RESUMEN
INTRODUCTION AND IMPORTANCE: The aim of this case report is to present a technical report for rehabilitation of patients with atrophic maxilla with the use of extra-long transnasal implants associated with unilateral zygomatic implants. CASE PRESENTATION: The indications, contraindications, planning and surgical procedure are described in order to give surgeons confidence in the management of this surgical approach to how to increase the range of rehabilitative options available to surgeons and patients. CLINICAL DISCUSSION: Maxillary bone atrophy is a challenge demanding a high degree of experience of dental surgeons who trains themselves to rehabilitate these patients, whose treatment options range from bone grafts through to zygomatic implants. Extensive regions of atrophy require the use of 4 zygomatic implants which, in spite of offering predictability of the treatment, increase the surgical risk, require zygomatic bone with volume for anchoring 2 zygomatic implants. Generally, this bone density is reduced in elderly patients, making apical anchorage of the implants unfeasible. CONCLUSION: The case report presented is a feasible alternative for replacing the placement of a second zygomatic implant, thereby diminishing the surgical risk, and making it possible for the technique to be more extensively used and performed by a larger number of surgeons.
RESUMEN
The aim of this case report was to show the 10-year follow-up of a zygomatic implant supported rehabilitation treatment to replace the hybrid dental prosthesis with resin teeth - one by one - with ceramic teeth. The complications that occurred were described right from the time when the first implant supported prosthesis with immediate loading was placed, through the fabrication of a personalized dental prosthesis with twelve ceramic crowns, with a view to achieving esthetic excellence and restoring the patient's self-esteem. It was concluded that all patients with zygomatic implants must participate in a preventive maintenance program to assure the predictability of this type of treatment.
RESUMEN
PURPOSE: To make a comparative evaluation, by means of the finite element method, of the stress generated on supporting tissues and prosthetic system components, using zygomatic implants with the exteriorized and extramaxillary techniques, and different placement positions, associated either with inclined anterior implants, or those without inclination. MATERIALS AND METHODS: Eight (8) tridimensional models were created to represent the clinical situations being researched, using the dataset of scanned images of an edentulous model. The implants and prosthetic components were photographed on millimeter paper and inserted into Rhinoceros 3D modeling computer software. From the measurements made on the image, the virtual models were made. The application force was distributed on the occlusal surface of the working side of the left maxillary first molar, first and second premolars, and incisal regions of the central incisor, simulating the occlusal load during mastication, in a total of 150â¯N. RESULTS: The extramaxillary technique presented considerable variation in increased tension on the prosthesis screws and bone tissue. In the exteriorized technique, the highest tension values occurred in the region of the ridge, and the lowest, on the zygomatic process; the absence of cantilever reduced the stress on bone tissue in almost all regions. CONCLUSION: The exteriorized technique was shown to be more favorable to the distribution of stresses on the micro-unit screws and bone tissue, with the model with zygomatic implant placed in the region of the first molar and inclined anterior implant presenting the best results.
