Zygoma implant

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Zygoma implants (or zygomatic implants) are different from conventional dental implants in that they anchor in to the zygomatic bone (cheek bone) rather than the maxilla (upper jaw). They may be used when maxillary bone quality or quantity is inadequate for the placement of regular dental implants. [1] Inadequate maxillary bone volume may be due to bone resorption as well as to pneumatization of the maxillary sinus or to a combination of both. [2] The minimal bone height for a standard implant placement in the posterior region of the upper jaw should be about 10 mm to ensure acceptable implant survival. [3] When there is inadequate bone available, bone grafting procedures and sinus lift procedures may be carried out to increase the volume of bone. Bone grafting procedures in the jaws have the disadvantage of prolonged treatment time, restriction of denture wear, morbidity of the donor surgical site and graft rejection. [4]

Zygoma implants were first introduced in late 1990s by Dr. Per Ingvar Brånemark, widely acknowledged as the "Father of Dental Implantology". Zygomatic implants have been used for dental rehabilitation in patients with insufficient bone in the posterior upper jaw, due to, for example, aging, tumor resection, trauma, or atrophy. Zygoma implants take the anchorage from the zygoma/zygomatic bone (cheek bone). The zygomatic bone is denser in quality and more cortical in nature than posterior maxillary bone. [5] Because of the sturdy anchorage achievable in the dense bone of the zygomatic region, and the wide stress distribution achieved on these tilted implants, a prosthesis can often be immediately placed at the time of surgery. [6] The zygoma implant is available in lengths ranging from 30 to 52.5 mm. The head of the zygoma implant is engineered to allow prosthesis attachment at a 45-degree angle to the long axis of the implant. [7] Zygomatic implants can be used in patients who do not have any teeth in the upper jaw, patients who have heavily broken down teeth or very mobile teeth due to diseases such as generalised aggressive periodontitis. [8] The success rate of zygomatic implants reported in the literature world-wide is 97–98%. [9] Complications associated with these implants are sinusitis, paresthesia in the cheek region and oroantral fistula. [10]

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Osseointegration is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. A more recent definition defines osseointegration as "functional ankylosis ", where new bone is laid down directly on the implant surface and the implant exhibits mechanical stability. Osseointegration has enhanced the science of medical bone and joint replacement techniques as well as dental implants and improving prosthetics for amputees.

<span class="mw-page-title-main">Orthognathic surgery</span> Surgery of the jaw

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<span class="mw-page-title-main">Maxillary sinus</span> Largest of the paranasal sinuses, and drains into the middle meatus of the nose

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<span class="mw-page-title-main">Palatal expansion</span> Orthodontics device to widen the upper jaw

A palatal expander is a device in the field of orthodontics which is used to widen the upper jaw (maxilla) so that the bottom and upper teeth will fit together better. This is a common orthodontic procedure. The use of an expander is most common in children and adolescents 8–18 years of age. It can also be used in adults, although expansion is more uncomfortable and takes longer in adults. A patient who would rather not wait several months for the end result achieved by a palatal expander may be able to opt for a surgical separation of the maxilla. Use of a palatal expander is most often followed by braces to then straighten the teeth.

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<span class="mw-page-title-main">Tomas Albrektsson</span> Swedish physician

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<span class="mw-page-title-main">Alveolar cleft grafting</span> Surgical procedure

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References

  1. ↑ Aparicio, Carlos Ed (2012). Zygomatic Implants: The Anatomy-guided Approach (illustrated ed.). Quintessence, 2012. pp. 268 pages. ISBN   9781850972259.
  2. ↑ Malevez, Chantal; Daelemans, Philippe; Adriaenssens, Philippe; Durdu, Françoise (2003-10-01). "Use of zygomatic implants to deal with resorbed posterior maxillae". Periodontology 2000. 33 (1): 82–89. doi: 10.1046/j.0906-6713.2002.03307.x . ISSN   1600-0757. PMID   12950843.
  3. ↑ ten Bruggenkate, Chris M.; van den Bergh, Johan P. A. (1998-06-01). "Maxillary sinus floor elevation: a valuable pre-prosthetic procedure". Periodontology 2000. 17 (1): 176–182. doi:10.1111/j.1600-0757.1998.tb00133.x. ISSN   1600-0757. PMID   10337323.
  4. ↑ Davo, Ruben; Malevez, Chantal; Rojas, Juliana (2007). "Immediate function in the atrophic maxilla using zygoma implants: A preliminary study". The Journal of Prosthetic Dentistry. 97 (6): S44–S51. doi:10.1016/s0022-3913(07)60007-9. PMID   17618933.
  5. ↑ Kato, Yorihisa; Kizu, Yasuhiro; Tonogi, Morio (2005). "Internal Structure of Zygomatic Bone Related to Zygomatic Fixture". J Oral Maxillofac Surg. 63 (9): 1325–1329. doi:10.1016/j.joms.2005.05.313. PMID   16122597.
  6. ↑ Maló, Paulo; Araujo Nobre, Miguel de; Lopes, Isabel (2008). "A new approach to rehabilitate the severely atrophic maxilla using extramaxillary anchored implants in immediate function: A pilot study". The Journal of Prosthetic Dentistry. 100 (5): 354–356. doi:10.1016/s0022-3913(08)60237-1. PMID   18992569.
  7. ↑ Kreissl, Marion; Heydecke, Guido; Metzger, Marc C; Schoen, Ralf (2007). "Zygoma implant-supported prosthetic rehabilitation after partial maxillectomy using surgical navigation: A clinical report" (PDF). The Journal of Prosthetic Dentistry. 97 (3): 121–8. doi:10.1016/j.prosdent.2007.01.009. PMID   17394908.
  8. ↑ Rajan, Gunaseelan; Baig, Mirza Rustum; Nesan, John; Subramanian, Jayaram (2010). "Fixed rehabilitation of patient with aggressive periodontitis using zygoma implants". Indian J Dent Res. 21.
  9. ↑ Kahnberg, Karl-Erik; Henry, Patric J.; Hirsch, Jan-Mikael; Öhrnell, Lars-Olov; Andreasson, Lars; Brånemark, Per-Ingvar (2007). "Clinical Evaluation of the Zygoma Implant: 3-Year Follow-Up at 16 Clinics". J Oral Maxillofac Surg. 65 (10): 2033–2038. doi:10.1016/j.joms.2007.05.013. PMID   17884535.
  10. ↑ Davó, Rubén; Malevez, Chantal; López-Orellana, Cristóbal; Pastor-Beviá, Francisco; Rojas, Juliana (2008). "Sinus reactions to immediately loaded zygoma implants: a clinical and radiological study". Eur J Oral Implantol. 1 (1): 53–60. PMID   20467644.
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