic maxilla: A retrospective follow‐up analysis of up to 17 years

Davó,

Fan,

Wang

et al. 2023

Clin Implant Dent Rel Res

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IntroductionThe objective of the study was to provide long‐term clinical outcomes and complications in the severely atrophic edentulous maxillae treated by means of the quad zygoma protocol (QZP) using the Anatomy‐Guided Approach (AGA).MethodsThis was a retrospective cohort study of all consecutive patients with severely atrophic edentulous maxilla and insufficient bone height and width in the anterior and posterior regions bilaterally, who underwent rehabilitation with the QZP between May 2006 and December 2021. All patients were followed for at least 1 year. All zygomatic implants (ZIs) were placed by the same surgeon. The primary endpoint of the study was the implant survival rate. Secondary endpoints were implant success rate, prosthesis success rate, complications, and Oral Health‐Related Quality of Life using the OHIP‐14 questionnaire.ResultsA total of 56 patients (men 16, women 40) with 224 ZIs (Nobel Biocare, n = 204; Straumann, n = 16; Southern Implant, n = 4) placement were included with a mean follow‐up period 8.8 ± 3.9 years (range, 1.2–17.0). The survival (success) rate was 97.7%. Five ZIs in four patients failed. The mean time between implant placement and failure was 8.6 years (range, 0.5–13.3). All patients received immediate loading with acrylic prosthesis. The successful rates for the definitive prosthesis were 98.2%. Forty‐two patients received posterior cantilever for rehabilitation of fixed definitive prosthesis. Local orofacial inflammation (35.7%) and Sinusitis (12.5%) were the most common complications, occurring at a mean follow‐up of 10.0 (range, 4.2–14.9) and 10.3 (range, 4.3–16.2) years, respectively. In 48 patients, the mean score of the OHIP‐14 questionnaire was 1.7 ± 2.6 with the follow‐up period of 9.0 ± 4.1 years.ConclusionsThe rehabilitation of severely atrophic edentulous maxilla using the QZP has shown a predictable and high survival rate in the long term. The implementation of an immediate loading protocol offers potential benefits in stabilizing ZIs with cross‐arch stabilization. Moreover, the use of a posterior cantilever in reconstruction can effectively establish functional occlusion through well‐distributed ZIs, eliminating the need for additional implant placement.

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Section: Discussionsupporting

confidence: 90%

Section: Ohrqolmentioning

confidence: 99%

Long‐term survival and complications of Quad Zygoma Protocol with Anatomy‐Guided Approach in severely atrophic maxilla: A retrospective follow‐up analysis of up to 17 years

Davó,

Fan,

Wang

et al. 2023

Clin Implant Dent Rel Res

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“…207 Compared with traditional implant treatment of the atrophic maxilla, the most notable advantage of augmentation-free zygomatic implant placement is immediate loading to restore the patient's oral function and esthetics after surgery. 208,209 In the literature, a prevalence of 22%-90% is given for immediate loading, with more recent studies showing a clear trend toward immediate restoration without significant differences in implant survival. 210,211 Compared with traditional implants, zygomatic implants require experienced surgeons and prosthodontists to successfully perform this treatment at the highest level.…”

Section: Alloplastic Reconstructionmentioning

confidence: 99%

“…Patients rehabilitated with zygomatic implant‐supported prosthetic superstructures report significant improvements in oral quality of life and overall satisfaction (Figure 12). 207 …”

Section: Alternativesmentioning

confidence: 99%

Bone reconstruction of extensive maxillomandibular defects in adults

Kämmerer,

Al‐Nawas

2023

Periodontology 2000

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Reconstruction of significant maxillomandibular defects is a challenge that has been much discussed over the last few decades. Fundamental principles were developed decades ago (bone bed viability, graft immobilization). Clinical decision‐making criteria are highly relevant, including local/systemic factors and incision designs, the choice of material, grafting technique, and donor site morbidity. Stabilizing particulated grafts for defined defects—that is, via meshes or shells—might allow significant horizontal and vertical augmentation; the alternatives are onlay and inlay techniques. More significant defects might require extra orally harvested autologous bone blocks. The anterior iliac crest is often used for nonvascularized augmentation, whereas more extensive defects often require microvascular reconstruction. In those cases, the free fibula flap has become the standard of care. The development of alternatives is still ongoing (i.e., alloplastic reconstruction, zygomatic implants, obturators, distraction osteogenesis). Especially for these complex procedures, three‐dimensional planning tools enable facilitated planning and a surgical workflow.

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“…There is less surgical morbidity and is similar to a standard lateral sinus approach 8 . Potential complications compared to zygomatic implants are reduced as is surgical trauma to the patient during surgery and during the postoperative period 9 , 10 . The implant platform can be positioned at the mesial portion of the first molar or at the second premolar depending on the A-P spread required for proper posterior support.…”

mentioning

confidence: 99%

Trans-sinus dental implants, for immediate placement when insufficient alveolar height is present: an alternative to zygomatic implants – surgical case series

Aalam

Krivitsky-Aalam

Zelig³

et al. 2023

Annals of Medicine &Amp; Surgery

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Low maxillary bone density associated with physiological bone remodeling and resorption accelerated by the presence or history of periodontal disease can prevent implant placement without either ridge and/or sinus augmentation in atrophic maxillary edentulous cases. As an alternative to avoid bone grafting and provide immediacy in restorative treatment care for the patient, remote anchorages to the basal bones of the maxilla of the patient are being used with zygomatic or pterygoid implants. The trans-sinus implant, when indicated can offer a reliable alternative to the zygomatic dental implant in that treatment of the severely edentulous maxilla. This approach is suggested in Bedrossian zones I and II atrophy and when an ‘L’ (or concave) anterior sinus wall anatomy is present. This approach will be discussed utilizing two case examples on how trans-sinus implants may be considered in treating the maxillary arch.

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Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review

Cited by 8 publications

References 32 publications

Long‐term survival and complications of Quad Zygoma Protocol with Anatomy‐Guided Approach in severely atrophic maxilla: A retrospective follow‐up analysis of up to 17 years

Long‐term survival and complications of Quad Zygoma Protocol with Anatomy‐Guided Approach in severely atrophic maxilla: A retrospective follow‐up analysis of up to 17 years

Bone reconstruction of extensive maxillomandibular defects in adults

Trans-sinus dental implants, for immediate placement when insufficient alveolar height is present: an alternative to zygomatic implants – surgical case series

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