Abstract
In this chapter, two main treatment options for severely edentulous atrophic posterior maxillae—bone augmentation procedure and zygomatic implant application—are presented. Poor bone quality and insufficient bone volume due to critical jawbone atrophy in the posterior maxillae are addressed as the main factors contribute to the failure of dental implant system. The rationales behind the introduction of each treatment option are discussed and compared for a better understanding. As this text placed an emphasis on the use of zygomatic implants, a high focus is given to this section covering the specification of zygomatic implants, advantages and disadvantages, indications and contraindications of treatment, types of surgical approach for the implant placement and survival rate of implants. This chapter provides sufficient information on the treatment of patient with severely atrophic posterior maxillae specifically via the use of nongrafting procedure, zygomatic implant. The application of zygomatic implant is gaining popularity over conventional bone augmentation procedure as a treatment modality.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Meyer U, Vollmer D, Runte C, Bourauel C, Joos U (2001) Bone loading pattern around implants in average and atrophic edentulous maxillae: a finite-element analysis. J Cranio Maxill Surg 29(2):100–105
Huang HL, Hsu JT, Fuh LJ, Tu MG, Ko CC, Shen YW (2008) Bone stress and interfacial sliding analysis of implant designs on an immediately loaded maxillary implant: a non-linear finite element study. J Dent 36(6):409–417
Baggi L, Cappelloni I, Maceri F, Vairo G (2008) Stress-based performance evaluation of osseointegrated dental implants by finite-element simulation. Simul Modell Pract Theory 16(8):971–987
Baggi L, Cappelloni I, Di Girolamo M, Maceri F, Vairo G (2008) The influence of implant diameter and length on stress distribution of osseointegrated implants related to crestal bone geometry: A three-dimensional finite element analysis. J Prosthet Dent 100(6):422–431
Li T, Kong L, Wang Y, Hu K, Song L, Liu B, Li D, Shao J, Ding Y (2009) Selection of optimal dental implant diameter and length in type IV bone: a three-dimensional finite element analysis. Int J Oral Maxillofac Surg 38(10):1077–1083
Devlin H, Horner K, Ledgerton D (1998) A comparison of maxillary and mandibular bone mineral densities. J Prosthet Dent 79(3):323–327
Seong WJ, Kim UK, Swift JQ, Hodges JS, Ko CC (2009) Correlations between physical properties of jawbone and dental implant initial stability. J Prosthet Dent 101(5):306–318
Rohlig BG (2004) The use of angulated implants in the maxillary tuberosity region. Dissertation. University of Marburg, Istanbul
Nomoto S, Matsunaga S, Ide Y, Abe S, Takahashi T, Saito F, Sato T (2006) Stress distribution in maxillary alveolar ridge according to finite element analysis using micro-CT. Bull Tokyo Dent Coll 47(4):149–156
Danza M, Zollino I, Paracchini L, Riccardo G, Fanali S, Carinci F (2009) 3D finite element analysis to detect stress distribution: spiral family implants. J Maxillofac Oral Surg 8(4):334–339
Sevimay M, Turhan F, Kiliçarslan MA, Eskitascioglu G (2005) Three-dimensional finite element analysis of the effect of different bone quality on stress distribution in an implant-supported crown. J Prosthet Dent 93(3):227–234
Lekholm U, Zarb GA (1985) Tissue-integrated prostheses. In: Branemark PI, Zarb GA, Albrektsson T. Tissue-integrated prosthese. Quintessence, Chicago
Aparicio C, Branemark PI, Keller EE, Olive J (1993) Reconstruction of the premaxila with autogenous iliac bone in combination with osseointegrated. Int J Oral Maxillofac Implants 8:61–67
Weischer T, Schettler D, Mohr C (1997) Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants 12:211–214
Uchida Y, Goto M, Katsuki T, Akiyoshi T (2001) Measurement of the maxilla and zygoma as an aid in installing zygomatic implant. J Oral Maxillofac Surg 59:1193–1198
Miyamoto S, Ujigawa K, Kizu Y, Tonogi M, Yamane GY (2010) Biomechanical three-dimensional finite-element analysis of maxillary prostheses with implants. Design of number and position of implants for maxillary prostheses after hemimaxillectomy. Int J Oral Maxillofac Surg 39(11):1120–1126
Nkenke E, Hahn M, Lell M, Wiltfang J, Schultze Mosgau S, Stech B et al (2003) Anatomic site evaluation of the zygomatic bone for dental implant placement. Clin Oral Impl Res 14:72–79
Kato Y, Kizu Y, Tonogi M, Ide Y, Yamane G (2005) Internal structure of zygomatic bone related to zygomatic fixture. J Oral Maxillofac Surg 63:1325–1329
Cawood JI, Stoelinga PJW, Blackburn TK (2007) The evolution of preimplant surgery from preprosthetic surgery. Int J Oral Maxillofac Surg 36(5):377–385
Eufinger H, Gellrich NC, Sandmann D, Dieckmann J (1997) Descriptive and metric classification of jaw atrophy: An evaluation of 104 mandibles and 96 maxillae of dried skulls. Int J Oral Maxillofac Surg 26(1):23–28
Misch CE (2008) Contemporary implant dentistry, 3rd edn. Mosby Elsevier, Canada
Bryant SR, Zarb GA (2002) Outcomes of implant prosthodontic treatment in older adults. J Can Dent Assoc 68(2):97–102
de Cos Juez FJ, Sánchez Lasheras F, García Nieto PJ, Álvarez-Arenal A (2008) Non-linear numerical analysis of a double-threaded titanium alloy dental implant by FEM. Appl Math Comput 206(2):952–967
Aparicio C, Ouazzani W, Hatano N (2008) The use of zygomatic implants for prosthetic rehabilitation of the severely resorbed maxilla. Periodontol 2000 47(1):162–171
Davo R, Malevez C, Rojas J, Rodríguez J, Regolf J (2008) Clinical outcome of 42 patients treated with 81 immediately loaded zygomatic implants: a 12- to 42-month retrospective study. Eur J Oral Implantol 1(1):1–10
Farzad P, Andersson L, Gunnarsson S, Johansson B (2006) Rehabilitation of severely resorbed maxillae with zygomatic implants: an evaluation of implant stability, tissue conditions, and patients’ opinion before and after treatment. Int J Oral Maxillofac Implants 21(3):399–404
Block MS, Haggerty CJ, Fisher GR (2009) Nongrafting implant options for restoration of the edentulous maxilla. J Oral Maxillofac Surg 67:872–881
Aparicio C, Ouazzani W, Aparicio A, Fortes V, Muela R, Pascual A, Codesal M, Barluenga N, Manresa C, Franch M (2010) Extrasinus zygomatic implants: Three year experience from a new surgical approach for patients with pronounced buccal concavities in the edentulous maxilla. Clin Implant Dent Relat Res 12(1):55–61
Aparicio C, Ouazzani W, Garcia R, Arevalo X, Muela R, Fortes V (2006) A prospective clinical study on titanium implants in the zygomatic arch for prosthetic rehabilitation of the atrophic edentulous maxilla with a follow-up of 6 months to 5 years. Clin Implant Dent Relat Res 8(3):114–122
Widmark G, Andersson B, Carlsson GE, Ivanoff CJ (2001) Rehabilitation of patients with severely resorbed maxillae by means of implants with or without bone grafts: A 3- to 5-year follow-up clinical report. Int J Oral Maxillofac Implants 16(1):73–79
Keller EE, Tolman DE, Eckert SE (1999) Maxillary antral-nasal inlay autogenous bone graft reconstruction of compromised maxilla: A 12-year retrospective study. Int J Oral Maxillofac Implants 14(5):707–721
Branemark PI, Grondahl K, Worthington P (2001) Osseointegration and autogenous onlay bone grafts: reconstruction of the edentulous atrophic maxilla. Quintessence, Chicago
Lekholm U, Wannfors K, Isaksson S, Adielsson B (1999) Oral implants in combination with bone grafts: A 3-year retrospective multicenter study using the Brånemark implant system. Int J Oral Maxillofac Surg 28(3):181–187
Peñarrocha-Diago M, Boronat A, Cervera R, Garcia B (2006) Fixed ceramometallic prostheses over anterior and transzygomatic implants by using the sinus slot technique-Report of a case. J Oral Implantol 32(1):38–40
Cordaro L, Torsello F, Accorsi Ribeiro C, Liberatore M, Mirisola di Torresanto V (2010) Inlay-onlay grafting for three-dimensional reconstruction of the posterior atrophic maxilla with mandibular bone. Int J Oral Maxillofac Surg 39(4):350–357
Chen X, Wu Y, Wang C (2009) Application of a surgical navigation system for zygoma implant surgery. In: 4th European conference of the international federation for medical and biological engineering, pp 940–943
Al-Nawas B, Wegener J, Bender C, Wagner W (2004) Critical soft tissue parameters of the zygomatic implant. J Clin Periodontol 31(7):497–500
Aparicio C, Ouazzani W, Aparicio A, Fortes V, Muela R, Pascual A, Codesal M, Barluenga N, Franch M (2010) Immediate/early loading of zygomatic implants: clinical experiences after 2 to 5 years of follow-up. Clin Implant Dent Relat Res 12:77–82
Stiévenart M, Malevez C (2010) Rehabilitation of totally atrophied maxilla by means of four zygomatic implants and fixed prosthesis: A 6–40-month follow-up. Int J Oral Maxillofac Surg 39(4):358–363
Bedrossian E, Stumpel LJ (2001) Immediate stabilization at stage II of zygomatic implants: rationale and technique. J Prosthet Dent 86(1):10–14
Maló P, de Araujo Nobre M, Lopes I (2008) A new approach to rehabilitate the severely atrophic maxilla using extramaxillary anchored implants in immediate function: a pilot study. J Prosthet Dent 100(5):354–366
Ujigawa K, Kato Y, Kizu Y, Tonogi M, Yamane GY (2007) Three-dimensional finite elemental analysis of zygomatic implants in craniofacial structures. Int J Oral Maxillofac Surg 36(7):620–625
Watanabe I, Hildebrand S, Woody RD, Talwar R (2005) Zygoma fixtures for a patient with a severely atrophic maxilla: a clinical report. Int Chin J Dent 5:71–74
Peñarrocha-Diago M, Uribe-Origone R, Rambla-Ferrer J, Guarinos-Carbó J (2004) Fixed rehabilitation of a patient with hypohidrotic ectodermal dysplasia using zygomatic implants. Oral Surg Oral Med O 98(2):161–165
Davo R, Malevez C, Rojas J (2007) Immediate function in the atrophic maxilla using zygoma implants: a preliminary study. J Prosthet Dent 97(6, Supplement 1):44–51
Hirsch JM, Ohrnell LO, Henry PJ, Andreasson L, Branemark PI, Chiapasco M, Gynther G, Finne K, Higuchi KW, Isaksson S, Kahnberg KE, Malevez C, Neukam FW, Sevetz E, Urgell JP, Widmark G, Bolind P (2004) A clinical evaluation of the zygoma fixture: one year of follow-up at 16 clinics. J Oral Maxillofac Surg 62(9 Suppl 2):22–29
Ferreira EJ, Kuabara MR, Gulinelli JL (2010) “All-on-four” concept and immediate loading for simultaneous rehabilitation of the atrophic maxilla and mandible with conventional and zygomatic implants. Brit J Oral Max Surg 48(3):218–220
Thomas J, Balshi GJW, Petropoulos Vicki C (2003) Quadruple zygomatic implant support for retreatment of resorbed iliac crest bone graft transplant. Implant Dent 12(1):47–51
Stevenson AR, Austin BW (2000) Zygomaticus fixtures: the Sidney experience. Ann R Australas Coll Dent Surg 15:337–339
Tamura H, Sasaki K, Watahiki R (2000) Primary insertion of implants in the zygomatic bone following subtotal maxillectomy. Bull Tokyo Dent Coll 41:21–24
Balshi TJ, Wolfinger GJ (2002) Treatment of congenital ectodermal dysplasia with zygomatic implants: a case report. Int J Oral Maxillofac Implants 17:277–281
Schmidt BL, Pogrel MA, Young CW, Sharma A (2004) Reconstruction of extensive maxillary defects using zygomaticus implants. J Oral Maxillofac Surg 62:82–89
Landes CA (2005) Zygoma implant-supported midfacial prosthetic rehabilitation: a 4-year follow-up study including assessment of quality of life. Clin Oral Impl Res 16:313–325
Bowden JR, Flood TR, Downie IP (2006) Zygomaticus implants for retention of nasal prostheses after rhinectomy. Brit J Oral Max Surg 44(1):54–56
Petruson B (2004) Sinuscopy in patients with titanium implants in the nose and sinuses. Scand J Plast Reconstr Surg Hand Surg 38:86–93
Branemark PI (1998) Surgery and fixture installation. Zygomaticus fixture clinical procedures, 1 edn. Nobel Biocare AB, Goteborg, Sweden
Zwahlen RA, Gratz KW, Oechslin CK, Studer SP (2006) Survival rate of zygomatic implants in atrophic or partially resected maxillae prior to functional loading: a retrospective clinical report. Int J Oral Maxillofac Implants 21(3):413–420
Zygoma Implant Placement and Prosthetic Procedure (2004) Branemark System, vol 12. Nobel Biocare, Sweden
Penarrocha M, Garcia B, Marti E, Boronat A (2007) Rehabilitation of severely atrophic maxillae with fixed implant-supported prostheses using zygomatic implants placed using the sinus slot technique: Clinical report on a series of 21 patients. Int J Oral Maxillofac Implants 22(4):645–650
Stella J, Warner M (2000) Sinus slot technique for simplification and improved orientation of zygomaticus dental implants: a technical note. Int J Oral Maxillofac Implants 15:889–893
Peñarrocha M, Uribe R, García B, Martí E (2005) Zygomatic implants using the sinus slot technique: clinical report of a patient series. Int J Oral Maxillofac Implants 20:788–792
Boyes Varley J, Howes D, Lownie J, Blackbeard G (2003) Surgical modifications to the Branemark zygomaticus protocol in the treatment of the severely resorbed maxilla: a clinical report. Int J Oral Maxillofac Implants 18:232–237
Ahlgren F, Storksen K, Tornes K (2006) A study of 25 zygomatic dental implants with 11 to 49 months’ follow-up after loading. Int J Oral Maxillofac Implants 21(6):421–425
Becktor JP (2006) On factors influencing the outcome of various methods using endosseous implants for reconstruction of the atrophic edentulous and partially dentate maxilla. Dissertation. Göteborg University, Sweden
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2013 The Author(s)
About this chapter
Cite this chapter
Ishak, M.I., Kadir, M.R.A. (2013). Treatment Options for Severely Atrophic Maxillae. In: Biomechanics in Dentistry: Evaluation of Different Surgical Approaches to Treat Atrophic Maxilla Patients. SpringerBriefs in Applied Sciences and Technology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32603-5_2
Download citation
DOI: https://doi.org/10.1007/978-3-642-32603-5_2
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-32602-8
Online ISBN: 978-3-642-32603-5
eBook Packages: EngineeringEngineering (R0)