Rehabilitation of Severely Resorbed Maxilla with Zygomatic Implants

Objectives: The purpose of the present study was to describe experiences of our first eleven patients with severely reorbed maxilla rehabilitated with a combination of zygomatic and conventional implants by registering tissue conditions clinically, radiographically and by resonance frequency analysis (RFA). Methods: Eleven patients were treated with implant-retained fixed prostheses. A total of 64 implants were placed, 22 of which were placed in the zygoma. Fixed prostheses were removed to allow clinical and radiographic evaluations during the period from 18 to 46 months. Resonance Frequency Analysis was performed on all implants. A visual analogue scale (VAS) was used to assess patient satisfaction before and after treatment. Results: All zygomatic implants demonstrated clinical signs of osseointegration while one anterior implant was lost during follow-up. Mean ISQ values for the zygomatic and anterior implants were 65.9 (42-100) and 61.5 (48-71), respectively. Twenty-four implants showed moderate peri-implant inflammation, with three exhibiting severe inflammation. Most anterior implants (75.6%) showed an apical marginal bone shift of one thread or less. Ten anterior implants (24.4%) indicated marginal bone loss of two to four threads. Four zygomatic implants showed bone loss of 4-5 threads and five zygomatic implants (22.7%) exhibited no marginal bone loss. Patients described significant improvement in chewing ability and aesthetics but did not experience improvement in speech. Conclusion: This preliminary report demonstrates that Zygomatic implants provide posterior support to fixed prostheses that may otherwise not be possible. However lack of integration in the marginal bone of the zygomatic implant merit close scrutiny.