REHABILITATION OF SEVERELY RESORBED MAXILLAE WITH ZYGOMATIC IMPLANTS:
A LITERATURE REVIEW
Table 1 Treatment recommendations based on the presence of bone in the different zones of the maxilla
Presence of bone
Surgical approach
Zones I, II and III
Traditional, axial, implants
Zones I and II
Four traditional implants,tilted
Zones I only
Zygomatic implants plus two or four traditional implants
Insufficient bone
Four zygomatic implants
Table 2 Zygomatic Success Code
Criteria
Condition I
Success grade I
Condition II
Success grade II
Condition III
Success garde III
Condition IV
Failure
Clear clinical mobility
= evidence of
disintegration of the
apical part of the implant
Rotation and/or pain
Criterion A: zygomatic
implant stability
No mobility
No pain
Light clinical mobility
No pain
Clear clinical mobility
= no evidence of
disintegration of the
apical part of the
implant or rotation
No pain
Criterion B:
Associated sinus
pathology
Lanza & Kennedy
test Lund-Mackay
score = 0
Lanza & Kennedy test Lund-Mackay score
=0
Lanza & Kennedy test Lund-Mackay score
>0
Lanza & Kennedy test +
Lund-Mackay score > 0
Light recession
Implant head is visible
= yuxta-gingival
No exposed threads
Recession
Up to seven exposed
threads
Recession.
More than seven
exposed threads
6mm15mm
D<-5mm
Criterion C: periimplant soft tissue
condition
No recession
Criterion D: prosthetic
offset
0 mm ≤D≤6mm
-3mm≤D≤0mm
the posterior zygomatic implants can restore the
second premolar/first molar (Fig. 4).
The main indications for this type of implant are:
1) Patients with extensive defects of the maxilla
caused by tumour-resections (17, 26);
2) History of periodontitis (27);
3) Traumatic injuries , cleft lip and palate and
congenital defects (20, 27-29);
4) Failure of previous maxillary rehabilitations (30).
Contraindications to the use of zygomatic
implants include (19):
1) Acute sinus infections;
2) Maxillary or zygoma pathology;
3) Uncontrolled or malignant systemic disease.
Relative contraindications are:
1) Chronic infectious sinusitis
2) The use of bisphosphonates
3) Smoking more than 20 cigarettes a day
STOMA.EDUJ (2015) 2 (1)
For these reasons, accurate pre-surgical
evaluations are required before the placement of
the zygomatic implants.
Data collection
The articles reported in this literature review
were searched on pubmed/medline database,
considering only the English-written scientific
journals; case reports and review studies were
excluded.
The keywords selected were “Zygoma Implants”,
“Rehabilitation”, “Survival” and “Results”. After
this research only 17 works presented the
characteristics described above.
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