REHABILITATION OF SEVERELY RESORBED MAXILLAE WITH ZYGOMATIC IMPLANTS:
A LITERATURE REVIEW
Table 5 Peri-implant diseases in studies in which zygomatic implants were placed using the immediate function protocol or the
two-stage protocol
Follow-up
period
(months)
Patients
affected by
peri-implant
pathology
Number of
zygomatic
implants with
peri-implant
diseases
Patients in
which the
situation was
resolved
Treatment
Study
(reference)
Patients
(n)
Zygoma
implants
(n)
Al-Nawas
et al.(2004)
14
20
20
?
9
?
?
Hirsch
et al.(2004)
76
124
12
8 especially
on the palatal
surface
?
?
?
Miglioranca
et al.(2011)
75
150
≥12
?
2
?
?
Rodriguez
et al.(2014)
29
67
20
?
4
?
?
Malò
et al.(2015)
352
747
6-84
54
54
43
Scaling+CHX/
antibiotics or
surgery
Table 6 Prosthetic results reported in studies in which zygomatic implants were placed using the immediate function protocol or the
two-stage protocol
Study
(reference)
Patients (n)
Becktor
et al.(2005)
16
Farzad
et al.(2006)
11
18-56
100
Mozzati
et al.(2008)
7
24
100
Miglioranca
et al.(2011)
75
- Cone Beam Computed Tomography (CBCT)
- Panoramic images
- Intraoral radiographs
- Lateral cephalograms
Especially, computed tomography is crucial for the
evaluation of the zygomatic implant site,the sinus
status and the implant path (19).
In literature different surgical protocols were
reported and Le Fort I, crestal and palatal incisions
resulted the most commonly applied approaches.
These techniques provided excellent prosthetic
stabilization (33, 34).
Analysing complications described in literature,
(1, 22, 35-41) the main adverse reactions related
to zygomatic implants were caused by sinus
pathologies, poor oral hygiene, implant mobility
and
inadequate
prosthetic
rehabilitation.
Specifically a Zygomatic Success Code (Table
2), describing criteria to score the success of a
rehabilitation anchored on zygomatic implants,
is represented by the outcomes of the previous
variables (19): implant stability, associated sinus
pathology, peri-implant soft tissues condition
STOMA.EDUJ (2015) 2 (1)
Follow-up
(months)
9-69
≥12
Prosthetic survival rate %
100
100
and prosthetic results. The success grade of the
implant is determined by the worst condition of
the four criteria.
The percentage of sinus pathology in clinical
studies has been reported by many authors (Table
3-4). In particular, Becktor et al. (1) in a 3 years
and 10 months study, reported on 16 patients
consecutively treated with 31 zygomatic
implants and 74 additional dental implants.
Six patients were affected by sinusitis. Three
patients had bilateral sinus infection and
another three unilateral. It occurred both early
and later in the period after the abutment
connection surgery. They were treated with
antibiotics and sinus rinses. Three zygomatic
implants failed because medications have did
not solve the infection. One patient was treated
for sinusitis throughout the observation periods.
Farzad et al. (42) described experiences of 11
patients treated consecutively who received
zygomatic implants. Two patients reported
a maxillary sinus discomfort after surgery, but it
resolved spontaneously.
73