Zygomatic Implants Placed in Immediate Function through Extra-Maxillary Surgical Technique and 45 to 60 Degrees Angulated Abutments for Full-Arch Rehabilitation of Extremely Atrophic Maxillae: Short-Term Outcome of a Retrospective Cohort

Abstract

The use of new devices for the rehabilitation of the severely atrophic maxillae needs validation. We aimed to report the short-term outcome of severely atrophic jaws rehabilitated with zygomatic implants with no implant head angulation placed extramaxillary in conjunction with standard implants. Forty-four patients were consecutively included with 77 zygomatic implants (31 abutments of 45 degrees and 46 abutments of 60 degrees) and 115 standard implants. Outcome measures were prosthetic survival, implant/abutment success, complications, modified plaque index (mPLI), modified bleeding index (mBI), mucosal seal efficacy evaluation (MSEE) >4 mm, and Zygomatic implants classification level (ZICL). Two patients (4.5%) were lost to follow-up. No prosthesis was lost; one patient lost one zygomatic implant; two angulated abutments of 60 degrees needed to be replaced in one patient due to an aesthetic complaint; rendering a cumulative success rate at 2-years of 95.3% and 95.9% using patient and implant/abutment as unit of analysis, respectively. Mechanical and biological complications occurred in 13 and six patients, respectively; all resolved. The median mPLI and mBI was 1; MSEE > 4 mm occurred in 17% and 21% of patients at 1- and 2-years, respectively; ZICL1 was registered in 80% of patients. The current protocol enabled good short-term outcomes.

Evaluation of the stress levels of different implant treatment options in extremely atrophic maxillae by finite element analysis method

“…In contrast to the results of this study, an increase in stress was observed in the groups using a 30-degree multi-unit abutment. [30] Planning an implant-supported prosthetic restoration is an important factor affecting the amount of stress on implants. When we look at the literature on this subject, the study conducted by Yu et al comparing single-piece prostheses with multi-piece prostheses demonstrates that in single-piece prostheses where cantilevers are not used, the force distribution is more homogeneous.…”

Assessment of the content and quality of YouTube videos related zygomatic implants: A content–quality analysis

“…7 In clinical studies, cumulative survival rates, ranging from 95.2% to 98.6%, were achieved with a follow-up of 2-12 years. [10][11][12][13] Despite the advantages and success rates, complications associated with zygomatic implant treatment such as sinusitis, soft tissue infection, paresthesia, and orbital perforations can occur. However, the incidence of prosthetic complications is very low (4.9%) regardless of the type of prosthetic treatment.…”

“…The implant technique involves bypassing the atrophic alveolar bone and using the highly dense bone of the zygomatic complex as the fixation unit for longer implants (30–52.5 mm long) 7 . Indications for zygomatic implants may include rehabilitation of atrophic maxilla, 8 treatment of patients with ectodermal dysplasia, 9 and post‐surgical maxillary reconstruction in patients with oral cancer 10 . The success rate of treatment increases with the use of zygomatic implants.…”

“…Conversely, the number of surgical steps, treatment time, and the use of bone grafts decrease 7 . In clinical studies, cumulative survival rates, ranging from 95.2% to 98.6%, were achieved with a follow‐up of 2–12 years 10–13 . Despite the advantages and success rates, complications associated with zygomatic implant treatment such as sinusitis, soft tissue infection, paresthesia, and orbital perforations can occur.…”

“…7 Indications for zygomatic implants may include rehabilitation of atrophic maxilla, 8 treatment of patients with ectodermal dysplasia, 9 and post-surgical maxillary reconstruction in patients with oral cancer. 10 The success rate of treatment increases with the use of zygomatic implants. Conversely, the number of surgical steps, treatment time, and the use of bone grafts decrease.…”