CLINICAL FINDINGS
  • Severely resorbed maxillary ridges
  • Poor alveolar bone volume and quality
  • Enlarged/pneumatized maxillary sinuses
  • Knife-edge ridge deformities
  • Failing maxillary implants in revision cases
  • Fully or partially edentulous arches
  • CBCT scans demonstrated:
    • Severe ridge atrophy
    • Bilateral sinus pneumatization
    • Inadequate anterior-posterior spread for conventional implants
    • Poor residual bone volume
    • Severe posterior maxillary bone loss
PP
Dr. Paul Petrungaro
Moderator · IML CaseRounds™
  • Limitations of conventional grafting procedures:
    • Long treatment times
    • Multiple surgeries
    • Increased morbidity
    • Increased cost
    Advantages of zygomatic implants:
    • Immediate loading capability
    • Avoidance of sinus grafting
    • Reduced treatment time
    • High survival rates
    • Use in severely atrophic maxillae
    Importance of:
    • CBCT-guided planning
    • Proper anterior-posterior spread
    • Surgical experience
    • Prosthetic-driven implant positioning
    Potential complications:
    • Sinusitis
    • Oroantral fistula
    • Periorbital edema
    • Sensory disturbances
    Reported implant survival:
    • Overall survival rate: 97.6%
    • Quad zygoma: 95%
    • Bilateral single zygoma: 98.7%
    • Unilateral zygoma with premaxillary implants: 99.1%
Treatment Planning

TOPIC D - MAXILLARY ATROPHY ZYGOMATIC IMPLANTS

Severe maxillary atrophy preventing conventional implant placement Difficulty tolerating removable prostheses Desire for fixed implant-supported prosthetic rehabilitation Avoidance of extensive grafting procedures and prolonged healing times
PATIENT SUMMARY
AGE / SEX
34-80
CHIEF COMPLAINT
Severe maxillary atrophy preventing conventional implant placement Difficulty tolerating removable prostheses Desire for fixed implant-supported prosthetic rehabilitation Avoidance of extensive grafting procedures and prolonged healing times
ASA CLASS
Class II
SMOKING
Non-smoker
KEY MEDICATIONS
Local anesthesia General anesthesia with nasal intubation for surgical procedures Postoperative medications not specifically listed in article
WORKING DIAGNOSIS
DR. PAUL'S TREATMENT PLAN
  1. Comprehensive clinical and CBCT evaluation
  2. Virtual implant planning
  3. Surgical guide fabrication
  4. Placement of zygomatic implants:
    • Quad zygoma
    • Bilateral single zygoma
    • Unilateral zygoma with anterior implants
  5. Immediate loading with fixed prostheses
  6. Multi-abutment placement
  7. Postoperative healing and prosthetic rehabilitation
  8. Long-term follow-up over 5 years