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academic article

Michael Alterman, DMDa,b,*, Yoram Fleissig, MD, DMDa,b, Nardy Casap, MD, DMDa,b

Zygomatic implants were first introduced by Br°anemark1 in 1988 as an alternative treatment for patients with extensive defects of the maxilla caused by tumor resections, trauma, and congenital defects. Later, uses for these implants were expanded to other indications, including rehabilitation of completely edentulous patients with severe maxillary atrophy, excessive maxillary sinus pneumatization, and in cases of failed maxillary sinus augmentation procedures.2,3 The zygomatic implants are anchored in the zygomatic basal bone, and usually there is no need for additional bone augmentation or grafting in these patients.4 Different surgical approaches and implant placement techniques and configurations have been proposed, with the reported success rate ranging between 95.8% and 99.9%, all aiming for full-arch maxillary rehabilitation.
  • The armamentarium for zygomatic implants includes zygoma retractors, specific drills, and burrs, depth gauge, inserting hand tools, prosthetic tools, and multiple angulated abutments from 0 to 60.
  • When a guided system is used, the armamentarium also includes surgical guides, guiding drilling sleeves, and fixing pins and screws.
  • The surgical approach is dictated by the maxillary bone volume availability and the prosthetic demands upon which the implant layout is chosen.
  • The extra maxillary approach is prosthetically derived. The emergence profile is located at the alveolar crest and the prosthetic work is easy and intuitive.

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