Abstract
Purpose: To present a case series of zygomatic implants combined with bone regeneration and soft tissue enhancement techniques to reduce the risk of biological delayed complications such as maxillary sinusitis and soft tissue recession. Materials and methods: Zygomatic implants placed simultaneously with different bone regeneration techniques (buccal, palatal and buccal-palatal bone regeneration) and soft tissue enhancement techniques (pediculate and free connective tissue graft) were followed for at least 12 months. The following information was collected: patient age and sex, number of zygomatic implants, zygomatic implant success rate, zygomatic implant position according to classification of the Zygomatic Anatomy Guide Approach (ZAGA), sinus membrane perforation, type and outcome of the bone regeneration or the soft tissue enhancement technique, bone gain (width and length along the zygomatic implant) and keratinized buccal mucosa width, duration of follow-up, loading protocol (immediate or delayed) and biological complications (maxillary sinusitis and soft tissue recession). Results: Thirty-one zygomatic implants placed in 19 patients were included. All implants were successful and none of the implants presented biological complications. The bone regeneration technique was successful in 30 of 31 cases with a mean palatal bone width of 3 mm, buccal bone width of 2.65 mm, palatal bone length of 6.5 mm and buccal bone length of 8.3 mm. The success rate of soft tissue enhancement was 100% and it established at least 2 mm of keratinized buccal mucosa width in all implants. Conclusions: Within the limitations of the present study, bone regeneration and soft tissue enhancement techniques were useful to establish more favorable conditions of the peri-implant tissues around zygomatic implants. This could prevent biological complications such as maxillary sinusitis and soft tissue recessions. Prospective and randomized controlled clinical trials with longer follow-up periods are advisable.
Highlights
The original zygomatic implant placement technique was described by Branemark with a 97% of success rate in 81 treated patients [1]
The present study describes a retrospective case series of zygomatic implants combined with simultaneous bone regeneration and soft tissue enhancement techniques to reduce the risk of biological complications such as maxillary sinusitis and soft tissue recession
Biocare T.H, Sweden) and 18 Smooth IPX-Tilted System ® zygomatic implants
Summary
The original zygomatic implant placement technique was described by Branemark with a 97% of success rate in 81 treated patients [1]. The classical protocol introduced the placement of conventional implants in the maxillary anterior region in combination with posterior zygomatic implants through a palatal entrance and extensive sinus opening [1,2,3,4,5]. This method was proposed for the rehabilitation of atrophic maxillae (grade V and VI of Cawood–Howell classification [6]) without the use of Materials 2020, 13, 1577; doi:10.3390/ma13071577 www.mdpi.com/journal/materials. The classical intrasinus position was associated with a maxillary sinus infection rate of
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