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Immediate Loading in Atrophic Jaws: Zygomatic Implants

  • Miguel Peñarrocha-Diago
  • Javier Aizcorbe-Vicente
  • Alberto Fernández-Ruiz
  • Reginaldo Mario Migliorança
  • Blanca Serra-Pastor
  • David Peñarrocha-OltraEmail author
Chapter

Abstract

The zygomatic fixture is an extended length (35–55 mm) titanium implant, placed into the zygomatic and maxillary alveolar bone. It was designed for situations where atrophy of the posterior maxilla complicates or prevents the placing of conventional implants. The use of zygomatic implants avoids the need for bone grafting, shortens treatment times, and reduces morbidity. They have also been used in patients with maxillectomies resulting from tumors or diseases associated with atrophic conditions of the maxilla.

We elaborated a review for this chapter summarizing the implant survival rates of zygomatic implants immediately loaded. Of a total of 1040 patients treated with zygomatic (2179 implants) and regular implants (3117 implants), an implant survival rate of 95.12–100% and 94.9–100% is expected, respectively, up to 10 years. For patients treated with the all-on-four zygoma or quad zygoma concept, 80 patients treated with 360 zygomatic implants, an implant survival rate of 96–100% is expected up to 5 years. The most frequent mechanical complication is the fracture of the prosthesis or the veneering material. Because the original protocol to insert zygomatic implants needs an intrasinusal approach, sinus complications are reported frequently in the literature associated with this procedure. In our review, of 764 patients, 63 (8.24%) suffered sinus complications.

Five different surgical techniques have been described in the literature for zygomatic implant placement: the classical approach or Brånemark approach, the sinus slot technique, the exteriorized approach, the minimally invasive approach by the use of custom-made drill guides, and the computer-aided surgical navigation system approach. In this chapter we are going to resume the first three, because these are still the most common approaches for the surgical placement of zygomatic implants.

Keywords

Zygomatic implants Immediate loading Implant survival Surgical technique Complications Full-arch 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Miguel Peñarrocha-Diago
    • 1
  • Javier Aizcorbe-Vicente
    • 1
  • Alberto Fernández-Ruiz
    • 2
  • Reginaldo Mario Migliorança
    • 3
  • Blanca Serra-Pastor
    • 4
  • David Peñarrocha-Oltra
    • 1
    Email author
  1. 1.Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and DentistryUniversity of ValenciaValenciaSpain
  2. 2.Private Clinical PracticeClínica FernándezIbizaSpain
  3. 3.Department of ImplantologySao Leopoldo Mandic Institute and Research CenterCampinasBrazil
  4. 4.Prosthodontics and Occlusion Unit, Department of Stomatology, Faculty of Medicine and DentistryUniversity of ValenciaValenciaSpain

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