Finding Better Ways to Perform Graftless Full Rehabilitation of a Compromised Maxilla: New Platform-Switched Zygomatic Implants Placed Extra-Sinus Improve Prosthetic Restoration-A Preliminary Study of 25 Cases and 85 Implants.

Standard treatment for full rehabilitation of compromised maxillae with regular implants includes sinus elevation grafting, a minimum of two to three surgeries, and a minimum treatment time of 9 to 15 months. Zygomatic implants are a viable alternative. However, prosthetic restorations have been compromised due to abutments emerging on the palate. The purpose of this study was to find ways that abutments will emerge on the ridge (occlusal surface). The presented results show it can be done if zygomatic implants are placed in the sinus wall (extra-sinus) and use an internal, conical connection with platform-switching and 45-degree abutments. Thus, marginal tissue prognosis and primary stability may also be improved by adding coronal threads to an implant design. These improvements, if confirmed in longer follow-ups and further studies, may encourage more graftless rehabilitations of severely compromised maxillae, reducing the number of surgeries and overall treatment time.

Platform switch hybrid zygoma implants improve prosthetics and marginal bone protection after extra-sinus placement.

PURPOSE: The aim of our studdy is clinical evaluation of Platform switch hybrid zygoma implants. MATERIALS AND METHODS: 117 zygomatic implants were followed up during this time. They included 55 Brånemark System zygoma implants, 38 Noris implants, and 24 novel iRES hybrid implants with platform switch. RESULTS: Bone quality and quantity are the prerequisite for successful implant treatment. Zygomatic implants are intended for patients with severely resorbed maxilla that cannot accommodate conventional implants without prior extensive bone grafting. Such regenerative procedures, like sinus lifts, prolong implant rehabilitation to several months (12-18). Furthermore, extensive grafts are less predictable showing varying degrees of graft resorption. Zygoma implants enable full, often immediate, reconstruction of the upper dental arch without the need for sinus lift treatment. The original zygoma protocol runs the implants through the sinus, requires general anesthesia, and positions the prosthetic platform of the implants on the palate, which makes prosthesis cumbersome. It also induces risk for post-op sinusitis. Extra-sinus approach with novel zygoma hybrid implants bypasses sinuses and positions the implant prosthetic platform on the crest allowing for same good prosthetics as on conventional dental implants. Furthermore, crestal threads and a platform-switch, of the novel zygoma design, increase implant anchorage and minimize marginal bone loss. The study presents evolution of zygoma implant rehabilitation protocol and zygoma implant design in our clinical practice over 15 years (2004-2019). CONCLUSION: Extra-sinus zygomatic implant placement lowers the risk of post-op sinusitis and makes procedure possible to be done in local anesthesia.

Immediate Palatal Molar Implants: A Simple, Safe, Minimally Invasive Technique.

The purpose of this study was to determine whether a single immediate implant placed into the postextraction palatal socket of a maxillary molar would be as efficacious as a single implant placed centrally in a staged approach. A total of 61 immediate implants were placed in 52 patients and restored after 6 months. Periotest and Osstell were used to determine implant stability, and cone beam computed tomography was used for marginal bone level assessment. During the 2-year follow-up, implant survival was 100%. It was concluded that immediate palatal implants can safely restore extracted molars in the maxilla.