ORAL IMPLANTOLOGY
ZYGOMATIC IMPLANT COMPLICATED
WITH RECURRENT ORO-ANTRAL
COMMUNICATION
Constantinus Politis 1a*
Luc Vrielinck 2b
Titiaan Dormaar 1c
Luc Daems 3d
Paul Legrand 4e
Lloyd Nanhekhan 5f
Joseph Schoenaers 1g
Department of Oral and Maxillofacial Surgery,
Leuven University Hospitals, Department of
Imaging and Pathology, KULeuven, Belgium
2
Department of Oral and Maxillofacial Surgery,
Ziekenhuis Oost Limburg, Genk, Belgium
3
Department of Oral and Maxillofacial Surgery, ZNA
Middelheim Antwerp, Belgium
4
Department of Oral and Maxillofacial Surgery,
MariaZiekenhuis Overpelt, Belgium
5
Department of Plastic and Reconstructive Surgery,
Leuven University Hospitals, Belgium
1
MD, DDS, PhD, Head
b
MD, DDS, Head
MD, DDS, Staff Member
d
MD, DDS, Head
e
MD, DDS, Head
f
MD, Staff Member
g
MD, DDS, Staff Member
a
c
Cite this article:
Politis C, Vrielinck L,
Dormaar T, Daems L,
Legrand P, Nanhekhan L,
Schoenaers J.
Zygomatic implant
complicated with recurrent
oro-antral communication.
Stoma Edu J.
2015;2(2):145-152.
Abstract
Aim: Zygomatic implants are not without complications, but they can be contained
with surgical techniques available in contemporary oral and maxillofacial surgery.
Summary: A 52 year old Caucasian male received 2 zygomatic implants and
2 screw form implants in the upper jaw with a bridge construction. Both the
implants and the prosthetic solution were stable and fully functional. However
the patient developed a large oro-antral communication along the left zygomatic
implant. Several reconstructions with local flaps failed, only enlarging the
defect with deterioration of speech and loss of fluids through the nose. An
anterolateral thigh free flap transfer was used to cover the implant and to close
the hemimaxillary defect. Healing was uneventful and no secondary measures
or additional procedures were needed to retain the integrated implants and the
well-functioning bridge at the one year follow-up.
Key learning points: Removal of a zygomatic implant can exceptionally be
avoided with a free flap transfer to obliterate a soft and hard tissue defect around
a well-integrated implant that is surrounded by an oro-antral communication
and maxillary sinusitis. Infection of the transferred tissue is rare due to the
perfect vascularization of a free flap. The anterolateral thigh flap is well suited
for obliteration of large unilateral maxillary Brown-Shaw class II defects.
Keywords: zygomatic implant, complication, oro-antral communication, free flap,
anterolateral thigh flap.
CASE-REPORT
Introduction
Zygomatic implants have been used as an
alternative to bone grafts in the treatment
of very atrophic maxillae or as a salvage
solution after