A long term of edentulism often prescribes with an atrophic bone. The zygomatic implants or zygomatic fixtures provide a perfect solution to conditions where implant insertion and the outcomes are feared to be poor.
This new technologic development offers alternatives to bone grafting or sinus-lifting procedures, which involve rather invasive surgery
Zygomatic Implant Design
In their study, Malevez2 et al described zygomatic implants as self-tapping screws in commercially pure titanium with a well-defined machined surface. They are available in 8 different lengths, ranging from 30 to 52.5 mm with an angulation of 45 degree. The portion that engages the zygoma, the apical two thirds, has a diameter of 4.0 mm, and the portion that engages the residual maxillary alveolar process, alveolar one third, has a diameter of 4.5 mm1 to 5 mm.
Why Prefer Zygomatic Implants over the Conventional One???
- Decreased cost of treatment
- Patients with severe maxillary resorption they facilitate rehabilitation
- Enhancing cross-arch effect
- Multi-cortex stabilization
- Adaptation and maintenance of normal physiology
- Reduced treatment time
- Lack of need of bone grafting.
How Do Zygomatic Implants Work?
Like we said previously, the Zygomatic Implants are attached to the area of the jawbone close to the zygoma bone. The area of insertion has to be from the premolar side, right into the sinus, then engaging into the thick and solid zygomatic bone.
It takes around 4 months for the whole tissues, bone, implant to adapt at this particular site. After which the prosthesis could be given to the patient. By the end of this period, patients can enjoy their new set of teeth.
Presurgical evaluation
According to Bothur et al4 preoperative considerations should involve –
- Shape of the face – A narrow face will be unfavorable as far as intraoperative access and implant inclination are concerned.
- Degree of resorption – An alveolar crest that is very thin but vertically sufficient tends to encourage implant entrance palatally, and thus buccal onlay bone grafting might be considered as an alternative treatment approach.
- Sinus status – Oral pantography can give distorted information; therefore, the choice of examination should be CT scan
- Maxillomandibular jaw relationship – If the patient’s denture is well fitting, it is duplicated and adapted to be used as the surgical guide
- Patient expectations
Complication / Risk Associated
- Risk of oro-antral fistula formation.
- May cause maxillary sinusitis
- More difficult to place in patients with limited mouth opening.
- Possibility of difficulty in cleaning due to the palatal location of the implant platform.
FAQ’s
QUESTION- ARE ZYGOMATIC DENTAL IMPLANTS PAINFUL?
ANSWER- Although they may look a bit scary, there is no such increase in pain tendency as compared with any other bone grafting procedures. and you would be given oral pain killers for that.
Most of our patients are pretty amaze how the procedure went soo easy.
QUESTION – WHAT IS THE DIFFERENCE BETWEEN A ZYGOMATIC AND A CONVENTIONAL IMPLANT?
Answer- The pterygoid implants are considerably longer than conventional implants, reaching upto 55 mm in lenth and are placed in angled position.
QUESTION- WHY TO PREFER ZYGOMATIC IMPLANTS THAN GOING FOR A REGULAR ONE?
Answer- The main characteristic of zygomatic implant is that it is placed in the bone that is never reabsorbed, the zygomatic.
QUESTION- WHO ARE THE IDEAL PATIENTS FOR ZYGOMATIC IMPLANTS?
Answer- All those patients who present bone resorption in the region of the jaw or maxilla after the loss of teeth, either by general factors such as sex or age, or local injuries such as or bone metabolism.
QUESTION- DESPITE ALL THE ADVANTAGES, WHY ZYGOMATIC IMPLANTS ARE NOT SOO COMMON?
Answer- This procedure requires good practicing skills, not any dentist without proper education and training routinely can place zygomatic dental implants in patients with in-sufficient bone conditions.
QUESTION- WHY RELY ON IMPLANTS WHEN ONE CAN OPT FOR REMOVABLE PROSTHESIS?
Answer- In patients with in-sufficient bone conditions, removable dentures are not stable, they’re bulky, can irritate the underlying tissues and will cause additional bone resorption. Other bone grafting procedures are expensive,painful and the results may not be predictable. Each one of these options significant problems. For these type of patients zygomatic implants present a faster, safer, reliable, long lasting and a far more economical treatment option.
