Abstract
Background: Zygomatic implants have been proposed alone or in combination with premaxillary conventional implants for severe resorbed maxillary atrophy rehabilitation. The aim of the present investigation was to evaluate through a qualitative systematic review and meta-analysis the survival rate of zygomatic implants in conjunction with regular fixtures for maxillary rehabilitation. Methods: The article screening was conducted on the PubMed/Medline and EMBASE electronic databases according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines. The scientific papers were included for qualitative analysis and risk-of-bias evaluation. Only the papers that included rehabilitation with zygomatic implants in combination with regular implants were considered for the meta-analysis comparative evaluation of the implant survival rate. Results: The paper search screened a total of 137 papers. After the initial screening, a total of 32 articles were considered for the qualitative analysis. There was a similar implant survival rate between zygomatic and premaxilla regular implants (p = 0.02; Z: 2.26). Conclusions: Zygomatic and conventional implants showed a high long-term survival rate for fixed maxillary rehabilitations, but few included studies reported the marginal bone loss after loading. Further studies are necessary to evaluate the pattern of marginal bone loss between zygomatic and conventional implants after long-term functional loading.
Highlights
The rehabilitation of severely atrophic maxilla represents a complex treatment due to functional and aesthetic alteration related to tooth loss and extreme bone ridge resorption [1,2,3]
The present investigation aimed to evaluate through a qualitative analysis the effectiveness and survival rate of regular vs. zygomatic implants for combined fixed maxillary rehabilitation in the literature through a meta-analysis
A significantly higher survival rate of zygomatic implants vs. regular maxillary implant was present, while included papers showed a wide heterogeneity of study design, surgical protocols with or without bone graft and regeneration procedures and implant geometries
Summary
The rehabilitation of severely atrophic maxilla represents a complex treatment due to functional and aesthetic alteration related to tooth loss and extreme bone ridge resorption [1,2,3]. The loss of masticatory and phonetic efficiency could produce important implications for social relationships and quality of life [4,5]. The positioning of implants to rehabilitate partial or total edentulous ridges represents a validated long-term treatment option, while the availability of adequate bone volume and density could determine a possible clinical limitation for implant fixation and loading [6,7,8,9,10,11]. The atrophies of the maxilla have been classified from Cawood–Howell Class I to Class VI [2]:
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