Private Practitioner, Department of Oral Rehabilitation, Istituto Stomatologico Italiano, Milan, Italy.
Private Practice, Private Practitioner, Modena, Italy.
J Oral Maxillofac Surg. 2021 Feb;79(2):356-365. doi: 10.1016/j.joms.2020.10.003. Epub 2020 Oct 13.
The use of zygomatic implants is an alternative to major grafting procedures for the treatment of the atrophic posterior maxilla. However, only few studies reported solid and correct data about the use of extrasinus zygomatic implants. Starting from these considerations, this study aims to investigate the 1-year survival and success rates of extrasinus zygomatic implants immediately loaded in patients with severe atrophy of the posterior maxilla.
Twenty-three consecutive patients fully edentoulus or with failing dentition in the upper arch and with a severe atrophy of the posterior maxilla were enrolled. All patients underwent prosthodontic rehabilitation with the application of implants in both anterior maxilla areas and zygomatic bone. All the zygomatic implants were inserted with an extrasinus path. Primary outcomes were prosthesis and implant failures. Secondary outcomes were complications, bleeding scores, probing pocket depths, and peri-implant marginal bone-level changes. A total of 98 implants were inserted.
During the 1-year follow-up, no implant failure was reported as well as no pain and/or no sinusitis were detected. No other significant events were reported, except for minor soft tissue and technical problems. A maxillary sinus membrane rupture occurred during the surgical phase in 4 (17.4%) patients, but healing was not compromised. Peri-implant mucositis was observed in 2 (8.7%) patients. Twelve months after surgery, average bone loss around conventional implants was 1.11 ± 0.23 mm. In addition, no peri-implant radiolucency was observed around zygomatic implants. Within the limits of this study, preliminary short-term data (1-year after loading) suggested that extrasinus zygomatic implants represent a predictable treatment option for the atrophic maxilla. Further follow-up data (≥5 years) are needed to confirm these results.
The present study supports the conclusion that extrasinus zygomatic implants for the immediate rehabilitation of the atrophic maxilla have high success rate with minimal or no complications.
颧骨种植体的使用是治疗后牙区萎缩性上颌骨的一种替代方法，无需进行大型移植手术。然而，只有少数研究报告了关于鼻窦外颧骨种植体使用的可靠数据。基于这些考虑，本研究旨在调查严重上颌后牙区萎缩患者即刻负重鼻窦外颧骨种植体的 1 年存活率和成功率。
共纳入 23 例完全无牙或上颌牙列缺失伴严重上颌后牙区萎缩的连续患者。所有患者均行种植体修复，在前上颌区和颧骨处应用种植体。所有颧骨种植体均采用鼻窦外途径植入。主要结局为修复体和种植体失败。次要结局为并发症、出血评分、探诊袋深度和种植体边缘骨水平变化。共植入 98 枚种植体。
在 1 年的随访期间，未报告种植体失败，也未发现疼痛和/或鼻窦炎。除了轻微的软组织和技术问题外，未报告其他重大事件。4 例（17.4%）患者在手术阶段发生上颌窦膜破裂，但愈合未受影响。2 例（8.7%）患者出现种植体周围黏膜炎。术后 12 个月，常规种植体周围平均骨丢失量为 1.11±0.23mm。此外，未观察到颧骨种植体周围有种植体周围放射性透亮区。在本研究的范围内，初步短期（负荷后 1 年）数据表明，鼻窦外颧骨种植体是治疗萎缩上颌骨的一种可预测的治疗选择。需要进一步的随访数据（≥5 年）来证实这些结果。
本研究支持以下结论：鼻窦外颧骨种植体即刻修复萎缩上颌骨具有较高的成功率，并发症少或无。
