Rehabilitation of severe atrophic maxilla using zygomatic implants. Case report

Abstract

Introduction. Although zygomatic implants represent an effective and predictable solution for the rehabilitation of edentulous patients with severe atrophy of the upper jaw, it is also accompanied by a series of difficulties, such as surgical access and intraoperative ergonomics, the presence of important anatomical structures with increased risk of injury with subsequent complications, etc. Extensive analysis of anatomical conditions and careful preoperative planning is required to optimize and obtain predictable results, thus increasing the indications of the given method. Case presentation. In this case report a 54-year-old male patient was treated in the dental clinic SRL“OMNI DENT” between January and February 2022. The patient had the following complaints: lacking teeth, mastication, phonation and aesthetic disorders. After thorough clinical and paraclinical examination (OPG, CBCT), the diagnosis was established: severe atrophy of the upper jaw class C-h (Misch) in the anterior area and SA-3 and SA-4 (Misch) in the posterior areas. All treatment options were then discussed and evaluated together with the patient. The first option was to perform several bone grafting procedures and delayed implant placement using standard protocol. The second option included immediate rehabilitation through alternative implantation according to the "Quad Zygoma" protocol. The patient excluded the first method, as being more traumatic, long-lasting and with an unpredictable result, thus opting for the alternative method, which offers the possibility of immediate rehabilitation, with a reduced trauma and prediction. Discussion. The method used allowed us to reduce the total number of surgeries and to reduce the patient's rehabilitation time. The number of implants was also significantly reduced, reducing the number of retentive areas, facilitating the hygienic maintenance of the prosthetic construction. Another considerable advantage is the possibility to immediately benefit from a proper aesthetic and functional result without additional trauma. Conclusion. The use of zygomatic implants in conditions of severe atrophy has proven to be an effective solution with predictable results.