StomatologyEduJournal1-2015 | Page 56

ORAL IMPLANTOLOGY Figure 1. Panoramic radiograph at the initial presentation of the patient Figure 2. Panoramic radiograph immediately after implant placement; an all-on-four construction existing of two zygomatic implants and two paranasal implants is supporting a temporary bridge in the upper jaw patient received 2 standard Nobel Biocare Nobel Groovy RP implants of 13 mm and 2 zygomatic Nobel Biocare implants of 47,5 mm each. The 2 standard implants were placed in the left and right paranasal area and the two zygomatic implants were placed in de left and right zygomatic buttress (Fig. 2). In the lower jaw three BICON short 5 x 5 mm implants were placed with a 3 mm internal well. The zygomatic implants were placed according to Stella’s technique7 using a channel through which the implant installation was guided into the maxillary sinus and further vertically into 146 the zygomatic buttress. The zygomatic implants emerged closely to the crest of the alveolar ridge. A temporary bridge was used to splint the implants. After 12 months a final bridge restoration was accomplished. All implants integrated well, but the patient continued to complain about the left zygomatic implant. The complaints consisted of mucosal inflammation adjacent to the abutments, chronic discharge around the implant with bad taste. In 2014, 15 months after placement of the implants the zygomatic implant at the left zygomatic buttress was removed and the oro-antral communication STOMA.EDUJ (2015) 2 (2)