Full arch rehabilitation in patients with atrophic upper jaws with zygomatic implants: a systematic review.

BACKGROUND: The main objective of this systematic review was to present the outcomes of the treatment with zygomatic implants (ZIs) in the rehabilitations of atrophic upper jaw. FINDINGS: An electronic database search in PubMed, along with a manual search, taking into account language and study period, was performed by two observers; any type of clinical trial and series that included the use of ZIs was used. In the search strategy, the following search terms were used: zygom* AND dental (Implant OR implants) AND edentulous NOT (biomechanic* OR finite element) NOT cadaver. The search was limited to English language, full text, and humans. Literature reviews and clinical case reports were not considered. Forty-two articles published between March 2003 and April 2019 were included in this analysis. The cases of 1247 patients were recovered; these patients received 2919 ZIs. Fifty-two ZIs were removed during the follow-up time. The survival rate of these implants was 98.22%, with a minimum follow-up of 1 month and a maximum of 228 months. Different surgical techniques were used to place ZIs; however, the intrasinusal technique was the most used (23 studies). Post-surgical sinusitis was the most common complication reported in the studies (39 cases). CONCLUSIONS: Based on this review, ZIs were commonly used for rehabilitation of patients with atrophic upper jaw. The survival rates presented were high, and the surgical technique is dependent on the professional experience and the local anatomy. However, it needed additional clinical evidence on bone resorption, esthetic outcomes, and physiological characteristics.

Como otimizar a confecção da prótese total sobre implantes em casos de cirurgia guiada / How to optimize the fabrication of implant-supported full-arch prostheses in guided surgery ­ a case report

O presente trabalho apresentou um caso de cirurgia guiada onde o guia cirúrgico foi modificado para facilitar a posterior confecção da prótese fixa sobre implantes, minimizando o risco de falhas na adaptação e na relação interoclusal. Foi descrito o passo a passo das fases cirúrgica e protética de uma cirurgia guiada de paciente desdentado total, atentando para as vantagens de tal técnica, como a alta taxa de sobrevivência dos implantes, a elevada satisfação do paciente e a baixa perda óssea marginal ao redor dos implantes.

The present study presents a guided surgery case, where the surgical stent has been modified to facilitate the confection of an implant-supported prosthesis, reducing the risk of failures during fit and interocclusal registration. The step-by-step surgical and prosthetic approach is described, highlightening the advantages of this technique such as high implant survival rates, patient satisfaction, and low peri-implant bone loss.

Técnica todo sobre -4 y carga inmediata para rehabilitación del maxilar superior: reporte de caso clínico / All on -4 technique and immediate loading for maxilla rehabilitation a clinical case report

La Técnica TODO SOBRE -4 (All-on-4) desarrollada por el Dr. Paulo Maló, está basada en la rehabilitación completa de los maxilares con una prótesis fija de carga inmediata sobre 4 implantes adecuadamente distribuidos; 2 implantes angulados posteriores y 2 implantes axiales anteriores, sin la utilización de injertos óseos. En este trabajo presentamos un caso clínico de rehabilitación completa del maxilar superior con la técnica Todo Sobre -4

The All-on-4 technique developed by Dr. Paulo Maló, is based on the full arch rehabilitation of the jaws with a fixed prostheses on four implants immediately loaded and adequately distributed; 2 tilted posterior implants and 2 axial anterior implants without the need of bone grafts. In this work we present a clinical case of full arch rehabilitation of the maxilla with the All-on-4 technique