Title of Presentation:
Complex Cases, Simple Solutions: The Efficacy of Zygomatic Implants
Abstract Summary:
Oral rehabilitation of atrophic edentulous maxilla poses a great challenge to both surgeon and prosthodontist. Although procedures like sinus augmentation and bone grafts are of routine use to increase bone volume to allow anchorage, long duration of wait for rehabilitation during graft consolidation and healing period has resulted in shift of focus from maxilla to zygoma for anchorage. Zygoma implant has proven to be an effective management option for atrophic edentulous maxilla as well as for maxillectomy defect . Apart from relieving surgeon from hassles of graft harvesting and donor site morbidity, excellent initial stability offered by zygoma implant gives opportunity for immediate loading resulting in early return of function and esthetics of oral cavity. Severe resorption of alveolar bone in all 3 zones of maxilla(anterior, premolar, molar)can either be managed by combination of 2 zygoma implants with 2 anterior implants or via quad zygoma. The author aims to present various clinical scenarios where zygomatic implants can be simple solution to fixed dental rehabilitation when other options are exhausted.
Background and Objectives:
Zygomatic implants are an advanced surgical and prosthetic solution developed for patients with severe maxillary atrophy or maxillofacial defects, where conventional dental implants or bone grafting are not viable. They anchor into the dense zygomatic bone, bypassing the need for extensive grafting and allowing for immediate or early prosthetic loading.
Problem or Question Addressed:
Many patients present with extreme upper jaw bone loss due to trauma, pathology, or long-term edentulism, where traditional implant options fail or are not feasible. The challenge is to provide a stable, functional, and esthetic prosthesis without resorting to prolonged, invasive bone reconstruction procedures.
Main Objectives of the Talk:
To present real-world complex case scenarios where all conventional prosthetic options were exhausted.
To demonstrate the decision-making process leading to zygomatic implant selection.
To showcase treatment outcomes and highlight the efficacy, predictability, and patient benefits of zygomatic implants as the ultimate solution in such cases.
To reinforce clinical considerations, surgical protocols, and long-term results for optimal use of this technique.
These challenges were addressed by the MET-ZI method, which enhances visibility while decreasing tissue trauma. By engaging in the vestibular incision, MET-ZI ensures precise implant placement and decreases postoperative complications such as numbness, bruising, inflammation, sinus communication, implant exposure, and infections. The researchers have suggested the possible links of post-zygomatic implant paresthesia to infraorbital and zygomaticofacial nerve damage [2,3,4], with studies reporting incidences of 5.4 % (Besdrosdian) and 4.6% (Aparicio et al.) [5,6]. MET-ZI’s minimally invasive nature significantly lowers these risks.
Key Takeaway Points:
1. Zygomatic implants can play a vital role in restoring function and aesthetics in cases of severe edentulism, traumatic deformities, and periodontal tooth loss.
2. Zygomatic implants provide a solution for primary failure of eruption and impacted teeth when traditional options fail.
3. Segmental teeth loss can also be effectively managed with zygomatic implants in indicated cases.
The author will be discussing a range of complex cases, including long-term edentulism, post-traumatic deformity, periodontal tooth loss, primary failure of eruption of almost all permanent teeth (all impacted), and segmental teeth loss. These case studies will demonstrate how zygomatic implants offer an effective solution when traditional prosthetic options have been exhausted..
