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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.
Int J Oral Maxillofac Implants ; 36(1): 126-130, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600533

RESUMEN

PURPOSE: To present a case series treated by inferior meatal antrostomy as a prophylactic maneuver after the placement of zygomatic implants to decrease the risk of sinusitis. MATERIALS AND METHODS: All patients undergoing zygomatic implant placement using the lower meatal antrostomy protocol between June 2011 and March 2019 at the Department of Oral and Maxillofacial Surgery, Universidad El Bosque, were included. Patients were evaluated after 12 months of the procedure using clinical and radiologic criteria described by Kuriyama and Reiskin. RESULTS: Forty-eight patients were included, in whom 184 implants were placed. Complications were as follows: paresthesia (6.2%), orosinusal fistula (4.1%), skin infection (2.1%), and loss of the implant (1.6%). There were no cases of sinusitis. CONCLUSION: This study provides evidence that the technique is effective and should be considered because of its simplicity. The inferior meatal antrostomy has been proven to be a simple, effective, and reliable technique to decrease the risk of sinusitis associated with the placement of zygomatic implants.


Asunto(s)
Implantes Dentales , Sinusitis Maxilar , Sinusitis , Implantación Dental Endoósea/efectos adversos , Humanos , Seno Maxilar/cirugía , Sinusitis Maxilar/etiología , Sinusitis Maxilar/prevención & control , Sinusitis Maxilar/cirugía , Cigoma/diagnóstico por imagen , Cigoma/cirugía
3.
J Craniomaxillofac Surg ; 49(3): 223-230, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33509673

RESUMEN

BACKGROUND: The aim of this prospective study is to objectively assess 3D soft tissue and bone changes of the malar region by using the malar valgization osteotomy in concomitant association with orthognatic surgery. MATERIALS AND METHODS: From January 2015 to January 2018, 10 patients who underwent single stage bilateral malar valgization osteotomy in conjunction with maxillo-mandibular orthognatic procedures for aesthetic and functional correction were evaluated. Clinical and surgical reports were collected and patient satisfaction was evaluated with a VAS score. For each patient, maxillofacial CT-scans were collected 1 month preoperatively (T0) and 6 months after the operation (T1). DICOM data were imported and elaborated in the software MatLab, which creates a 3D soft tissue model of the face. 3D Bone changes were assessed importing DICOM data into iPlan (BrainLAB 3.0) software and the superimposition process was achieved using autofusion. Descriptive statistical analyses were obtained for soft tissue and bone changes. RESULTS: Considering bone assessment the comparison by superimposition between T0 and T1 showed an increase of the distance between bilateral malar prominence (Pr - Pl) and a slight forward movement (87,65 ± 1,55 to 97,60 ± 5,91); p-value 0.007. All of the patients had improvement of α angle, ranging from 36,30 ± 1,70 to 38,45 ± 0,55, p-value 0,04 (αr) and 36,75 ± 1,58 to 38,45 ± 0,35; p-value 0,04 (αl). The distance S increased from 78,05 ± 2,48 to 84,2 ± 1,20; p-value 0,04 (Sr) and 78,65 ± 2,16 to 82,60 ± 0,90 (Sl); p-value 0,03. Considering the soft tissue, the comparison by superimposition between T0 and T1 showed an antero-lateral movement (p-value 0.008 NVL; p-value 0.001 NVR) of the malar bone projection together with an increase in width measurements (p-value 0,05 VL; p-value 0,01 VR). Angular measurement confirmed the pattern of the bony changes (p-value 0.034 αL; p-value 0,05 αR). CONCLUSION: The malar valgization osteotomy in conjunction with orthognatic surgery is effective in improving zygomatic projection contributing to a balanced facial correction in midface hypoplasia.3D geometrical based volume and surface analysis demonstrate an increase in transversal and forward direction. The osteotomy can be safely performed in conjunction with orthognatic procedures.


Asunto(s)
Estética Dental , Huesos Faciales , Humanos , Osteotomía , Estudios Prospectivos , Cigoma/diagnóstico por imagen , Cigoma/cirugía
4.
Facial Plast Surg ; 36(5): 613-622, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33368084

RESUMEN

Zygoma reduction is indicated in patients where the primary aim of surgery is reduction in the width of cheekbones to achieve smoother and more feminine facial aesthetic lines. Surgeons should evaluate the width of midface (bizygomatic width) and the protrusion of zygoma (volume and position of the zygomatic body) when evaluating patients where such a procedure is indicated. Intraoral high-L osteotomy is the most useful method to successfully treat a wide spectrum of zygomatic protrusions and is widely accepted as the treatment of choice for aesthetic purposes. The amount of ostectomy is determined by evaluating the volume of zygomatic body. The zygomatic body and arch are usually moved posteromedially during surgery; the point of maximal malar projection is evaluated and transposed to a new ideal position. Zygoma reduction can be performed solely or in combination with other facial bone contouring procedures such as mandible reduction, genioplasty, or forehead augmentation. Soft tissue sagging, nonunion, malunion, and paresthesia are the most common complications of this procedure. Undercorrection and asymmetry are the most common aesthetically unfavorable sequelae and should be carefully prevented by proper preoperative planning and meticulous execution of surgical technique.


Asunto(s)
Procedimientos Quirúrgicos Reconstructivos , Cigoma , Estética Dental , Humanos , Mandíbula/cirugía , Osteotomía , Cigoma/diagnóstico por imagen , Cigoma/cirugía
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 845-850, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171557

RESUMEN

Objective: To evalute the accuracy and clinical outcome of a real-time navigation system for the placement of quad zygomatic implants. Methods: Twenty-four patients [9 males and 15 females, mean age was (50.8±14.7) years old], from January 2015 to December 2019, with 96 zygomatic implants placed under a real-time navigation system in Department of Second Dental Center and Department of Oral Implantology of Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were included in the study. The preoperative and the postoperative multislice CT or cone-beam CT were fused to measure and record the entry, exit and angle deviation between the planned and placed implants. The implants were divided into groups according to implant insertion approach (real-time navigation and free-hand), implant length (<47.5 mm and ≥47.5 mm) and implant position (proximal and distal implant). And the differences of implant accuracy were analyzed. The intraoperative and postoperative complications were also recorded. The implant survival rate was evaluated after 6 months follow-up. A P value<0.05 indicates statistical significance. Results: The mean entry, exit and angle deviation of zygomatic implants were (1.49±0.64) mm, [2.03(1.58, 2.40)] mm and (2.49°±1.12°), respectively. The average entry, exit and angle deviation of the navigation guided implant insertion group were (1.45±0.60) mm, (1.96±0.44) mm and (2.66±1.13°) respectively, while those of the free-hand group were (1.50±0.64) mm, (2.04±0.79) mm and (2.50°±1.13°) respectively. There was no significant difference between the two groups (P>0.05). The average entry, exit and angle deviation of the group with length<47.5 mm were (1.42±0.60) mm, (2.13±0.60) mm and (2.61°±1.08°) respectively and those of the group with length ≥ 47.5 mm were (1.52±0.65) mm, (1.98±0.82) mm and (2.43°±1.14°) respectively. No significant difference was found between the two groups (P>0.05). In proximal implant group, the average entry, exit and angle deviation were (1.55±0.69) mm, (2.05±0.92) mm and (2.48°±1.16 °) respectively while those of distal implant group were (1.43±0.57) mm, (2.01±0.57) mm and (2.49°±1.10°), respectively. No significant difference was detected between the two groups (P>0.05). All zygomatic implants were placed uneventfully. There were no intra-operative complications, and post-operative reversible complications developed in 3 patients. Two zygomatic implants were lost and the overall zygomatic implant survival rate was 97.9% (94/96) within a follow-up of 6 months. Conclusions: Quad zygomatic implant placement can be achieved with high accuracy and predictable clinical outcome under guidance of a real-time navigation system.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Cirugía Asistida por Computador , Adulto , Anciano , China , Implantación Dental Endoósea , Femenino , Humanos , Arcada Edéntula/cirugía , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Cigoma/cirugía
6.
Medicine (Baltimore) ; 99(41): e22529, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031295

RESUMEN

BACKGROUND: Reduction malarplasty is a routine clinical procedure among Asian women, but the traditional surgical methods are still associated with serious complications, such as nonunion of the osteotomy sites. Revisional surgery to correct such complications is common, but poor bone healing in the osteotomy area presents a challenge to plastic surgeons. In this report, the authors present a new technique for revision malarplasty that uses the piezosurgery (piezoelectric bone surgery) approach. PATIENT AND DIAGNOSIS: A 30-year-old female patient underwent reduction malarplasty with titanium plate fixation in the zygomatic region at another hospital 4 years ago, but the root of the zygomatic arch was not fixed. The patient was diagnosed with bone nonunion, facial asymmetry, and soft tissue sagging on the right side of the face after malarplasty. INTERVENTION: We used piezosurgery to truncate the displaced healed broken end of the zygomatic bone according to the original osteotomy line. Following this, the malar was re-fixed with micro-titanium mesh, and the zygomatic arch was fixed with a titanium plate. OUTCOME: The patient was followed up for 11 months after the revision procedure. Her facial appearance was satisfactory, and no complications were observed on computed tomography images. LESSONS: This report presents a novel therapeutic option for surgical revision of failed malarplasty. Piezosurgery can help overcome the limitations of traditional surgical methods by reducing bone resorption, preventing resorption of the bone in revision malarplasty, modifying the degree of inward and upward movement of the zygomatic bone by facilitating adjustment of the position of the drill hole in the cortex of the bone stump for stable fixation. Hence piezosurgery can be a simple, accurate, and non-invasive osteotomy method for revision malarplasty.


Asunto(s)
Asimetría Facial/cirugía , Piezocirugía , Complicaciones Posoperatorias/cirugía , Cigoma/cirugía , Adulto , Grupo de Ascendencia Continental Asiática , Placas Óseas , Femenino , Humanos , Osteotomía , Procedimientos Quirúrgicos Reconstructivos , Reoperación
7.
Av. odontoestomatol ; 36(2): 63-70, mayo-ago. 2020. ilus
Artículo en Español | IBECS | ID: ibc-194687

RESUMEN

Se presenta un caso clínico en el que se rehabilita a una paciente con maxilar superior atrófico mediante una combinación de implantes cigomáticos, colocados mediante una aproximación exteriorizada, e implantes anteriores convencionales palatinizados. Se realizó un procedimiento de regeneración ósea guiada alrededor de los implantes cigomáticos para obtener un mayor grosor de la cortical vestibular y palatina alrededor de los implantes del maxilar superior y mejorar el pronóstico. A un año de la carga protésica, el hueso periimplantario se mantiene estable


A clinical case is presented in which a patient with atrophic upper jaw is rehabilitated by a combination of zygomatic implants, placed using an exteriorized approach, and conventional palatalized anterior implants. A guided bone regeneration procedure is performed around the zygomatic implants to obtain a greater thickness of the facial bone and improve the prognosis. One year after loading, the peri-implant bone remains stable


Asunto(s)
Humanos , Femenino , Anciano , Regeneración Ósea , Atrofia/diagnóstico por imagen , Implantes Dentales , Implantación Dental Endoósea/métodos , Arcada Edéntula/cirugía , Cigoma/cirugía , Atrofia/cirugía , Maxilar/anomalías , Maxilar/cirugía , Cigoma/diagnóstico por imagen
9.
Int J Oral Maxillofac Implants ; 35(4): 750-756, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32724927

RESUMEN

PURPOSE: The aim of this study was to evaluate 141 zygomatic implants for the reconstruction of severely atrophic maxillae. MATERIALS AND METHODS: In this retrospective case series study, zygomatic implants were placed under general anesthesia. Inclusion criteria were as follows: ASA I or ASA II, age older than 18 years, inadequate bone for restoration with conventional implants, alternative augmentation procedures considered either inappropriate or contraindicated, absence of a medical condition related to implant failure, and providing written consent. Zygomatic implants used in the study consisted of three different brands: NobelZygoma, Southern Implants System, and Implantswiss. RESULTS: The study included 45 patients, in whom 141 zygomatic implants were placed. The mean age of the patients was 51.76 (range: 23 to 72) years. Three patients were rehabilitated with removable prostheses, 19 patients with fixed prostheses, and 23 patients with hybrid prostheses. The overall complication rate was 5.67% (two zygomatic implants developed infection [1.4%], one zygomatic implant developed peri-implantitis [0.7%], three zygomatic implants developed sinusitis [2.1%], and two zygomatic implants showed unsuccessful prosthetic rehabilitation [1.4%]). The follow-up period ranged from 6 to 36 months. CONCLUSION: Clinical complications of zygomatic implants are acceptable, and their survival rates are similar to those of endosteal implants. Zygomatic implants can contribute to prosthetic rehabilitation.


Asunto(s)
Implantes Dentales , Arcada Edéntula/cirugía , Adulto , Anciano , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Maxilar/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven , Cigoma/cirugía
11.
12.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e541-e548, jul. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-196508

RESUMEN

BACKGROUND: Oral rehabilitation of atrophic maxillae features high complexity, for which there are several therapeutic modalities reported on scientific literature. Zygomatic implant placement is a viable option that features low morbidity and allows immediate prosthetic loading. The purpose of the present study was to determine the methodological quality of systematic reviews that assessed the effectiveness of zygomatic implants placed in atrophic maxillae. MATERIAL AND METHODS: Searches were conducted on Medline via Pubmed, LILACS, Dare Cochrane, Scopus, and Sigle via Open Grey up to June 2019. RESULTS: Seven systematic reviews were eligible for Overview and comprised a total of 2313 patients, 4812 zygomatic implants, and a 96,72% success rate. Common surgical complications, in decreasing order, were: maxillary sinusitis, peri-implant mucositis, prosthetic fracture, and infections. Methodological quality was assessed using the AMSTAR 2 tool, which revealed that six systematic reviews showed critically low methodological quality and one review was assessed as of low methodological quality. CONCLUSIONS: Zygomatic implants seem to be an adequate option for atrophic maxilla rehabilitation, however, new studies with a higher methodological rigor are needed to provide more reliable results to professionals and patients undergoing this modality of oral rehabilitation


No disponible


Asunto(s)
Humanos , Revisiones Sistemáticas como Asunto , Implantación Dental Endoósea/métodos , Cigoma/cirugía , Enfermedades Maxilares/cirugía , Resultado del Tratamiento
14.
J Oral Maxillofac Surg ; 78(9): 1518-1528, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32598868

RESUMEN

PURPOSE: Zygomatic implants present a unique treatment option for patients with severe resorption of the maxilla; however, palatally positioned zygomatic implant platforms will result in a significant buccopalatal cantilever, speech disturbances, and unhygienic prosthesis contours. The purpose of the present study was to introduce a novel preoperative workflow to help attain predictable surgical and prosthetic outcomes with zygomatic implants. METHODS: To minimize prosthetic complications, an appropriate preoperative workup is imperative. A restoratively driven approach commonly used in traditional intra-alveolar implant dentistry has been adapted for zygomatic implant rehabilitation and described in the present report. RESULTS: With zygomatic implants, applying a prosthetically driven approach is possible. However, it involves a unique application of traditional biomechanical and soft tissue principles of implant dentistry and digital integration of the prosthetic and surgical treatment plans. CONCLUSIONS: Striving to attain zygomatic implant platforms as close as possible to the central fossae and cingulum of prosthetic teeth should be the goal when placing zygomatic implants. The restoratively aimed zygomatic implant routine introduced in the present report is a progressive and modern approach to prosthetically driven implant rehabilitation.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Maxilar/cirugía , Flujo de Trabajo , Cigoma/cirugía
15.
J Craniofac Surg ; 31(5): 1488-1491, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32541268

RESUMEN

INTRODUCTION: Autologous reconstruction of segmental craniomaxillofacial bone defects is limited by insufficient graft material, donor site morbidity, and need for microsurgery. Reconstruction is challenging due to the complex three-dimensional (3D) structure of craniofacial skeleton. Customized 3D-printed patient-specific biologic scaffolds hold promise for reconstruction of the craniofacial skeleton without donor site morbidity. The authors report a porcine craniofacial defect model suitable for further evaluation of custom 3D-printed engineered bone scaffolds. METHODS: The authors created a 6 cm critical load-bearing defect in the left mandibular angle and a 1.5 cm noncritical, nonload bearing defect in the contralateral right zygomatic arch in 4 Yucatan minipigs. Defects were plated with patient-specific titanium hardware based on preoperative CT scans. Serial CT imaging was done immediately postoperatively, and at 3 and 6 months. Animals were clinically assessed for masticatory function, ambulation, and growth. At the 6-month study endpoint, animals were euthanized, and bony regeneration was evaluated through histological staining and micro-CT scanning compared to contralateral controls. RESULTS: All 4 animals reached study endpoint. Two mandibular plates fractured, but did not preclude study completion due to loss of masticatory function. One zygoma plate loosened while the site of another underwent heterotopic ossification. Gross examination of site defects revealed heterotopic ossification, confirmed by histological and micro-CT evaluation. Biomechanical testing was unavailable due to insufficient bony repair. CONCLUSIONS: The presented porcine zygoma and mandibular defect models are incapable of repair in the absence of bone scaffolds. Based on the authors' results, this model is appropriate for further study of custom 3D-printed engineered bone scaffolds.


Asunto(s)
Enfermedades Mandibulares/diagnóstico por imagen , Impresión Tridimensional , Cigoma/diagnóstico por imagen , Animales , Regeneración Ósea , Enfermedades Mandibulares/cirugía , Modelos Teóricos , Porcinos , Andamios del Tejido , Microtomografía por Rayos X , Cigoma/cirugía
16.
Int J Oral Maxillofac Surg ; 49(12): 1605-1610, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32381374

RESUMEN

The aim of this study was to introduce a new computer-guided technique for contouring and shaving of craniofacial fibrous dysplasia involving the zygoma. Computer-guided contouring was performed for five patients with unilateral craniofacial fibrous dysplasia involving the zygoma, using a patient-specific surgical depth guide. This patient-specific guide with depth holes was virtually designed for each patient based on mirroring of the unaffected side. The guide was printed using rapid prototyping. In the surgical theatre, the guide was seated in place and implant drills were inserted through the guide holes, creating depth holes according to the preoperative planning. Bone removal was then continued using surgical burs and/or bone chisels, connecting the guiding depth holes. Satisfaction with facial aesthetics was evaluated by the patients using a Likert scale, and by the surgeons using the Whitaker rating scale. All patients were satisfied with the postoperative facial aesthetics. Four patients were rated category I on the Whitaker rating scale, and one patient as category II. In conclusion, this patient-specific surgical depth guide appears to offer a solution for the unpredictability of conventional bone removal in unilateral craniofacial fibrous dysplasia, especially in three-dimensional multiplanar areas such as the zygoma. Further investigations are required.


Asunto(s)
Displasia Fibrosa Craneofacial , Implantes Dentales , Cirugía Asistida por Computador , Estética Dental , Huesos Faciales , Humanos , Imagenología Tridimensional , Tomografía Computarizada por Rayos X , Cigoma/diagnóstico por imagen , Cigoma/cirugía
17.
J Craniofac Surg ; 31(4): 1142-1145, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32371718

RESUMEN

Untreated zygomaticomaxillary complex fractures may lead to aesthetical and functional sequelae needing secondary surgical correction. A 31-year-old male was addressed to our department for right enophthalmos and loss of cheek projection 3 months after facial trauma. Restauration of facial symmetry can be achieved by repositioning of the zygomaticomaxillary complex by osteotomies. To achieve good functional and aesthetical results, the reduction needs to be accurate. This is the main difficulty in delayed cases as there are less anatomical landmarks due to initial trauma and bone remodeling. Nowadays, in France, thanks to good care access, very few patients are not treated within the first two weeks after trauma; thus, surgeons have little experience on secondary reduction. It has been reported that navigation-guided surgery and use of stereolithographic models improve results. In small centers, access to both technologies and induced over-cost may limit their use. With the ease to access a 3D printer, small centers have to develop innovative, simple ways to offer comparative results. In the case presented, surgery planning and plate modeling were achieved using an office-based three-dimensional printed model. To reduce the cost, free open source software has been used. In this case, facial symmetry has been restored and post-operative computed tomography scan shows good stability. This simple, cost effective technique, is applicable in most centers equipped with a 3D printer and ensures a good and reproductive result even when this surgery is not routinely done.


Asunto(s)
Fracturas Óseas/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Osteotomía , Cigoma/diagnóstico por imagen , Adulto , Fracturas Óseas/cirugía , Humanos , Imagenología Tridimensional , Masculino , Maxilar/cirugía , Impresión Tridimensional , Procedimientos Quirúrgicos Reconstructivos , Tomografía Computarizada por Rayos X , Cigoma/cirugía
18.
J Oral Maxillofac Surg ; 78(8): 1328-1333, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32461065

RESUMEN

Zygomatic implants (ZIs) are used to support dental prostheses in patients with inadequate maxillary bone volume. Although the ZI success rates have been high, cases of inadvertent orbital entry during zygoma drilling have been reported, with varying severity of clinical sequelae. We report the second case treated at our institution of inadvertent orbital entry during zygoma drilling. The patient experienced partial lateral rectus muscle transection resulting in diplopia, and ultimately underwent strabismus surgery. Postoperatively, his diplopia resolved, and only a small angle esophoria persisted. A review of the literature revealed 3 other cases of extraocular muscle injury secondary to orbital entry during zygoma drilling, all of which required strabismus surgery to restore alignment. We propose placement of a metal shoehorn in the inferior fornix during zygoma drilling to protect the globe and intraorbital structures from injury in the event of orbital entry.


Asunto(s)
Implantes Dentales , Músculos Oculomotores , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Humanos , Maxilar/cirugía , Resultado del Tratamiento , Cigoma/cirugía
19.
J Prosthodont ; 29(5): 369-373, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32304120

RESUMEN

Late cluster implant failures can be one of the most devasting outcomes of implant therapy for patients. It can have anatomic, functional, psychological and financial consequences for patients, and sometimes the loss of residual bone can preclude subsequent implant placement. Fortunately, management of cluster implant failures in the maxilla can be mitigated by using implant anchorage from remote sites like zygomatic and pterygoid regions. Few reports exist in the literature that have described the management of cluster implant failure using extra-maxillary implants such as zygomatic and pterygoid implants. This case report describes the management of a female patient with bruxism who experienced late cluster implant failure in the maxilla after 9 years of function with an overdenture. Due to the loss of residual bone, subsequent implant therapy involved the use of bilateral zygomatic, pterygoid and anterior maxillary implants, which were immediately loaded and thereafter used to support a complete arch fixed implant-supported zirconia prosthesis.


Asunto(s)
Implantes Dentales , Maxilar/cirugía , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Femenino , Humanos , Cigoma/cirugía
20.
Clin Implant Dent Relat Res ; 22(3): 415-423, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32291961

RESUMEN

BACKGROUND: Zygomatic implant surgery is considered as a safe and successful alternative to the conventional implant surgery with bone grafts for patients with severe atrophic maxilla. PURPOSE: The aim of this retrospective clinical case series was to report clinical outcome of zygomatic implants with a follow-up between 6 months and 7 years. MATERIALS AND METHODS: A total of 110 patients with 302 zygomatic implants were included in this study. The intra and postoperative complications and survival rate of zygomatic implants were evaluated. RESULTS: The study included 110 consecutively treated patients with an age range of 21 to 76 years (mean 57.35 years, SD 10.42). The overall zygomatic implant survival rate was 98.34%. There were five implant failures in four patients. One intraoperative and 17 postoperative complications developed in 18 patients. There were no dropouts and the median follow-up of the patients was 41.75 months (with a range of 6-89 months). CONCLUSIONS: According to the results, in cases of severely atrophic posterior maxilla, zygomatic implant surgery can be considered as an effective and safe alternative to conventional implants and bone grafting procedures.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Adulto , Anciano , Atrofia , Implantación Dental Endoósea , Estudios de Seguimiento , Humanos , Maxilar/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven , Cigoma/cirugía
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