Abstract
PurposeSeveral authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis.Patients and methodsThe patient presented with a subtotal bilateral maxillectomy and total rhinectomy defect because of a squamous cell carcinoma of the nose. No reconstructive surgery was performed because of the high risk of recurrence; moreover, the patient refused any secondary procedure. After surgery, the patient presented a wide palatal defect associated to the absence of the nasal pyramid. Zygoma-retained prostheses are well documented, and they offer good anchorage in rehabilitating wide defects after oncological surgery and a good chance for patients to improve their quality of life. We hereby describe two prosthetic devices rehabilitating two iatrogenic defects by means of a single intraoral implant-supported bar extending throughout the oronasal communication, thus offering nasal epithesis anchorage.ResultsAt 1-year follow-up after functional prosthetic loading, no implant failure has been reported. Clinical and radiological follow-up showed no sign of nasal infection or peri-implantitis. The patient reported a sensitive improvement of his quality of life.ConclusionsSimultaneous oral and nasal rehabilitation of complex oronasal defects with zygoma-implant-supported dental prosthesis and nasal epithesis represents a reliable surgical technique. According to this clinical report, the above-mentioned technique seems to be a valuable treatment option as it is safe, reliable and easy to handle for both surgeon and patient.
Highlights
The use of zygoma implants in the rehabilitation of patients who underwent surgical resection for oral cancer has been widely described [1,2,3]
In case of wide midfacial resections with oronasal communication, zygoma implants may be used through the communication to support an extraoral nasal prosthesis
This article describes the rehabilitation of two defects, one intraoral and one extraoral, resulting from a single surgical act. Both intra- and extraoral prosthetic rehabilitation are supported by four zygoma implants positioned in the resected maxilla in order to create an artificial nose and a prosthetic denture
Summary
The use of zygoma implants in the rehabilitation of patients who underwent surgical resection for oral cancer has been widely described [1,2,3]. While dealing with facial defects, it is mandatory to consider that this kind of defect has a big impact on the patient’s quality of life [6, 7] For this reason, medical science made a strong effort in developing rehabilitation solutions that enable operated patients to re-achieve a normal life as soon as possible. This article describes the rehabilitation of two defects, one intraoral and one extraoral, resulting from a single surgical act. Both intra- and extraoral prosthetic rehabilitation are supported by four zygoma implants positioned in the resected maxilla in order to create an artificial nose and a prosthetic denture
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