ZYGOMATIC IMPLANT COMPLICATED WITH RECURRENT ORO-ANTRAL COMMUNICATION
Figure 3. Panoramic radiograph; after earlier loss of the left zygomatic implant and recurrence of the
oroantral communication the surgical procedure consisted of a reconstruction of the posterior maxilla
with a bone graft of the right iliac crest, a new zygomatic implant and soft tissue closure; the bone graft is
stabilized with one osteosynthesis plate
Figure 4. Preoperative panoramic radiograph; around the left zygomatic implant the entire alveolar crest
together with the bonegraft and whatever has been left of the bony sinus wall has vanished; the only bone
supporting the implant is the zygomatic buttress
was closed with a local flap. This resolved the
complaints of the patient.
Three months later a new surgical procedure
was performed consisting of the placement of
a bone graft from the right anterior iliac crest to
reconstruct the distal maxilla at the left side, the
placement of a new zygomatic implant and tight
soft tissue closure. The bone graft was stabilized
with a osteosynthesis plate (Fig. 3).
Due to recurring infections, eight weeks later
the bone graft was removed including the
osteosynthesis material and the new oro-antral
communication was closed with a mobilized
buccal fat pad.
Due to unfavorable healing with recurrence of
the oro-antral communication four weeks later
a new attempt to close the fistula in presence of
the zygomatic implant was performed, this time
utilizing a palatal rotation flap.
This did not resolve the problem. A large soft
tissue and bony defect remained around the wellintegrated zygomatic implant at the left side.
Meanwhile a new bridge incorporating the new
zygomatic implant was constructed to replace the
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