Abstract
The process of bone remodeling that occurs after tooth loss is responsible for the decrease in bone availability, which is considered a key factor for success in rehabilitation with dental implants. The loss of bone quality and quantity combined with pneumatization of the maxillary sinus are factors that limit the rehabilitation of the maxilla. Rehabilitation of the mandible is usually difficult due to bone loss in height, and positioning of the inferior alveolar nerve (IAN) that hinders the placement of conventional implants in posterior region. In this case report, we present a follow-up of total rehabilitation of the maxillary arch with placement of zygomatic implants associated with conventional implants in the anterior region (14 years of follow-up), treatment evolution of the mandibular arch through short implants until its failure and removal (after 11 years), and rehabilitation with full-arch prosthesis with 29 months of follow-up. It was observed in this clinical case a great predictability and reliability in rehabilitation with zygomatic implants, as well as a limitation of rehabilitation involving borderline events with short implants, which - despite their failure - can be indicated in cases of conservative treatments that postpone the indication of full mouth extraction and total rehabilitation with implants.
References
Mercier P, Lafontant R. Residual alveolar ridge atrophy: Classification and influence of facial morphology. J Prosthet Dent. 1979;41(1):90-100. doi:10.1016/0022-3913(79)90363-9
Eufinger H, Gellrich NC, Sandmann D, Dieckmann J. Descriptive and metric classification of jaw atrophy: An evaluation of 104 mandibles and 96 maxillae of dried skulls. Int J Oral Maxillofac Surg. 1997;26(1):23-28. doi:10.1016/S0901-5027(97)80841-7
Atwood DA. Reduction of residual ridges: A major oral disease entity. J Prosthet Dent. 1971;26(3):266-279. doi:10.1016/0022-3913(71)90069-2
Lemos CAA, Ferro-Alves ML, Okamoto R, Mendonça MR, Pellizzer EP. Short dental implants versus standard dental implants placed in the posterior jaws: A systematic review and meta-analysis. J Dent. 2016;47:8-17. doi:10.1016/j.jdent.2016.01.005
Thoma DS, Wolleb K, Schellenberg R, Strauss FJ, Hämmerle CHF, Jung RE. Two short implants versus one short implant with a cantilever: 5-Year results of a randomized clinical trial. J Clin Periodontol. 2021;48(11):1480-1490. doi:10.1111/jcpe.13541
Lombardo G, Signoriello A, Marincola M, Liboni P, Bonfante EA, Nocini PF. Survival rates of ultra‐short (<6 mm) compared with short locking‐taper implants supporting single crowns in posterior areas: A 5‐year retrospective study. Clin Implant Dent Relat Res. 2021;(July):1-16. doi:10.1111/cid.13054
Brånemark PI. Surgery and fixture installation. Zygomaticus fixture clinical procedures (ed 1). Nobel Biocare AB. 1998.
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(6):889-893.
Migliorança RM, Dias RCL, Coppedê A, Dias Rezende RCL, de Mayo T, Dias RCL. Restoration of the edentulous maxilla using extrasinus zygomatic implants combined with anterior conventional implants: a retrospective study. Int J Oral Maxillofac Implants. 2011;26(3):665-672. http://www.ncbi.nlm.nih.gov/pubmed/21691615.
Aparicio C. A proposed classification for zygomatic implant patients based on the zygoma anatomy guided approach (ZAGA): A cross-sectional survey. Eur J Oral Implantol. 2011;4(3):269-275. http://www.ncbi.nlm.nih.gov/pubmed/22043470.
Bedrossian E. Rehabilitation of the edentulous maxilla with the zygoma concept: a 7-year prospective study. Int J Oral Maxillofac Implants. 2010;25(6):1213-1221. http://www.ncbi.nlm.nih.gov/pubmed/21197500.
Sartori EM, Padovan LEM, De Mattias Sartori IA, Ribeiro PD, Gomes De Souza Carvalho AC, Goiato MC. Evaluation of satisfaction of patients rehabilitated with zygomatic fixtures. J Oral Maxillofac Surg. 2012;70(2):314-319. doi:10.1016/j.joms.2011.03.044
Yates JM, Brook IM, Patel RR, et al. Treatment of the edentulous atrophic maxilla using zygomatic implants: Evaluation of survival rates over 5-10 years. Int J Oral Maxillofac Surg. 2014;43(2):237-242. doi:10.1016/j.ijom.2013.08.012
Agliardi EL, Panigatti S, Romeo D, Sacchi L, Gherlone E. Clinical outcomes and biological and mechanical complications of immediate fixed prostheses supported by zygomatic implants: A retrospective analysis from a prospective clinical study with up to 11 years of follow-up. Clin Implant Dent Relat Res. 2021;23(4):612-624. doi:10.1111/cid.13017
Faot F, Thomé G, Bielemann AM, et al. Simplifying the Treatment of Bone Atrophy in the Posterior Regions: Combination of Zygomatic and Wide-Short Implants - A Case Report with 2 Years of Follow-Up. Case Rep Dent. 2016;2016. doi:10.1155/2016/5328598
Filho HN, Amaral WS, Curra C, Cardoso CL, Dos Santos PL. Zygomatic implant: late complications in a period of 12 years of experience. 176 | Rev Clin Periodoncia Implant Rehabil Oral. 2017;10(3):176-179. doi:10.1016/j.piro.2016.03.007
Bedrossian E, Stumpel L, Beckely ML, Indresano T, Indersano T. The zygomatic implant: preliminary data on treatment of severely resorbed maxillae. A clinical report. Int J Oral Maxillofac Implants. 2002;17(6):861-865. http://www.ncbi.nlm.nih.gov/pubmed/12507247.
Esposito M, Davó R, Marti-Pages C, et al. Immediately loaded zygomatic implants vs conventional dental implants in augmented atrophic maxillae: 4 months post-loading results from a multicentre randomised controlled trial. Eur J Oral Implantol. 2018;11(1):11-28. http://www.ncbi.nlm.nih.gov/pubmed/29557398.
Aparicio C, Manresa C, Francisco K, et al. The Long-Term Use of Zygomatic Implants: A 10-Year Clinical and Radiographic Report. Clin Implant Dent Relat Res. 2014;16(3):447-459. doi:10.1111/cid.12007
Ramos Verri F, Santiago Junior JF, de Faria Almeida DA, et al. Biomechanical influence of crown-to-implant ratio on stress distribution over internal hexagon short implant: 3-D finite element analysis with statistical test. J Biomech. 2015;48(1):138-145. doi:10.1016/j.jbiomech.2014.10.021
Tawil G, Aboujaoude N, Younan R. Influence of prosthetic parameters on the survival and complication rates of short implants. Int J Oral Maxillofac Implants. 2006;21(2):275-282. http://www.ncbi.nlm.nih.gov/pubmed/16634499.
Vazouras K, de Souza AB, Gholami H, Papaspyridakos P, Pagni S, Weber HP. Effect of time in function on the predictability of short dental implants (≤6 mm): A meta-analysis. J Oral Rehabil. 2020;47(3):403-415. doi:10.1111/joor.12925
Lemos CAA, Ferro-Alves ML, Okamoto R, Mendonça MR, Pellizzer EP. Short dental implants versus standard dental implants placed in the posterior jaws: A systematic review and meta-analysis. J Dent. 2016;47:8-17. doi:10.1016/j.jdent.2016.01.005
Monje A, Aranda L, Diaz KT, et al. Impact of maintenance therapy for the prevention of peri-implant diseases. J Dent Res. 2016;95(4):372-379. doi:10.1177/0022034515622432
Tawil G, Aboujaoude N, Younan R. Influence of prosthetic parameters on the survival and complication rates of short implants. Int J Oral Maxillofac Implants. 2006;21(2):275-282.
Blanes RJ. To what extent does the crown-implant ratio affect the survival and complications of implant-supported reconstructions? A systematic review. Clin Oral Implants Res. 2009;20(SUPPL. 4):67-72. doi:10.1111/j.1600-0501.2009.01762.x
Ravidà A, Barootchi S, Alkanderi A, Tavelli L, Suárez-López del Amo F. The Effect of Crown-to-Implant Ratio on the Clinical Outcomes of Dental Implants: A Systematic Review. Int J Oral Maxillofac Implants. 2019;34(5):1121-1131. doi:10.11607/jomi.7355
Quaranta A, Piemontese M, Rappelli G, Sammartino G, Procaccini M. Technical and biological complications related to crown to implant ratio: A systematic review. Implant Dent. 2014;23(2):180-187. doi:10.1097/ID.0000000000000026
Misch CE, Steigenga J, Barboza E, Misch-Dietsh F, Cianciola LJ, Kazor C. Short Dental Implants in Posterior Partial Edentulism: A Multicenter Retrospective 6-Year Case Series Study. J Periodontol. 2006;77(8):1340-1347. doi:10.1902/jop.2006.050402
Malo P, Rangert B, Nobre M. “All‐on‐Four” Immediate‐Function Concept with Brånemark System® Implants for Completely Edentulous Mandibles: A Retrospective Clinical Study. Implant Dent. 2003;5(Supplement I):2-9. doi:10.1111/j.1708-8208.2003.tb00010.x
Maló P, de Araújo Nobre M, Lopes A, Ferro A, Botto J. The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up. Clin Implant Dent Relat Res. 2019;21(4):565-577. doi:10.1111/cid.12769
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