CONTROL ID: 2598396
CONTACT: Gerardo Pellegrino
CURRENT CATEGORY: Clinical
PRESENTATION TYPE: Oral
Computer Aided Implant Supported Rehabilitation of Atrophic/oncologic Patients Using Zygomatic Implants
AUTHORS: Pellegrino, Gerardo; Tarsitano, Achille; Basile, Francesco; Relics, Daniela; Marchetti, Claudio
Introduction: Zygomatic implants have been used for rehabilitation of atrophic jaws and oncologic patients. The aim of this study is to evaluate the possibility to perform a computer aided zygomatic implant planning and surgery. The key points of the research are:
1) a three-dimensional virtual planning to choose the appropriate implant length;
2) the use of dynamic navigation system to reproduce intra-operatively the planning; 3) the evaluation of the clinical outcome and quality of life during the follow-up period.
Thirteen patients were treated up today, following the ethical committee approval. The oncologic patients were treated according to a defect based classification (Pellegrino et al,JOMS,2015). All patients had three dimensional computer-aided surgical planning to choose the appropriate implant length. In several cases, a dynamic navigation system was used and in two cases ultrasonic instruments too. Only in one case, the zygomatic implants were connected with standard implants. In all cases with the exception of two oncologic patients, a fixed prosthesis was delivered and loaded within 72 hours. The deviation between the planned implant length and that really choice was evaluated. The minor and major complications occurred intraoperatively and during the follow-up period were reported. Quality of life questionnaire was administered pre-operatively and after prosthetic rehabilitation.
The follow-up period was 6 up to 36 months. The choice length of the implants was observed in almost all cases. Two of the positioned implants failed during the follow-up period: one in an oncologic patient and one in an atrophic patient. No failure of the rehabilitation and only minor complications were reported up to now. In all patients, the quality of life score value has significantly increase.
Zygomatic implants can be placed even in the case of advanced jaw atrophy or post-resection maxillary bone defect because they obtain a bicortical stability through the malar bone. Early prosthesis loading certainly allows the patient to have better functional outcomes. Computer-aided surgery and intra-operative navigation allowed the surgical team to simulate implant placement on a 3D model and consent a constant visualisation of the drill trajectory in a complex maxillary anatomy. More clinical trials with a longer follow-up period are required to confirm the reliability of this method.
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