ZİGOMA İMPLANTLARI

ÖZETErken diş kayıpları, periodontal hastalıklar, tümör rezeksiyonu gibi sistemik ve lokal faktörler neticesinde maksillada ileri derecede horizontal ve vertikal kemik rezorbsiyonu meydana gelebilmektedir. İleri derecede atrofik maksillanın rehabilitasyonu için geleneksel tam protez ya da kemik grefti kullanılarak yapılan implant destekli protez tedavi seçenekleri arasındadır. Bununla birlikte, 1998 yılında Branemark tarafından ileri derecede atrofik maksillaya sahip hastalarda alternatif bir tedavi seçeneği olarak zigoma implantları tanıtılmıştır. Literatürde farklı yazarlar tarafından yapılan araştırmalarda zigoma implantla- rının başarı oranının % 82-100 arasında olduğu bildi- rilmiştir. Bu sonuçlar zigoma implantlarının geçerli bir tedavi seçeneği olduğunu göstermiştir.  Bu derlemenin amacı, zigoma implantlarının endikasyon, avantaj, dezavantajlarının yanı sıra başarı oranları ve olası komplikasyonları hakkında bilgi vermektir.
Anahtar Kelimeler:

implant, zigoma, rezorbsiyon

ZYGOMATIC IMPLANTS

Severe vertical and horizontal bone resorption in the maxilla may be caused by a complex interaction of local and systemic factors, such as early tooth loss, periodontal disease and tumour resection. Treatment options for the rehabilitation of the severely atrophic maxilla include conventional complete dentures and implant-supported prosthesis with bone grafts. However, zygomatic implants were described by Branemark in 1998 as a suitable alternative for patients with atrophic maxilla. In literatures, the success rate of the zygoma implants obtained by different authors varies between 82 % and 100 %, indicating the technique as a valid treatment option. The aim of this compilation is to give with information advantages, disadvantages as well as potential complications and the success rate of the zygomatic implants

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  • Kreissl ME, Heydecke G, Metzger MC, Schoen R. Zygoma implant-supported prosthetic rehabilitation after navigation: a clinical report. J Prosthet Dent 2007;97:121-8. using surgical
  • Stievenart M, Malevez C. 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 2010;39:358- 63.
  • O'Connell JE, Cotter E, Kearns GJ. Maxillary reconstruction using zygomatic implants: a report of two cases. J Irısh Dent Association 2011;57:146-55.
  • Kahnberg KE, Henry PJ, Hirsch JM, Ohrnell LO, Andreasson L, Branemark PI, et al. Clinical evaluation of the zygoma implant: 3-year follow-up at 16 clinics. J Oral Maxillofac Surg 2007;65:2033- 8.
  • Xiaojun C, Ming Y, Yanping L, Yiqun W, Chengtao W. Image guided oral implantology and its application in the placement of zygoma implants. Comput Methods Programs Biomed 2009;93:162- 73.
  • Bedrossian E, Stumpel LJ, 3rd. Immediate stabilization at stage II of zygomatic implants: rationale and technique. J Prosthet Dent 2001;86:10-4.
  • Cordero EB, Benfatti CA, Bianchini MA, Bez LV, Stanley K, de Souza Magini R. The use of zygomatic implants for the rehabilitation of atrophic maxillas with 2 different techniques: Stella and Extrasinus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:e49-53.
  • Sudhakar J, Ali SA, Karthikeyan S. Zygomatic Implants- A Review. J Indian Academy of Dent Specialist Res 2011;2:24-8.
  • Davo R, Malevez C, Rojas J. Immediate function in the atrophic maxilla using zygoma implants: a preliminary study. J Prosthet Dent 2007; Suppl 6: S44-51.
  • Ishak MI, Abdul Kadir MR, Sulaiman E, Abu Kasim NH. Finite element analysis of different surgical approaches in various occlusal loading locations for zygomatic implant placement for the treatment of atrophic maxillae. Int J Oral Maxillofac Surg 2012.
  • Miglioranca RM, Sotto-Maior BS, Senna PM, Francischone CE, Cury AA. Immediate occlusal loading of extrasinus zygomatic implants: A prospective cohort study with a follow-up period of 8 years. Int J Oral Maxillofac Surg 2012.
  • Jensen OT, Leopardi A, Gallegos L. The case for bone graft reconstruction including sinus grafting and distraction osteogenesis for the atrophic edentulous maxilla. J Oral Maxillofac Surg 2004;62:1423-8.
  • Weischer T, Schettler D, Mohr C. Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants 1997;12:211-4.
  • Branemark PI. The Zygomaticus Fixture: clinical procedures. Nobel Biocare AB 1998.
  • Galan Gil S, Penarrocha Diago M, Balaguer Martinez J, Marti Bowen E. Rehabilitation of severely resorbed maxillae with zygomatic implants: an update. Med Oral Patol Oral Cir Bucal 2007;12:E216-20.
  • Corvello PC, Montagner A, Batista FC, Smidt R, Shinkai RS. Length of the drilling holes of zygomatic implants inserted with the standard technique or a revised method: a comparative study in dry skulls. J Craniomaxillofac Surg 2011;39:119-23.
  • Davo R. Zygomatic implants placed with a two- stage procedure: a 5-year retrospective study. Eur J Oral Implantol 2009;2:115-24.
  • Schow SR, Parel SM. The Zygoma Implant. In: Miloro M, editor. Peterson's Principles of Oral and Maxillofacial Surgery. London: BC Decker; 2004. p. 235-49.
  • Keller EE, Van Roekel NB, Desjardins RP, Tolman DE. Prosthetic-surgical reconstruction of the severely resorbed maxilla with iliac bone grafting and tissue-integrated prostheses. Int J Oral Maxillofac Implants 1987;2:155-65.
  • Montazem A, Valauri DV, St-Hilaire H, Buchbinder D. The mandibular symphysis as a donor site in maxillofacial bone grafting: a quantitative anatomic study. J Oral Maxillofac Surg 2000;581368-71.
  • Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA. Complications of iliac crest bone graft harvesting. Clin Orthop Relat Res 1996:300- 9.
  • Penarrocha-Diago M, Uribe-Origone R, Rambla- Ferrer J, Guarinos-Carbo J. Fixed rehabilitation of a patient with hypohidrotic ectodermal dysplasia using zygomatic implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:161-5.
  • Schmidt BL, Pogrel MA, Young CW, Sharma A. Reconstruction of extensive maxillary defects using zygomaticus implants. J Oral Maxillofac Surg 2004;62:82-9.
  • Landes CA. Zygoma implant-supported midfacial prosthetic rehabilitation: a 4-year follow-up study including assessment of quality of life. Clin Oral Implants Res 2005;16:313-25.
  • Pham AV, Abarca M, De Mey A, Malevez C. Rehabilitation of a patient with cleft lip and palate with an extremely edentulous atrophied posterior maxilla using zygomatic implants: case report. Cleft Palate Craniofac J 2004;41:571-4.
  • Stella JP, Warner MR. Sinus slot technique for simplification and improved orientation of zygomaticus dental implants: a technical note. Int J Oral Maxillofac Implants 2000;15:889-93.
  • Aparicio C, Ouazzani W, Aparicio A, Fortes V, Muela R, Pascual A, et al. 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 2010;12:55-61.
  • Malo P, Nobre Mde A, Lopes I. A new approach to rehabilitate the severely atrophic maxilla using extramaxillary anchored implants in immediate function: a pilot study. J Prosthet Dent 2008;100:354-66.
  • Bedrossian E, Stumpel L, 3rd, Beckely ML, Indresano T. The zygomatic implant: preliminary data on treatment of severely resorbed maxillae. A clinical report. Int J Oral Maxillofac Implants 2002;17:861-5.
  • Davo R, Malevez C, Rojas J, Rodriguez J, Regolf J. Clinical outcome of 42 patients treated with 81 immediately loaded zygomatic implants: a 12- to 42-month retrospective study. Eur J Oral Implantol 2008;1:141-50.
  • Malevez C, Abarca M, Durdu F, Daelemans P. Clinical outcome of 103 consecutive zygomatic implants: a 6-48 months follow-up study. Clin Oral Implants Res 2004;15:18-22.
  • Kurkcuoglu I, Koroglu A, Ozkır SE. The criteria and evaluation methods for success of dental ımplants. J Dent Fac Atatürk Uni 2010;20:221-9.
  • Becktor JP, Isaksson S, Abrahamsson P, Sennerby L. Evaluation of 31 zygomatic implants and 74 regular dental implants used in 16 patients for prosthetic reconstruction of the atrophic maxilla with cross-arch fixed bridges. Clin Implant Dent Relat Res 2005;7:159-65.
  • Branemark PI, Grondahl K, Ohrnell LO, Nilsson P, Petruson B, Svensson B, et al. Zygoma fixture in the management of advanced atrophy of the maxilla: technique and long-term results. Scand J Plast Reconstr Surg Hand Surg 2004;38:70-85.
  • Chow J, Hui E, Lee PK, Li W. Zygomatic implants-- protocol for immediate occlusal loading: a preliminary report. J Oral Maxillofac Surg 2006;64:804-11.