Kuabara Marcos Rikio, Ferreira Edilson José, Gulinelli Jéssica Lemos, Paz Luis Guillermo Peredo
Oral and Maxillofacial Surgery, Dental School of Araçatuba, São Paulo State University Júlio de Mesquita Filho, São Paulo, Brazil.
Quintessence Int. 2010 Jan;41(1):9-12.
This article reports the 9-year clinical outcome of the two-stage surgical rehabilitation of a severely atrophic edentulous maxilla with a metal-resin fixed denture supported by implants anchored in the zygomatic bone and the maxilla. After clinical and radiographic examination, zygomatic implants were inserted bilaterally and four standard implants were placed in the anterior region of the maxilla. Six months later, the implants were loaded with a provisional acrylic resin denture, and the definitive implant-supported metal-resin fixed denture was provided 1 year after implant placement. After 9 years of follow-up, no painful symptoms, peri-implant inflammation or infection, implant instability, or bone resorption was observed. In the present case, the rehabilitation of severe maxillary atrophy using the zygomatic bone as a site for implant anchorage provided good long-term functional and esthetic results. Therefore, with proper case selection, correct indication, and knowledge of the surgical technique, the use of zygomatic implants associated with standard implants offers advantages in the rehabilitation of severely resorbed maxillae, especially in areas with inadequate bone quality and volume, without needing an additional bone grafting surgery, thereby shortening or avoiding hospital stay and reducing surgical morbidity.
本文报道了采用金属树脂固定义齿对严重萎缩的无牙上颌骨进行两阶段手术修复的9年临床结果，该义齿由锚固于颧骨和上颌骨的种植体支持。经过临床和影像学检查后，双侧植入颧骨种植体，并在上颌前部植入4枚标准种植体。6个月后，为种植体安装临时丙烯酸树脂义齿，并在种植体植入1年后提供最终的种植体支持式金属树脂固定义齿。经过9年的随访，未观察到疼痛症状、种植体周围炎症或感染、种植体不稳定或骨吸收情况。在本病例中，以颧骨作为种植体锚固部位对严重上颌骨萎缩进行修复，取得了良好的长期功能和美学效果。因此，通过适当的病例选择、正确的适应证判断以及对手术技术的了解，联合使用颧骨种植体和标准种植体在严重吸收的上颌骨修复中具有优势，尤其是在骨质和骨量不足的区域，无需额外的骨移植手术，从而缩短或避免住院时间并降低手术并发症。
