ORAL REHABILITATION
Table 7 Reported zygomatic implant outcome
Study
(reference)
Follow-up
(months)
Patients (n)
Zygoma
implants
Conventional
implants
CSR%
Zygoma
implants
CSR%
Conventional implants
Bedrossian et al.
(2002)
34
22
44
80
100
91.25
Hirsch
et al. (2004)
12
76
145
?
97.9
?
Malevez
et al.(2004)
6-48
55
103
194
100
91.75
Becktor
et al.(2005)
46.4
16
31
74
90.3
95.9
Farzad
et al.(2006)
18-46
11
22
42
100
97.7
Aparicio
et al.(2006)
60
69
131
304
100
99
Peñarrocha
et al.(2007)
12
23
44
?
97.7
?
95
244
?
99.5
?
25
47
127
100
100
95
244
?
99.5
?
352
747
795
98.2
97.9
Fernández
et al.(2014)
Aparicio
et al.(2010)
Fernández
et al.(2014)
Malò
et al.(2015)
27
7-38
27
6-84
However, with a third patient this sinus problem
was not resolved sponta neously and a nasal
antrostomy was performed. After surgery, the
patient did not complain of any symptoms anymore.
Bedrossian et al. (43) did not observe sinusitis
during their study. As discussed in literature, it is
likely that problems with sinusitis are related more
to the extreme thinness of the palatal bone tissue
and the consequent oro-antro communications,
than to exposed implant threads , to the surgical
procedure and to the micro-movement of the
functioning zygomatic implant (1, 39, 44-46).
Complications in the soft tissues may occur with
this type of implants (Table 5). Malò et al. (47)
reported the outcome of rehabilitating 352
patients with complete edentulous atrophied
maxillae using 747 zygomatic implants. Periimplant pathology, such as higher probing pocket
depths together with bleeding on probing and/
or presence of dental plaque, were observed in
54 patients and 54 implants. The situations were
resolved for 43 patients by means of non surgical
or surgical interventions. With 11 patients the
inflammation persisted. As discussed by Aparicio
(19), one concern may be the long-term effect of
74
having exposed threads towards the soft tissues
at the lateral aspect of the zygomatic implants.
However, Miglioranca (18) did not report irritation
or inflammation of the soft tissues despite a
dehiscence in the cervical portion of the implant
was observed. This was directly related to the strict
control protocol with periodic professional hygiene
in which every patient enrolled in that study was
included. Based on anatomic reasons, especially
the lateral aspect of the zygomatic implant body
in the coronal and middle thirds covered only with
soft tissue, the maintenance of a good standard of
oral hygiene was suggested in most studies.
Another zygomatic implant complications may be
the clinical mobility. Aparicio et al. (19) described
slight mobility when extra-sinusally placed
implants are tested individually. This non-rotational
movement is due to the elastic modulus of the
zygomatic bone when bent by a remotely applied
force and it disappeared when implants were
splinted together. In case of a rotational movement
an implant failure should be considered.
The success of the zygomatic prosthesis and the
patients’ satisfaction described in literature were
encouraging - Table 6 (1, 42, 48).
STOMA.EDUJ (2015) 2 (1)