Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Surgical Protocol
2.3. Prosthetic Protocol
2.4. Outcome Measures
2.5. Statistical Analysis
3. Results
3.1. Patient and Implant Baseline Characteristics
3.2. Clinical Follow-up and Outcome Measures
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
- Esposito, M.; Worthington, H.V. Interventions for replacing missing teeth: Dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla. Cochrane Database Syst. Rev. 2013, CD004151. [Google Scholar] [CrossRef] [PubMed]
- Davo, R. Sinus reactions to zygomatic implants. In Zygomatic Implants: The Anatomy Guided Approach; Aparicio, C., Ed.; Quintessence Publishing Co., Inc.: Berlin, Germany, 2012; pp. 59–76. [Google Scholar]
- Chrcanovic, B.R.; Albrektsson, T.; Wennerberg, A. Survival and Complications of Zygomatic Implants: An Updated Systematic Review. J. Oral Maxillofac. Surg. 2016, 74, 1949–1964. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Al-Nawas, B.; Wegener, J.; Bender, C.; Wagner, W. Critical soft tissue parameters of the zygomatic implant. J. Clin. Periodontol. 2004, 31, 497–500. [Google Scholar] [CrossRef] [PubMed]
- Brunski, J.B. Biomechanical aspects of tilted regular and zygomatic implants. In Zygomatic Implants: The Anatomy Guided Approach; Aparicio, C., Ed.; Quintessence Publishing Co., Inc.: Berlin, Germany, 2012; pp. 25–45. [Google Scholar]
- Davo, R.; Malevez, C.; Rojas, J. Immediate function in the atrophic maxilla using zygoma implants: A preliminary study. J. Prosthet. Dent. 2007, 97, S44–S51. [Google Scholar] [CrossRef]
- Khoury, F.; Happe, A. Soft tissue management in oral implantology: A review of surgical techniques for shaping an esthetic and functional peri-implant soft tissue structure. Quintessence Int. 2000, 31, 483–499. [Google Scholar]
- Agliardi, E.; Romeo, D.; Panigatti, S.; Nobre, M.D.A.; Maló, P.; Mal?, P. Immediate full-arch rehabilitation of the severely atrophic maxilla supported by zygomatic implants: A prospective clinical study with minimum follow-up of 6 years. Int. J. Oral Maxillofac. Surg. 2017, 46, 1592–1599. [Google Scholar] [CrossRef]
- Lombardo, G.; D’Agostino, A.; Trevisiol, L.; Romanelli, M.G.; Mascellaro, A.; Gomez-Lira, M.; Pardo, A.; Favero, V.; Nocini, P.F. Clinical, microbiologic and radiologic assessment of soft and hard tissues surrounding zygomatic implants: A retrospective study. Oral Surgery, Oral Med. Oral Pathol. Oral Radiol. 2016, 122, 537–546. [Google Scholar] [CrossRef]
- Angle, E. Classification of malocclusion. Dental Cosmos 1899, 41, 248–264. [Google Scholar]
- Physical Status Classification System. Available online: https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system (accessed on 22 October 2019).
- Lekholm, U.; Zarb, G.A. Patient Selection and Preparation. In Tissue-Integrated Prosthesis. Osseointegration in Clinical Dentistry, Branemark; Branemark, P.I., Zarb, G.A., Albrektsson, T., Eds.; Quintessence Publishing Co., Inc.: Chicago, IL, USA; London, UK; Berlin, Germany; Rio de Janeiro, Brazil; Tokyo, Japan, 1985; Volume 1, pp. 199–208. [Google Scholar]
- Brånemark, P.-I.; Gröndahl, K.; Ohrnell, L.-O.; Nilsson, P.; Petruson, B.; Svensson, B.; Engstrand, P.; Nannmark, U. Zygoma fixture in the management of advanced atrophy of the maxilla: Technique and long-term results. Scand. J. Plast. Reconstr. Surg. Hand Surg. 2004, 38, 70–85. [Google Scholar] [CrossRef]
- Aparicio, C. The zygoma anatomy-guided approach (ZAGA). In Zygomatic Implants: The Anatomy Guided Approach; Aparicio, C., Ed.; Quintessence Publishing Co., Inc.: Berlin, Germany, 2012; pp. 113–135. [Google Scholar]
- Mombelli, A.; Oosten, M.A.C.; Schürch, E.; Lang, N.P. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol. Immunol. 1987, 2, 145–151. [Google Scholar] [CrossRef] [PubMed]
- Tuminelli, F.J.; Walter, L.R.; Neugarten, J.; Bedrossian, E. Immediate loading of zygomatic implants: A systematic review of implant survival, prosthesis survival and potential complications. Eur. J. Oral Implantol. 2017, 10, 79–87. [Google Scholar]
- Aboul-Hosn Centenero, S.; Lazaro, A.; Giralt-Hernando, M.; Hernandez-Alfaro, F. Zygoma Quad Compared With 2 Zygomatic Implants: A Systematic Review and Meta-analysis. Implant. Dent. 2018. [Google Scholar] [CrossRef]
- Aparicio, C.; Manresa, C.; Francisco, K.; Claros, P.; Alandez, J.; Gonzalez-Martin, O.; Albrektsson, T. Zygomatic implants: Indications, techniques and outcomes, and the zygomatic success code. Periodontology 2000 2014, 66, 41–58. [Google Scholar] [CrossRef] [PubMed]
- Davó, R.; Malevez, C.; Pons, O. Immediately loaded zygomatic implants: A 5-year prospective study. Eur. J. oral Implant. 2013, 6, 39–47. [Google Scholar]
- Malo, P.; de Araujo Nobre, M.; Lopes, A.; Ferro, A.; Moss, S. Extramaxillary Surgical Technique: Clinical Outcome of 352 Patients Rehabilitated with 747 Zygomatic Implants with a Follow-Up between 6 Months and 7 Years. Clin. Implant. Dent. Related Res. 2015, 17, e153–e162. [Google Scholar] [CrossRef] [PubMed]
- Chow, J.; Wat, P.; Hui, E.; Lee, P.; Li, W. A new method to eliminate the risk of maxillary sinusitis with zygomatic implants. Int. J. Oral Maxillofac. Implants 2010, 25, 1233–1240. [Google Scholar] [PubMed]
- Bedrossian, E. Rehabilitation of the Edentulous Maxilla with the Zygoma Concept: A 7-year Prospective Study. Int. J. Oral Maxillofac Implants 2010, 25, 1213–1221. [Google Scholar] [PubMed]
- Periodontal Disease Fact Sheet. Available online: https://www.perio.org/newsroom/periodontal-disease-fact-sheet (accessed on 8 January 2020).
- Dreyer, H.; Grischke, J.; Tiede, C.; Eberhard, J.; Schweitzer, A.; Toikkanen, S.E.; Glöckner, S.; Krause, G.; Stiesch, M. Epidemiology and risk factors of peri-implantitis: A systematic review. J. Periodontal Res. 2018, 53, 657–681. [Google Scholar] [CrossRef] [PubMed]
- Lin, G.-H.; Wang, H.-L. Periodontitis and the Presence of Adjacent Teeth may be Associated With a Higher Incidence of Early Implant Failure. J. Évid. Based Dent. Pr. 2018, 18, 168–170. [Google Scholar] [CrossRef] [PubMed]
- Rajan, G.; Natarajarathinam, G.; Kumar, S.; Parthasarathy, H. Full mouth rehabilitation with zygomatic implants in patients with generalized aggressive periodontitis: 2 year follow-up of two cases. J. Indian Soc. Periodontol. 2014, 18, 107–111. [Google Scholar] [CrossRef] [PubMed]
- Rodríguez-Chessa, J.G.; Olate, S.; Netto, H.D.; Shibli, J.; De Moraes, M.; Mazzonetto, R. Treatment of atrophic maxilla with zygomatic implants in 29 consecutives patients. Int. J. Clin. Exp. Med. 2014, 7, 426–430. [Google Scholar] [PubMed]
- Becktor, J.P.; Isaksson, S.; Abrahamsson, P.; Sennerby, L. Evaluation of 31 zygomatic implants and 74 regular dental implants used in 16 patients for prosthetic reconstruction of the atrophic maxilla with cross-arch fixed bridges. Clin. Implant. Dent. Relat. Res. 2005, 7, 159–165. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Characteristics | n (%) | n Evaluated | |
---|---|---|---|
Patients | 82 | ||
Gender | Female | 53 (64.6%) | 82 |
Male | 29 (35.4%) | ||
Oral hygiene status | Excellent | 1 (1.2%) | 82 |
Good | 15 (18.3%) | ||
Acceptable | 36 (43.9%) | ||
Poor | 30 (36.6%) | ||
Smoking status | Yes | 16 (19.5%) | 82 |
No | 66 (80.5%) | ||
Patient physical status | ASAI | 48 (71.6%) | 67 |
ASAII | 18 (26.9%) | ||
ASAIII, | 1 (1.5%) | ||
ASAIV, V, VI | 0 | ||
Health history | Diabetes | 0 | 82 |
Cancer | 0 | ||
Rheumatoid arthritis | 2 (2.4%) | ||
Bisphosphonate therapy | Yes (over 1 year) | 1 (1.2%) | 82 |
No | 81 (98.8%) | ||
Pathologic occlusion | Yes | 9 (13.4%) | 67 |
No | 58 (86.6%) | ||
History of periodontitis | No | 43 (53.8%) | 80 |
Yes, treated | 29 (36.3%) | ||
Yes, not treated | 8 (10.0%) | ||
History of sinusitis | No | 70 (87.5%) | 80 |
Yes, treated | 9 (11.3%) | ||
Yes, not treated | 1 (1.3%) | ||
Indication | Failing dentition | 13 (15.9%) | 82 |
Partially edentulous | 18 (22.0%) | ||
Fully edentulous | 51 (62.2%) | ||
Implants/implant sites | 182 | ||
Position | Central incisor | 3 (1.6%) | 182 |
Lateral incisor | 23 (12.6%) | ||
Canine | 8 (4.4%) | ||
1st premolar | 4 (2.2%) | ||
2nd premolar | 80 (44.0%) | ||
1st molar | 63 (34.6%) | ||
2nd molar | 1 (0.5%) | ||
Implant length (in mm) | 30.0 | 2 (1.1%) | 182 |
32.5 | 8 (4.4%) | ||
35.0 | 31 (17.0%) | ||
37.5 | 7 (3.8%) | ||
40.0 | 29 (15.9%) | ||
42.5 | 40 (22.0%) | ||
45.0 | 31 (17.0%) | ||
47.5 | 13 (7.1%) | ||
50.0 | 10 (5.5%) | ||
52.5 | 11 (6.0%) | ||
Bone quality | Soft | 19 (10.4%) | 182 |
Medium | 129 (70.9%) | ||
Hard | 34 (18.7%) | ||
Bone grafting prior to implant surgery | Yes | 0 | 182 |
No | 182 (100%) | ||
Bone grafting at implant surgery | Yes | 0 | 84 |
No | 84 (100%) | ||
Soft tissue grafting at implants surgery | Yes | 39 (21.4%) | 182 |
No | 143 (78.6%) | ||
Loading protocol | Immediate | 167 (93.8%) | 178 |
Early | 9 (5.1%) | ||
Delayed | 2 (1.1%) |
Nr | Gender | Indication | Oral Hygiene | Smoking | History of Sinusitis | History of Perio-Dontitis | Bone Quality | Soft Tissue Grafting during Implant Surgery | Insertion Torque | Placement Technique Body & Collar | Position of Implant Head | Loading Protocol | Provi-Sional Prosthesis |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Complication: post-operative sinusitis | |||||||||||||
1 | male | failing dentition | good | no | yes, treated | no | medium | no | 40 | extrasinus | vestibular | immediate | yes |
2 | medium | no | 40 | extrasinus | vestibular | ||||||||
3 | male | fully edentulous | acceptable | no | no | no | medium | no | 40 | extrasinus | vestibular | immediate | yes |
4 | medium | no | 35 | maxillary wall | vestibular | ||||||||
5 | medium | no | 40 | maxillary wall | vestibular | ||||||||
6 | male | fully edentulous | acceptable | no | yes, treated | no | medium | no | 40 | extrasinus | vestibular | immediate | yes |
7 | medium | no | 40 | extrasinus | vestibular | ||||||||
8 | medium | no | 40 | extrasinus | vestibular | ||||||||
9 | medium | no | 40 | extrasinus | vestibular | ||||||||
10 | female | fully edentulous | good | yes | no | yes, not treated | medium | no | 50 | extrasinus | vestibular | immediate | yes |
11 | female | failing dentition | good | no | yes, treated | yes, treated | hard | yes | not reported | intrasinus | palatal | immediate | yes |
12 | medium | yes | 45 | maxillary wall | on ridge | ||||||||
Complication: hyperplasia around zygomatic implant | |||||||||||||
1 | male | fully edentulous | poor | yes | no | yes, treated | hard | yes | 40 | maxillary wall | on ridge | immediate | yes |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Davó, R.; Bankauskas, S.; Laurincikas, R.; Koçyigit, I.D.; Mate Sanchez de Val, J.E. Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study. J. Clin. Med. 2020, 9, 480. https://doi.org/10.3390/jcm9020480
Davó R, Bankauskas S, Laurincikas R, Koçyigit ID, Mate Sanchez de Val JE. Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study. Journal of Clinical Medicine. 2020; 9(2):480. https://doi.org/10.3390/jcm9020480
Chicago/Turabian StyleDavó, Ruben, Simonas Bankauskas, Remigijus Laurincikas, Ismail Doruk Koçyigit, and José Eduardo Mate Sanchez de Val. 2020. "Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study" Journal of Clinical Medicine 9, no. 2: 480. https://doi.org/10.3390/jcm9020480
APA StyleDavó, R., Bankauskas, S., Laurincikas, R., Koçyigit, I. D., & Mate Sanchez de Val, J. E. (2020). Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study. Journal of Clinical Medicine, 9(2), 480. https://doi.org/10.3390/jcm9020480