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1.
Int J Oral Maxillofac Implants ; 36(1): 21-29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600519

RESUMEN

PURPOSE: To assess the postoperative complications and outcome (implant survival) of quad zygomatic implants inserted in patients with edentulism and severely atrophic maxillae. MATERIALS AND METHODS: Two independent reviewers conducted an electronic search of the literature (PubMed, Scopus, EBSCO, Web of Science) from January 2000 to February 2019. The inclusion criteria were articles published in English reporting data of at least five patients with severely atrophic edentulous maxillae undergoing placement of four zygomatic implants without additional insertion of standard implants, with a minimum of 6 months of follow-up. Data extracted included number of patients, characteristics of the maxillary defect, number of zygomatic implants, implant details, surgical procedure, prosthetic rehabilitation, postoperative complications, survival rate, and length of follow-up after definitive prosthesis delivery. RESULTS: Eleven studies with 166 patients were included. The heterogeneity among studies was not significant. The pooled incidence rates of complications were as follows: sinusitis 12% (95% confidence interval [CI]: 4% to 23%), malposition and surgical guiding failure 11% (95% CI: 3% to 21%), local infection/injury 10% (95% CI: 3% to 18%), and prosthetic complications 5% (95% CI: 0% to 13%). The implant survival rate ranged between 95.8% and 100%, and the pooled implant survival rate in the meta-analysis was 98% (95% CI: 97% to 99%). CONCLUSION: Quad zygomatic implants inserted in patients with severely atrophic edentulous maxillae have a high implant survival rate, but the incidence of complications should not be underestimated.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Maxilar/cirugía , Resultado del Tratamiento , Cigoma/cirugía
2.
J Clin Med ; 9(2)2020 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-32050501

RESUMEN

The main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients who had received 182 zygomatic implants. Patients were fully edentulous (62.2%), partially edentulous (22.0%), or had failing dentition (15.9%). Most patients (87.5%) did not have previous sinusitis and 11.3% had been previously treated for it. Additionally, about half of the patients (53.8%) did not present periodontal pathology, and one-third (36.3%) did, but were subsequently treated. Most implants (93.8%) were loaded immediately, i.e., within 48 h of placement. Implants were followed for 10.5 ± 7.2 months, and all were recorded as surviving and stable at last follow-up. Post-operative complications were infrequent and included sinusitis (10.1%) and peri-implant hyperplasia (0.8%). The low complication rate and 100% implant survival and stability indicate that zygomatic implants offer a viable treatment option when performing graftless restoration of severely resorbed maxilla, including immediate loading protocols.

3.
Int J Oral Maxillofac Implants ; 35(1): 150-159, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31923298

RESUMEN

PURPOSE: To clinically evaluate a recently developed, standardized, three-implant-supported full-arch treatment concept for fully edentulous mandibles. MATERIALS AND METHODS: This ongoing multinational prospective cohort study is evaluating the performance of the treatment concept over 5 years in patients who were fully edentulous or had failing dentition of the mandible. The primary outcome was the cumulative survival rate of implants (CSRI). Secondary outcomes included the cumulative survival rate of the prostheses (CSRP), marginal bone level change, soft tissue outcomes, impact on quality of life, and patient and clinician satisfaction. The 1-year report is presented here. RESULTS: In total, 110 patients (330 implants) were included. Prostheses underwent immediate loading in 76.4% of cases and early loading in 23.6% of cases. The mean surgical time was 1.60 ± 0.78 hours, and the mean laboratory time was 3.99 ± 1.74 hours. At 1 year, eight implants and three prostheses failed, yielding an implant-level CSRI of 97.5% and a CSRP of 97.3%. All prosthetic failures were due to loss of two implants in the patient. The mean marginal bone level change at 1 year was -0.62 ± 1.39 mm. Among soft tissue outcomes, the Bleeding Index improved significantly between the 6-month and 1-year follow-up, and 242 implants (75%) were surrounded by keratinized mucosa by the 6-month follow-up. Patients reported a significant improvement in quality of life between prosthesis placement and the 6-month follow-up based on the Oral Health Impact Profile for Edentulous 21 questionnaire. Both patient and clinician satisfaction with function and esthetics were high throughout treatment. CONCLUSION: This novel treatment concept using a passively fitting standardized framework with simplified surgical and prosthetic workflow demonstrated high survival and excellent outcomes at 1 year while reducing chair and fabrication time. This concept may offer patients a safe and efficient option for full-arch mandibular prostheses.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Mandíbula , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estética Dental , Estudios de Seguimiento , Humanos , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento
4.
Oral Maxillofac Surg Clin North Am ; 31(2): 285-297, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30947849

RESUMEN

Four zygomatic implants may be used in patients with severe maxillary atrophy for rehabilitation with a fixed or removable prosthesis. Immediate loading is also typically performed, providing patients with a less invasive and more efficient solution for rehabilitation. Options for immediate loading are presented. The indications, contraindications, procedure, and complications are reviewed. Appropriate treatment planning and work-up are highlighted, as they are required for success in conjunction with advanced surgical skill. Scientific evidence, although lacking in quantity, suggests that the quad zygoma approach offers a predictable solution for the challenge of severe maxillary atrophy; high implant survival rates are noted.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Arcada Edéntula/cirugía , Maxilar/cirugía , Cigoma/cirugía , Implantación Dental Endoósea , Humanos , Arcada Edéntula/rehabilitación , Maxilar/patología , Tasa de Supervivencia
5.
Eur J Oral Implantol ; 11(2): 145-161, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29806663

RESUMEN

PURPOSE: To compare the clinical outcome of immediately loaded cross-arch maxillary prostheses supported by zygomatic implants vs conventional implants placed in augmented bone. MATERIALS AND METHODS: In total, 71 edentulous patients with severely atrophic maxillas without sufficient bone volumes for placing dental implants, or when it was possible to place only two implants in the anterior area (minimal diameter 3.5 mm and length of 8 mm) and less than 4 mm of bone height subantrally, were randomised according to a parallel group design to receive zygomatic implants (35 patients) to be loaded immediately vs grafting with a xenograft, followed after 6 months of graft consolidation by placement of six to eight conventional dental implants submerged for 4 months (36 patients). For immediate loading, zygomatic implants had to be inserted with an insertion torque superior to 40 Ncm. Screw-retained metal reinforced acrylic provisional prostheses were provided, to be replaced by definitive Procera Implant Bridge Titanium prostheses (Nobel Biocare, Göteborg, Sweden), with ceramic or acrylic veneer materials 4 months after initial loading. Outcome measures were: prosthesis, implant and augmentation failures, any complications, quality of life (OHIP-14), patients' number of days with total or partial impaired activity, time to function and number of dental visits, assessed by independent assessors. Patients were followed up to 1 year after loading. RESULTS: No augmentation procedure failed. Five patients dropped out from the augmentation group. Six prostheses could not be delivered or failed in the augmentation group vs one prosthesis in the zygomatic group, the difference being statistically significant (difference in proportions = -16.5%; P = 0.045; 95% CI: -0.34 to -0.01). Eight patients lost 35 implants in the augmentation group vs two patients who lost four zygomatic implants, the difference being statistically significant (difference in proportions = -20.1%; P = 0.037; 95% CI: -0.38 to -0.02). A total of 14 augmented patients were affected by 22 complications, vs 28 zygomatic patients (40 complications), the difference being statistically significant (difference in proportions = 34.8%; P = 0.005; 95% CI: 0.12 to 0.54). The 1-year OHIP-14 score was 3.93 ± 5.86 for augmented patients and 3.97 ± 4.32 for zygomatic patients with no statistically significant differences between groups (mean difference = 0.04; 95% CI: -2.56 to 2.65; P = 0.747). Both groups had significantly improved OHIP-14 scores from before rehabilitation (P < 0.001 for both augmented and zygomatic patients). On average, the number of days of total infirmity was 7.42 ± 3.17 for the augmented group and 7.17 ± 1.96 for the zygomatic group, the difference not being statistically significant (mean difference = -0.25; 95% CI: -1.52 to 1.02; P = 0.692). The number of days of partial infirmity were on average 14.24 ± 4.64 for the augmented group and 12.17 ± 3.82 for the zygomatic group, the difference being statistically significant (mean difference = -2.07; 95% CI: -4.12 to -0.02; P = 0.048). The mean number of days that needed to have a functional prosthesis was 444.32 ± 207.86 for augmented patients and 1.34 ± 2.27 for zygomatic patients, the difference being statistically significant (mean difference = -442.98; 95% CI: -513.10 to -372.86; P < 0.001). The average number of dental visits was 19.72 ± 12.22 for augmented patients and 15.12 ± 5.76 for zygomatic patients, the difference not being statistically significant (mean difference = -4.61; 95% CI: -9.31 to 0.92; P = 0.055). CONCLUSIONS: Preliminary 1-year post-loading data suggest that immediately loaded zygomatic implants were associated with statistically significantly fewer prosthetic failures (one vs six patients), implant failures (two vs eight patients) and time needed to functional loading (1.3 days vs 444.3 days) when compared to augmentation procedures and conventionally loaded dental implants. Even if more complications were reported for zygomatic implants, they proved to be a better rehabilitation modality for severely atrophic maxillae. Long-term data are absolutely needed to confirm or dispute these preliminary results.


Asunto(s)
Aumento de la Cresta Alveolar , Implantación Dental Endoósea , Carga Inmediata del Implante Dental , Maxilar/patología , Adulto , Anciano , Atrofia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Resultado del Tratamiento , Cigoma
6.
Eur J Oral Implantol ; 11(1): 11-28, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29557398

RESUMEN

PURPOSE: To compare the clinical outcome of immediately loaded cross-arch maxillary prostheses supported by zygomatic implants vs conventional implants placed in augmented bone. MATERIALS AND METHODS: A total of 71 edentulous patients with severely atrophic maxillas, who did not have sufficient bone volume to place dental implants or when it was possible to place only two implants in the front area (minimal diameter 3.5 mm and length of 8 mm) and less than 4.0 mm of bone height subantrally, were randomised according to a parallel group design. They (35 patients) received zygomatic implants to be loaded immediately vs grafting with a xenograft, followed, after 6 months of graft consolidation, by the placement of six to eight conventional dental implants, submerged for 4 months (36 patients). To be loaded immediately, zygomatic implants had to be inserted with an insertion torque superior to 40 Ncm. Screw-retained, metal-reinforced, acrylic provisional prostheses were provided to be replaced by definitive Procera Implant Bridge Titanium prostheses (Nobel Biocare, Göteborg, Sweden) with ceramic or acrylic veneer materials 4 months after initial loading. Outcome measures were: prosthesis, implant and augmentation failures, any complications, quality of life (OHIP-14), the number of days that patients experienced total or partial impaired activity, time to function, and number of dental visits, assessed by independent assessors. Patients were followed up to 4 months after loading. RESULTS: No augmentation procedure failed. Three patients dropped out from the augmentation group. Six prostheses could not be delivered or failed in the augmentation group vs one prosthesis in the zygomatic group, the difference being statistically significant (difference in proportions = 15.32%; P = 0.04; 95% CI: 0.23 to 31.7). Eight patients lost 35 implants in the augmentation group vs three implants in one patient from the zygomatic group, the difference being statistically significant (difference in proportions = 21.38%; P = 0.001; 95% CI: 3.53 to 39.61). In total, 14 augmented patients were affected by 20 complications vs 26 zygomatic patients (35 complications), the difference being statistically significant (difference in proportions = 31.87%; P = 0.008; 95% CI: 6.48 to 53.37). The OHIP-14 score was 3.68 ± 5.41 for augmented patients and 4.97 ± 5.79 for zygomatic patients, with no statistically significant differences between groups (mean difference = 1.29; 95%CI -1.60 to 4.18; P = 0.439). Both groups had significantly improved OHIP-14 scores from before rehabilitation (P < 0.001 for both augmented and zygomatic patients). The number of days of total infirmity was, on average, 7.42 ± 3.17 for the augmented group and 7.17 ± 1.96 for the zygomatic group, the difference not being statistically significant (mean difference = -0.25; 95% CI: -1.52 to 1.02; P = 0.692). Days of partial infirmity were on average 14.24 ± 4.64 for the augmented group and 12.17 ± 3.82 for the zygomatic group, the difference being statistically significant (mean difference = -2.07; 95% CI: -4.12 to -0.02; P = 0.048). The mean number of days to have a functional prosthesis was 444.32 ± 207.86 for augmented patients and 1.34 ± 2.27 for zygomatic patients, the difference being statistically significant (mean difference = -442.9; 95% CI: -513.10 to -372.86; P < 0.001). The average number of dental visits was 16.79 ± 10.88 for augmented patients and 12.58 ± 5.21 for zygomatic patients, the difference not being statistically significant (mean difference = -4.21; 95% CI -8.48 to 0.06; P = 0.053). CONCLUSIONS: Preliminary 4-months post-loading data suggest zygomatic implants were associated with statistically significantly less prosthetic (one vs six patients) and implant failures (one patient lost three implants versus 35 implants in eight patients) as well as time needed to functional loading (1.3 days vs 444.3 days) when compared with augmentation procedures and conventionally loaded dental implants. Even if more complications were reported for zygomatic implants, which were solved spontaneously or could be handled, zygomatic implants proved to be a better rehabilitation modality for severely atrophic maxillae. Long-term data are essential to confirm or dispute these preliminary results. Conflict of interest statement: This study was originally supported by Nobel Biocare, the manufacturer of the implants, and the provisional and definitive prosthetic components used in this study, which were provided free for the patients. However, before any results were known, Nobel Biocare withdrew the financial support and recruitment had to be stopped. Tecnoss (Giaveno, Torino, Italy) kindly donated the bone substitutes and the membranes, whereas Global D (Brignais, France) donated the osteosynthesis screws. Data property belonged to the authors and by no means did the manufacturers interfere with the publication of the results.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea/métodos , Implantes Dentales , Cigoma/cirugía , Adulto , Anciano , Pérdida de Hueso Alveolar/patología , Pérdida de Hueso Alveolar/cirugía , Atrofia/patología , Atrofia/cirugía , Sustitutos de Huesos/uso terapéutico , Prótesis Dental de Soporte Implantado , Femenino , Xenoinjertos , Humanos , Carga Inmediata del Implante Dental , Arcada Edéntula/rehabilitación , Masculino , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Calidad de Vida , Resultado del Tratamiento
7.
Eur J Oral Implantol ; 8(2): 169-74, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26021227

RESUMEN

PURPOSE: To evaluate the clinical outcome of maxillary prostheses supported by four immediately loaded zygomatic implants in the rehabilitation of edentulous patients with severe atrophic maxillae after 5 years of function. MATERIALS AND METHODS: Out of a total of 17 consecutive patients with severe atrophy in the maxillae (Cawood and Howell classification C-VI and D-V or D-VI) and whom were rehabilitated using four immediately loaded zygomatic implants, three were lost during follow-up. Outcome measures were success rates of the prostheses, success rates of the zygomatic implants, complications and oral health-related quality of life (OHIP-14 questionnaire). RESULTS: In 14 patients assessed at 5 years after operation, no prosthesis or zygomatic implants failed, although one implant placed in an unfavourable position was not used. Fifty percent of the patients had complications, which included penetration of the orbital cavity during the drilling procedure (1 patient), infection followed by a fistula at one zygomatic implant (1 patient), sinusitis (2 patients), fracture of the abutment screw (1 patient) and fracture of the prostheses (2 patients). All complications were resolved without clinical consequences. At 5 years the mean score of the OHIP-14 was 3.8, which is similar to that of the general population. CONCLUSION: Results at 5 years indicate that the use of four immediately loaded zygomatic implants is a reliable approach for successful rehabilitation of edentulous patients with severely atrophied maxillae.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Dentadura Completa Superior , Carga Inmediata del Implante Dental , Cigoma/cirugía , Adulto , Anciano , Atrofia , Enfermedades Óseas/etiología , Prótesis Dental de Soporte Implantado/psicología , Fracaso de la Restauración Dental , Dentadura Completa Superior/psicología , Femenino , Fístula/etiología , Estudios de Seguimiento , Humanos , Complicaciones Intraoperatorias , Arcada Edéntula/rehabilitación , Masculino , Maxilar/patología , Sinusitis Maxilar/etiología , Persona de Mediana Edad , Salud Bucal , Órbita/lesiones , Complicaciones Posoperatorias , Estudios Prospectivos , Calidad de Vida , Infección de la Herida Quirúrgica/etiología , Resultado del Tratamiento
8.
Int J Oral Maxillofac Implants ; 30(2): 293-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25830389

RESUMEN

PURPOSE: The reliability of oral rehabilitation by four zygomatic implants with no anterior support remains to be determined. The aim of this systematic review was to assess the predictability of this approach in regard to implant survival, technical and biologic complications, and quality of life. MATERIALS AND METHODS: An electronic literature search was conducted from September 2000 to November 2013. Human clinical trials in which oral rehabilitation was achieved by the use of four zygomatic implants with no additional placement of standard implants were included. The primary outcome was the survival rate of the zygomatic implants. In addition, random effects meta-analyses of the selected studies were applied to avoid potential bias caused by methodologic differences among studies. RESULTS: Zygomatic implant survival rate weighted mean (WM) was 96.7% (range, 95.8% to 99.9%), with a 95% confidence interval (CI) of 92.5% to 98.5%. Only a limited number of surgical complications were reported, with orbital perforation the most significant. Similar results were obtained for prosthetic complications (few occurrences). Additionally, patient satisfaction levels were shown to be high, approaching that of the general population. CONCLUSION: Data from the present systematic review suggest that maxillary rehabilitation by four zygomatic implants with no anterior support is a reliable approach.


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Maxilar/patología , Enfermedades Maxilares/cirugía , Cigoma/cirugía , Atrofia/rehabilitación , Ensayos Clínicos como Asunto , Prótesis Dental de Soporte Implantado/normas , Humanos , Enfermedades Maxilares/rehabilitación , Satisfacción del Paciente , Calidad de Vida , Reproducibilidad de los Resultados
9.
Eur J Oral Implantol ; 6(3): 263-9, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24179980

RESUMEN

PURPOSE: To assess the clinical 3-year outcome of prostheses supported by four immediately loaded zygomatic implants. MATERIALS AND METHODS: A total of 17 consecutively treated patients (7 men, 10 women, mean age 57.7 years) with severe maxillary atrophy were immediately rehabilitated with prostheses supported by four immediately loaded zygomatic implants. The patients were followed up for 3 years and the outcome measures included success rates of the prostheses, success rates of the zygomatic implants, complications and oral-health related quality of life (OHRQoL). RESULTS: No patients dropped out. No prosthesis or zygomatic implants failed, though one implant was not used to support the final prosthesis because it emerged in an unfavourable position. Seven complications occurred: penetration of the orbital cavity during the drilling procedure with no relevant consequences; an infection followed by a fistula at one zygomatic implant, which was resolved with antibiotic treatment and surgical drainage; two patients developed sinusitis, and were successfully treated with antibiotics and meatotomy; fracture of the abutment screw occurred in one patient; and fracture of the prosthesis occurred in two patients and the definitive prostheses were repaired. The average score for the OHIP-14 questionnaire was 2.7, which was similar to that of the general population. CONCLUSIONS: The present 3-year study suggests that prostheses supported by four immediately loaded zygomatic implants can be used for successful rehabilitation of patients with severely atrophic maxillae.


Asunto(s)
Pérdida de Hueso Alveolar/rehabilitación , Implantación Dental Endoósea/métodos , Prótesis Dental de Soporte Implantado , Carga Inmediata del Implante Dental , Cigoma/cirugía , Adulto , Anciano , Pérdida de Hueso Alveolar/cirugía , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar/patología , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Prospectivos , Resultado del Tratamiento
10.
Eur J Oral Implantol ; 6(1): 39-47, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23513201

RESUMEN

PURPOSE: This prospective study was designed to assess the long-term outcome of immediately loaded zygomatic implants placed in atrophic maxillae. MATERIALS AND METHODS: Forty-two consecutively treated patients received 81 zygomatic implants and 140 conventional implants for oral rehabilitation and were followed for 5 years. Complete arch rehabilitation was accomplished in 37 patients and partial arch rehabilitation in 5 (one zygomatic implant in combination with two conventional implants). Outcome measures were prosthetic and implant failures, and complications. RESULTS: Twelve zygomatic and 22 conventional implants in 6 patients were not reviewed as patients were lost to follow-up. One zygomatic implant was removed at the 3-year follow-up visit because of lack of osseointegration and disturbances around the zygomatic region. The success rate of zygomatic implants was 98.5% (68/69). Six conventional implants were lost, with a success rate of 94.9% (112/118). One of the definitive prostheses was changed after 4 years of follow-up. Six complications occurred during the entire follow-up period. CONCLUSIONS: The 5-year prognosis was found to be good for immediately loaded zygomatic implants together with conventional implants in severely resorbed maxillae.


Asunto(s)
Pérdida de Hueso Alveolar/rehabilitación , Implantación Dental Endoósea/métodos , Prótesis Dental de Soporte Implantado , Carga Inmediata del Implante Dental , Cigoma/cirugía , Adulto , Anciano , Implantes Dentales , Diseño de Prótesis Dental , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento
11.
Eur J Oral Implantol ; 3(4): 323-34, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21180685

RESUMEN

PURPOSE: To evaluate the clinical outcome of maxillary prostheses supported by four immediately loaded zygomatic implants after 1 year of function. MATERIALS AND METHODS: Seventeen patients were consecutively included and followed up to 1 year after prosthetic loading. Patients had severely atrophic maxillae (Cawood and Howell classification C-VI and D-V or D-VI) and were rehabilitated using four immediately loaded zygomatic implants, two in each zygoma bone. Outcome measures were success rates of the prostheses, of the zygomatic implants, complications and oral health-related quality of life (OHRQoL). RESULTS: No patients dropped out. No zygomatic implants were lost, although one implant could not be used because it was placed in an unfavourable position. The orbital cavity was penetrated during the drilling procedure in one patient with no relevant clinical consequences. One patient experienced an infection followed by a fistula in one zygomatic implant, which was successfully treated. The average score from the OHIP-14 questionnaire was 3.4, which is similar to that of the general population. CONCLUSIONS: The present study suggests that four immediately loaded zygomatic implants can be used to rehabilitate patients with severely atrophied maxillae.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental/métodos , Cigoma/cirugía , Adulto , Anciano , Atrofia , Prótesis Dental de Soporte Implantado , Dentadura Completa Superior , Femenino , Estudios de Seguimiento , Humanos , Complicaciones Intraoperatorias , Arcada Edéntula/patología , Arcada Edéntula/cirugía , Masculino , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Fístula Oral/etiología , Órbita/lesiones , Estudios Prospectivos , Calidad de Vida , Infección de la Herida Quirúrgica/etiología , Resultado del Tratamiento
12.
Eur J Oral Implantol ; 2(2): 115-24, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-20467610

RESUMEN

AIM: The zygomatic implant represents a non-grafting alternative for the oral rehabilitation of patients with extreme resorption of the maxilla. Nevertheless, there are few studies concerning their long-term prognosis. The purpose of this retrospective study was to evaluate the prosthetic rehabilitation success rate and the survival rates of machined surface zygomatic implants and conventional implants placed using a 2-stage protocol in 21 consecutively treated patients with atrophic maxillae after a 5-year followup period. MATERIALS AND METHODS: A total of 24 consecutively treated patients (8 men, 16 women), with a mean age of 51.4 years (range 36 to 72 years) were included in this study. Rehabilitations were accomplished in 22 edentulous arches, and two partially edentulous arches. In total, 45 zygomatic and 109 conventional implants were inserted. A total of 21 patients had a screw-retained fixed implant-supported prosthesis within 6 months of implant placement and three patients had an implant-supported overdenture. Outcome measures were survival rates of the prosthetic rehabilitations, of the zygomatic and conventional implants, as well as complications. RESULTS: Three patients dropped out, two after 1 year and one after 3 years. Continuous stability of the prostheses was achieved in 20 out of the 21 patients throughout the study. Therefore, the success rate for the prosthetic rehabilitation after 5 years was 95.8%. One overdenture supported on two zygomatic implants was removed after 1 year of function. The patient is currently waiting for the installation of two more zygomatic implants or a grafting procedure. One zygomatic implant was lost giving a survival rate 97.4% after the 5-year follow-up period. A total of 11 conventional implants were lost, resulting in a survival rate of 89.9% after 5 years of follow-up. Sinusitis was observed in five patients throughout the study, which was solved with antibiotics, meatotomy, or Caldwell-Luc antrostomy with no further consequences. CONCLUSIONS: Zygomatic implants together with conventional implants in the atrophic maxillae appear to have an acceptable 5-year clinical outcome.


Asunto(s)
Pérdida de Hueso Alveolar/rehabilitación , Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado , Cigoma/cirugía , Adulto , Anciano , Pérdida de Hueso Alveolar/cirugía , Diseño de Prótesis Dental , Fracaso de la Restauración Dental , Prótesis de Recubrimiento , Dentadura Parcial Fija , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
13.
Eur J Oral Implantol ; 1(1): 53-60, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-20467644

RESUMEN

AIM: There are no published studies regarding sinus reactions to immediately loaded zygomatic implants. The aim of this study was to evaluate the maxillary sinus in a cohort of patients by means of clinical criteria and computerised tomography performed before surgery and after zygomatic implant placement (immediate function protocol). MATERIALS AND METHODS: A total of 36 patients with 71 immediately loaded zygomatic implants were evaluated to find clinical criteria of maxillary sinus disturbance 13 to 42 months (average 21.9 months) after zygoma implant placement. A total of 44 implants had a machined surface and 27 had a porous titanium oxide surface. Twenty-six patients with 52 immediately loaded zygomatic implants were evaluated by means of a CT scan of the paranasal sinuses, 3 to 20 months (average 10.5 months) after zygomatic implant placement. All patients had no sinus symptoms before surgery and had a preoperative CT scan. RESULTS: No clinical signs or symptoms of sinusitis were found. Radiological opacity of the antrum was found in two sinuses (out of 52), and minimal thickening of the Schneiderian membrane was found in 12 patients (out of 26). In eight of them, this was present in the preoperative CT scan. CONCLUSIONS: Sinuses penetrated by zygomatic implants seem to maintain a normal physiology. However, in approximately 15 to 20% of patients, early radiological findings without clinical symptoms were observed.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Seno Maxilar/diagnóstico por imagen , Cigoma/cirugía , Estudios de Cohortes , Pilares Dentales , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Endoscopía , Estudios de Seguimiento , Humanos , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Maxilar/cirugía , Seno Maxilar/fisiopatología , Sinusitis Maxilar/diagnóstico por imagen , Sinusitis Maxilar/fisiopatología , Membrana Mucosa/diagnóstico por imagen , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Enfermedades de los Senos Paranasales/fisiopatología , Tomografía Computarizada por Rayos X
14.
Eur J Oral Implantol ; 9 Suppl 1(2): 141-50, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-20467651

RESUMEN

AIM: Rehabilitation of the edentulous atrophic maxilla by implants to allow placement of a fixed dental prosthesis remains a challenge, especially if immediate function is provided. The aim of this retrospective study was to evaluate the success rate of immediately loaded zygomatic implants placed in atrophic maxillae. MATERIALS AND METHODS: Forty-two consecutively treated patients (19 men and 23 women), with a mean age of 57 years (range: 34 to 79 years) were followed for at least one year (range: 12 to 42 months, mean: 20.5 months). Thirty-seven patients were totally edentulous and five were partially edentulous. In total, 81 zygomatic and 140 conventional implants were inserted. The success criteria for the zygomatic implants were: (1) confirmed individual implant anchorage to the zygomatic bone by means of anteroposterior cranial radiograph; (2) the implant acting as an anchor for the functional prostheses; (3) no suppuration, pain, or ongoing pathological process at maxillary and zygomatic level; (4) confirmed individual implant stability. All patients had a fixed prosthesis screwed onto implants within 48 hours of implant placement. Descriptive statistics were used to analyse the data. RESULTS: After one year, there was no patient drop-out. None of the zygomatic implants were lost over the observation period (100% success rate). Four conventional implants were lost, resulting in a success rate of 97%. All the prostheses were stable. Oroantral fistula and sinusitis was found in one patient, which was solved with antibiotics and meatotomy, with no further complications. Soft tissue swelling and pain at the zygomatic area were found in another patient after 10 days of surgery. This was solved with antibiotics, with no further complications. CONCLUSIONS: Zygomatic implants together with conventional implants in severely resorbed maxillae appear to be a reliable technique for providing immediate function to patients. The time of treatment can be substantially decreased in a predictable way if zygomatic implants are loaded immediately after placement.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Cigoma/cirugía , Adulto , Anciano , Atrofia , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Arcada Parcialmente Edéntula/rehabilitación , Arcada Parcialmente Edéntula/cirugía , Masculino , Maxilar/cirugía , Sinusitis Maxilar/etiología , Persona de Mediana Edad , Fístula Oroantral/etiología , Oseointegración/fisiología , Dolor Postoperatorio/etiología , Estudios Retrospectivos , Infección de la Herida Quirúrgica/etiología , Resultado del Tratamiento
15.
J Prosthet Dent ; 97(6 Suppl): S44-51, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17618933

RESUMEN

STATEMENT OF PROBLEM: Oral rehabilitation of the edentulous atrophic maxilla to allow placement of a fixed dental prosthesis remains a challenge, especially if immediate function is provided. PURPOSE: The aim of this retrospective, preliminary study was to evaluate, after a period of a 6 to 29 months' follow-up of prosthetic loading, the survival rate of 36 immediately loaded zygomatic implants placed in 18 atrophied maxillae. MATERIAL AND METHODS: Eighteen consecutive patients (6 men and 12 women), with an average age of 58 years (range of 44-74 years), were followed up to 29 months (average of 14 months). The clinical criteria included stability of the implants and the prosthesis, resonance frequency analysis (RFA), and evaluation of swelling, pain, or discomfort. Radiographic analysis was completed for conventional implants, but not for zygoma implants. All patients had a fixed prosthesis screwed onto implants within 48 hours after implant placement. Descriptive statistics were used to analyze the data. RESULTS: No zygomatic implants were lost over the observation period. Survival rate was 100% over an average 14-month observation period. Three conventional implants were lost, resulting in a survival rate of 95.6%. All the provisional prostheses were stable, and no relevant complications were noted. CONCLUSIONS: The use of zygoma implants, together with conventional implants, in severely resorbed maxilla, appears to be a reliable technique for providing immediate function to patients.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Dentadura Completa , Cigoma , Femenino , Humanos , Arcada Edéntula/cirugía , Masculino , Maxilar , Persona de Mediana Edad , Complicaciones Posoperatorias , Análisis de Supervivencia
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