Today, dental implants are the best solution for replacing missing teeth. The placement of conventional implant is limited by inadequate bone support providing their anchorage; this is an ideal call for zygomatic implant. Zygomatic implants are placed through alveolar crest and maxillary sinus involving zygomatic bone for anchorage. They hold maximum support and lasts longer.
Techniques used while placing zygomatic implant are Branemarks technique, sinus slot technique and extra sinus technique.
COMPLICATION DURING SURGERY:
- Zygomatic bone fracture- This can be due to high pressure caused on the bone while placing an implant. This can be prevented by using sharp drills and drilling adapted to the bone.
- Orbital penetration- Clinician must be thorough with the direction of drills used for placing a successful implant. Wrong trajectory of the implant can cause the penetration into the orbit.This can be prevented by performing a proper diagnosis and planning with highly skilled clinician.
- Implant head damage- the damage is more likely due to improper placement of implant driver or by exceeding torque. This can be prevented if the clinician uses non engaging and short abutments.
POST- OPERATIVE COMPLICATIONS:
- Screw fracture on the abutment- Overload on the implant placed or long cantilever. Also double zygoma may cause screw fracture. This can be prevented by reducing occlusal force by introducing night guards to the patients or placing an extra implant.
- Implant failure- Failure can be due to systemic conditions like recurrent sinusitis which is a clear call for implant removal. It is not that every zygomatic implant will associate with sinusitis, but hence, to prevent this a good planning and diagnosis can be made considering the patients aspects.
- Oroantral communication- This is secondary to sinusitis, inadequate procedures around zygoma can lead to oroantral communication. This can be prevented by carefully handling associated tissues around and by treating sinusitis.
- Soft tissue inflammation- Commonly caused due to poor oral hygiene after surgery or due to bulky reconstruction around the implants. This can be limited by educating patient about maintaining good oral hygiene and forming thin reconstructions.
- Sinusitis- One of the major and common problems associated with zygomatic implants. Your clinician must perform a perfect surgery with adequate experience, hence, sinusitis can be prevented, then.
FREQUENTLY ASKED QUESTIONS:
Q1. When are the zygomatic implants indicated?
A1. Zygomatic implants are preferred in patients with no sufficient bone support in upper and lower jaw for conventional implants, patients who had failed conventional implants due to bone loss or any other medical condition, patients who avoid undergoing more than one surgical procedure like surgeries for sinus lift and bone augmentation followed by implant placement, separately- whereas, zygomatic implant placement is a single surgical procedure making comfortable for patient to opt for fixed prosthesis. Zygomatic implants are appropriate with all age groups, whereas, conventional implants are planned according to the age and bone density of a patient.
Q2. How durable are these implants?
A2. The insertion of zygomatic implant is in the thick, dense cheek bone providing maximum support.Also, such implants abstain from bone resorption with age or any other medical condition, responsible.Hence, the duration is longer than the conventional implants which are more likely to be affected by jawbone modulations with age or with any medical condition.
Q3. How long does it take to get final prosthesis over?
A3. Zygomatic implant surgery can be completed with placement of fixed prosthesis after 72 hours.Whereas, in conventional implants standard time for fixing prosthesis is around six months after implant placement.
Q4. Where do I get my zygomatic implant from?
A4. Despite the fact that zygomatic implants are practiced over 20 years, now, still are not common in practice. Hence, the zygomatic implant surgery requires a skilled clinician with adequate training and surgical experience.