Methods:The zygomatic implant,has been inserted in the scaphoid fossa of the pterygoid bone,at the base of the skull.This modification was made available,using CT based image planning and specific software.The surgeon is able to determine the exact position of the implants.Finally a customized drill guide is produced by strereolithography.Patients with severe maxillary atrophy were selected for inclusion in this study.This treatment was offered to the patients as an alternative to the sinus augmentation.
Results:From November 2006 until April 2008, 14 patients were included in this study.Clinically,at insertion,all pterygoid implants were very stable.In this study,14 patients with severe maxillary atrophy were treated using 22 implants in the pterygoid region.The treatment protocol was validated through the 14 case studies.From the postoperative images,all besides one of the inserted implants were judged to be adequately sited and were perfectly suited as support for a prosthetic restoration.A limited prospective clinical follow-up study was performed.
10 of the patients with 18 pterygoid implants have already undergone second stage surgery.At second stage surgery all implants were judged to be clinically stable,besides one.
Conclusions:This new modification of the zygomatic implant technique was performed and validated in 14 patients.Although all patients had severe maxillary atrophy, excellent cumulative survival rates have been obtained at second stage surgery.The pterygoid implant emerges on the dentoalveolar crest,making it very efficient as a support for the prosthetic work.The drill guide avoids performing traumatic incisions and deperiostation of the atrophic maxillary bone,reducing operative morbidity.