Rehabilitation Of Atrophic Maxilla Research Articles

Quality assessment of systematic reviews regarding the effectiveness of zygomatic implants: an overview of systematic reviews.

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. Key words:Zygomatic Implants, dental Implants, complications, oral rehabilitation.

Zygomatic and Conventional Implants for Management of Severe Alveolar Atrophy in Partial Edentulous Maxilla and Completely Edentulous Mandible

The geriatric population, atrophic maxilla is a common condition.1.Severely resorbed maxilla is challenging for the installation of conventional osseointegrated implants. 2. To reduce the complications associated with bone grafting procedures and to simplify the rehabilitation of atrophicmaxilla, zygomatic implants play an essential role. 3. With the use of zygomatic implants the wait for osseous graft maturation is eliminated saving the treatment time and money.4.In this case report,nasal floor lift for anterior implants was performed with placement of bilateral zygomatic implants and conventional implants.

Extra-short implants in the prosthetic rehabilitation of the posterior maxilla.

To compare clinical outcomes of 'extra-short' and regular bone level implants in the posterior maxilla for 12 months after loading. Twenty-three systemically healthy, non-smoking patients received 30 extra-short, 24 regular bone level implants. Acrylic stents were fabricated for each patient for correct implant positioning. Implant lengths were 4-6mm in the test, 8/10mm in the control group. Radiographic evaluation was performed at baseline, 6, and 12 months after loading. Crestal bone level (CBL), CBL change (CBLC), true crown length (TCL), implant/crown ratio (ICR) and residual bone height (RBH) below maxillary sinus floor were calculated digitally. Data were tested statistically. Residual bone height was significantly lower, and TCL and ICR were higher in the test than the control group (P<0.0001). CBL measurements at baseline were 0.19±0.18mm and 0.31±0.37mm and at 12 months, 0.24±0.24mm and 0.41±0.31mm, respectively in the test and control groups. CBL values at 12 months were significantly lower in the test than the control group (P<0.05). CBLCs were similar at all times (P>0.05). No correlation was found between the CBLC and implant/prosthetic parameters. Extra-short and regular implants might provide similar clinical outcomes in prosthetic rehabilitation of atrophic maxilla, during 12 months follow-up.

Rehabilitation of atrophic maxilla with tilted implants - Case report

Abstract Purpose: An 81-year-old male patient, without systemic disorders, came to the appointment referring lack of masticatory function. It was planned a rehabilitation with six implants in upper atrophic maxilla (Implant Direct – Swish Plus), including immediate placing of 4 implants and 2 posterior tilted implants due to the severe pneumatization of maxillary sinus and bone ridge resorption. The prosthetic phase was initiated 4 months after implants surgery. Case report: The placement of tilted implants with the objective of the necessity of bone grafts and increase bone support has been reported by several authors as a viable rehabilitation. And since it is a minimally invasive surgery, it has good acceptance by the patient. The placement of tilted implants is a viable surgical alternative in anatomic regions such as: the anterior or posterior wall of the maxillary sinus, the palatal curvature or the pterygoid process. This treatment option, allied to the use of longer implants, allows an improved primary stability favoring immediate loading. Also, allows the adequate distribution of the implants, resulting in a more uniform distribution of forces and avoids the necessity of cantilever. Some authors have been questioning the biomechanical qualities of this surgical option; however, there are no statistical differences when compared with implants conventionally placed. ​Conclusions: Tilted implants allow an implant-supported rehabilitation of atrophic maxilla without bone grafts, which decreases the waiting period, the patient’s morbidity and the costs of the treatment.

Implant Treatment in Atrophic Maxilla by Titanium Hybrid-Plates: A Finite Element Study to Evaluate the Biomechanical Behavior of Plates

A severely atrophied maxilla presents serious limitations for rehabilitation with osseointegrated implants. This study evaluated the biomechanical and long-term behavior of titanium hybrid-plates in atrophic maxilla rehabilitation with finite elements and probabilistic methodology. A three-dimensional finite element model based on a real clinical case was built to simulate an entirely edentulous maxilla with four plates. Each plate was deformed to become accustomed to the maxilla’s curvature. An axial force of 100 N was applied in the area where the prosthesis was adjusted in each plate. The von Mises stresses were obtained on the plates and principal stresses on maxilla. The difference in stress between the right and left HENGG-1 plates was 3%, while between the two HENGG-2 plates it was 2%, where HENGG means Highly Efficient No Graft Gear. A mean maximum value of 80 MPa in the plates’ region was obtained, which is a lower value than bone resorption stress. A probability cumulative function was computed. Mean fatigue life was 1,819,235 cycles. According to the results of this study, it was possible to conclude that this technique based on titanium hybrid-plates can be considered a viable alternative for atrophic maxilla rehabilitation, although more studies are necessary to corroborate the clinical results.

PD057: Extra short implants in the prosthetic rehabilitation of atrophic maxilla: a prospective randomized clinical study

PD057: Extra short implants in the prosthetic rehabilitation of atrophic maxilla: a prospective randomized clinical study

Use of Quadruple Zygoma Implants Technique for Atrophic Maxilla Rehabilitation with Immediate Loading - A Clinical Case Report

The maxilla with great atrophy can be due to various factors such as tumor resection, generalized aggressive periodontitis, genetic disorders or syndromes. The rehabilitation of patients with an atrophic edentulous maxilla presents a significant challenge for surgeons, and the treatment concept with zygomatic implants have evolved as an alternative for bone augmentation procedures.

Use of Zygomatic Implants for Atrophic Maxilla Rehabilitation - A Clinical Case Report of Unilateral Zygomatic Implant

Traditionally the atrophic maxilla has been treated with autologous bone grafts, alloplastic grafts, and techniques such as sinus lift. Now a day the use of zygomatic implant allows us to make a prosthetic rehabilitation of the atrophic maxilla without bone grafts need and the possibility of immediate loading protheses to patients.

Split crest: immediate expansion rim technique for rehabilitation of atrophic maxilla. A case report.

While the deploy planning, we come across morphological changes in the intervention area and the bone volume, which is extremely important for the treatment outcome. The objective of this study is to describe the technique Split-Crest through a clinical case in which success was obtained. Demonstrate indications and advantages of the technique in order to gain a significant increase in bone density to achieve an excellent aesthetic and functional result. Female patient, leucoderma, 46 years old, attended the Dental Clinic of Specialization in Implantodontics of ESAMAZ, with report of early teeth loss and poorly adapted prosthesis in the upper anterior region of the pre jaw. During the clinical evaluation was observed Edentulism in the anterior arch of the jaw. Total tomographic filming was done on the jaws, the initial diagnosis was a severe resorption present in the premaxilla requiring regenerative process to achieve bone gain. During surgery the patient had immediate installation of previous implants in the region of the elements 12 and 22 through the technique of “Slplit-Crest”, which consisted of two vertical cuts on the vestibular cortical portion and longitudinal osteotomy followed by the the shift vestibular cortical-spongy plate. Eight weeks later, the patient had clinically significant bone gain, proving the viability and success of the technique. A minimally invasive surgical procedure with well executed manipulation of tissue grafts and accelerates the clinical outcome, the working hours by the end of the treatment is smaller, has lower morbidity and lower operating costs.

Three-year clinical prospective follow-up of extrasinus zygomatic implants for the rehabilitation of the atrophic maxilla.

Placement of extrasinus zygomatic implants to support implant-supported rehabilitation is still controversial due to the scarcity of data. To evaluate the clinical outcomes of 94 extrasinus zygomatic implants, installed laterally to the maxillary sinus, for rehabilitation of the edentulous atrophic maxillae. A total of 42 patients (mean age 58 years) with severely atrophic maxillae were treated between November 2010 and July 2011, and followed up until July 2014. A total of 273 implants (94 zygomatic implants and 179 conventional implants) were used. The patients were followed in a standardized clinical and radiographic method. During the 3-year study period, 1 zygomatic implant and 4 conventional implants failed, resulting in a survival rate of 98.9% and 97.7% respectively. All restorations with titanium-welded bars were installed either 3 days after surgery (immediate loading) or 6 months after surgery (delayed loading), and were successful until the last follow-up appointment, except for minor technical problems. No patient presented any type of sinus adverse event. No other significant occurrences were reported. This 3-year clinical follow-up study indicates that extrasinus zygomatic implants represent predictable treatment option atrophic maxillae. Further longitudinal prospective clinical studies are necessary to confirm these results.

Rehabilitation of atrophic maxilla by means of Le Fort I osteotomy, zygomatic implants and immediate loading: a report of three cases

Background: The rehabilitation of atrophic maxilla is a challenge for maxillofacial surgeons. Bone grafts, short implants zygomatic fixtures, has show good results, however on maxillary atrophy associated with hypoplasia, anterior cant lever can lead the rehabilitation to mechanical failure. Objective: The aim of this paper is to report the surgical protocol adopted to the correction of edentulous atrophic and hypoplastic maxilla. Methods: Three patients (one male and two females) with sagittal maxillary deficiency and class V (Cawwod and Howell) alveolar atrophy were selected. The patients were rehabilitated by means of Le Fort I osteotomy associated with zygomatic implants and immediate loading. All patients were able to receive fixed prosthesis 3 days after the surgery. Results: All implants remain healthy and in function. One prosthesis required maintenance on the abutments screws six months after surgery, after that no other problem occurred. Conclusion: Maxillary reposition by Le Fort I osteotomy associated with zygomatic implants can be an alternative to bone grafts on rehabilitation of atrophic maxilla with maxillomandibular disrepancy.

Masticatory muscle activity evaluation by electromyography in subjects with zygomatic implants.

BackgroundZygomatic implants are an alternative treatment in the rehabilitation of atrophic maxilla to promote stability in the stomatognathic system. The aim of this study was to compare the electromyographic (EMG) activity of masseter and temporalis muscles in controls and in individuals with complete implant-supported dentures anchored in the zygomatic bone.Material and MethodsFifty-four volunteers of both genders (mean age 52.5 years) were selected and distributed into two groups: Individuals with zygomatic implant (ZIG; n=27) and fully dentate patients (CG; n=27). MyoSystem-BR1 was used to assess masseter and temporalis muscles EMG activity in different mandibular movements: protrusion, clenching, maximal voluntary contraction (MVC) with Parafilm M®, right and left laterality and chewing (peanuts and raisins). Data was processed, normalized (MVC) and analyzed using the SPSS 21.0. Student t-test (P ≤ 0.05) was used for group comparison.ResultsThe results were statistically significant (P ≤ 0.05) for protrusion, clenching, right and left laterality and raisin chewing. For the mandibular posture conditions, the ZIG obtained higher EMG activity patterns when compared to CG. For the masticatory performance during chewing of peanuts and raisins, the ZIG showed higher EMG mean values when compared to CG.ConclusionsThe zygomatic implant promoted an active response of the muscle fibers (hyperactivity) during both mandibular posture and chewing conditions, probably due to the absence of periodontal receptors, which play a significant role for preparing a bolus for swallowing. Key words:Zygomatic implant, electromyography, masseter muscle, temporal muscle.

Influence of the prosthetic arm length (palatal position) of zygomatic implants upon patient satisfaction

BackgroundTo assess the influence of the prosthetic arm length (palatal position) of zygomatic implants upon patient comfort and stability, speech, functionality and overall satisfaction.Material and MethodsA retrospective clinical study was made of patients subjected to rehabilitation of atrophic maxilla with complete maxillary implant-supported fixed prostheses involving a minimum of two zygomatic implants (one on each side) in conjunction with premaxillary implants, and with 12 months of follow-up after implant loading. Subjects used a VAS to score general satisfaction, comfort and stability, speech and functionality, and the results were analyzed in relation to the prosthetic arm length of the zygomatic implants 12 months after prosthetic delivery.ResultsTwenty-two patients participated in the study, receiving 22 prostheses anchored on 148 implants (44 were zygomatic and 94 were conventional implants). The mean right and left prosthetic arm length was 5.9±2.4 mm and 6.1±2.7 mm, respectively, with no statistically significant differences between them (p=0.576). The mean scores referred to comfort/retention, speech, functionality and overall satisfaction were high - no correlation being found between prosthetic arm length and patient satisfaction (p=0.815).ConclusionsNo relationship could be identified between prosthetic arm length (palatal position) and patient satisfaction. Key words:Zygomatic implants, patient satisfaction, zygomatic prosthesis, prosthetic arm length.

Predictability of short implants ( < 10 mm) as a treatment option for the rehabilitation of atrophic maxillae. A systematic review.

BackgroundShort implants (< 10 mm) are one of the treatment options available in cases of limited vertical bone. A purpose of this paper is to evaluate the predictability of short implants as an alternative to technically molthough such implants are now widely used, there is controversy regarding their clinical reliability. There complex treatments in patients with atrophic maxillae, based on a systematic review of the literature and the analysis of the implant survival rates, changes in peri-implant bone level, and associated complications. It is postulated that short implants offer clinical results similar to those of longer implants.Material and MethodsA Medline-PubMed search was made covering the period between January 2004 and December 2014 (both included). Studies in English published in indexed journals, involving at least 20 implants and with a follow-up period of at least 12 months were considered. A manual search in four high impact journals was also conducted.ResultsA total of 37 studies meeting the inclusion criteria were included in this review. 9792 implants placed in over 5000 patients were analyzed.ConclusionsBased on the results of this review, short implants are seen to offer clinical results in terms of survival, bone loss and complications similar to those of longer implants. Key words:Survival rate, clinical results, dental implants, oral implants, short implants, short lengt

Bilateral sinus floor augmentation using 100% alloplastic biomaterial for later rehabilitation of atrophic maxilla. A 5-year tomographic follow-up

Bilateral sinus floor augmentation using 100% alloplastic biomaterial for later rehabilitation of atrophic maxilla. A 5-year tomographic follow-up

Nasal floor elevation in the rehabilitation of atrophic maxilla with dental implants

Nasal floor elevation in the rehabilitation of atrophic maxilla with dental implants

Rehabilitation of atrophic maxilla without a reconstructive approach. A case report

Rehabilitation of atrophic maxilla without a reconstructive approach. A case report

Short implants: A new dimension in rehabilitation of atrophic maxilla and mandible

Insufficient alveolar bone height is a common clinical situation encountered more in the posterior jaws. Advanced surgical procedures such as bone grafting, sinus lifting, and nerve repositioning are required to overcome this condition and make implant treatment possible for such patients. Prolonged healing period, increased morbidity, and longer duration of the implant treatment accompanies these procedures. Short implants are considered as a viable alternative in patients with reduced alveolar bone height to avoid more invasive surgical procedures. They simplify the implant treatment, reduce patient morbidity, shorten the duration of treatment, and make it less expensive. In the past, when machined implants were used, rehabilitation with short implants showed increased failure rate in comparison to longer implants. With the improvements in the surface topography of implants, which increase the bone implant contact, and use of adapted surgical protocols similar survival rates as that of regular implants have been reported even with short implants. Various methods to increase the functional surface area and decrease the stress on the prosthesis have greatly contributed to the increased success rate of short implants. Clinical Relevance to Interdisciplinary Dentistry Successful outcome of implant treatment depends on the coordinated efforts of various specialties Proper technique of implant placement by the surgeon and prior planning of the prosthesis by the prosthodontist is essential Maintenance and periodic evaluation of periodontal health are necessary.

Rehabilitation of atrophic maxilla with a hollow maxillary complete denture: A case report

Residual ridge resorption is the reduction in size of the bony ridge under the mucoperiosteum. The rate of resorption is more in mandibular arch as compared to the maxillary arch; but severely atrophic maxillae with large inter-ridge distance often pose a clinical challenge during fabrication of complete denture due to decreased support, retention and stability. This clinical report describes successful rehabilitation of a completely edentulous patient with atrophic ridges using hollow maxillary complete denture.

Evaluation of beta tricalcium phosphate mixed with platelet rich fibrin for rehabilitation of atrophic maxilla with implant installation

Restoration of severely atrophic edentulous posterior maxilla with implant installation could be impossible unless, augmentation of that area was done. This study was made to evaluate augmentation of atrophic maxillary bone using beta tri-calcium phosphate (B-TCP) granules mixed with platelet-rich fibrin (PRF) for sinus lift and then implant installation 4 months latter.