Abstract

Introduction: Rehabilitation of atrophic maxillae can be a real challenge, even for experienced surgeons. The search for faster and less morbid treatments, with the possibility of immediate loading, has led surgeons to apply bone anchoring techniques, with longer implants, anchored in areas further away from the alveolar ridge.

Objective: The objective of this article is to describe a case report of rehabilitation of atrophic maxilla with Transnasal and Zygomatic implants.

Case report: Female patient, 70 years old, with severe bone resorption that made rehabilitation with conventional dental implants impracticable. Through virtual planning, adequate conditions were found for the placement of zygomatic implants on the left side, but the right side had insufficient bone availability. The rehabilitation was performed with 3 zygomatic implants and 1 transnasal implant. A definitive acrylic prosthesis was installed 5 days after surgery. The patient has 13 months of follow-up without peri-implant alterations, with the implants osseointegrated and her dental occlusion reestablished.

Conclusion: The Transnasal Implant may be an auxiliary option for the total rehabilitation of the atrophic maxilla. Virtual planning with computed tomography is essential to guarantee the success of the technique and reduce the chances of problems related to the installation of transnasal implants.

Keywords

• Dental Implants
• Maxilla
• Bone resorption
• Edentulous jaw
• Dental Prosthesis
• Implant-Supported
• Case Report

References

• - Nguyen TTH, Eo MY, Kuk TS, Myoung H, Kin SM. Rehabilitation of atrophic jaw using iliac onlay bone graft combined with dental implants. Int Implant Dent. 2019;19:11.
• - Sjöström M, Sennerby L, Nilson H, Lundgren S.Reconstruction of atrophic edentulous maxilla with free iliac crest grafts and implants: a 3-year report of a prospective clinical study. Clin Implant Dent Relat Res. 2007; 9:46-59.
• - Cawood JI, Howell RA. A classification od tge edentulous jaws. Int J Oral Maxillofac Surg. 1988; 17(4):232-6.
• - Davó R, David L. Quad Zygoma: Technique and Realities. Oral Maxillofac Surg Clin North Am. 2019; 31:285-297.
• - Cannizzaro G, Felice P, Minciarelli AF, Leone M, Viola P, Esposito M. Early implant loading in the atrophic posterior maxilla: 1-stage lateral versus crestal sinus lift and 8 mm hydroxyapatite-coated implants. A 5-year randomised controlled trial. Eur J Oral Implantol. 2013;6:13-25.
• - Maló P, Rangert B, Nobre M. All-on-4 Immediate-Function Concept with Brånemark System® Implants for Completely Edentulous Maxillae: A 1-Year Retrospective Clinical Study. Clin Implant Dent Relat Res. 2005:7 Suppl 1:S88-94.
• - Soto-Penaloza D, Zaragozì-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The all-on-four treatment concept: Systematic review. J Clin Exp Dent. 2017; 9(3)e:474-488.
• - Centenero SAH, Lázaro A, Giralt-Hernando M, Hernández-Alfaro F. Zygoma Quad Compared With 2 Zygomatic Implants: A Systematic Review and Meta-analysis. Implant Dent. 2018;27(2): 246-253.
• - Maló P, Nobre MA, Lopes A, Rodrigues. Preliminary Report on the Outcome of Tilted Implants with Longer Lengths (20–25 mm) in Low-Density Bone: One-Year Follow-Up of a Prospective Cohort Study. Clin Implant Dent Relat Res. 2015 Jan:17 Suppl 1:e134-42.
• - Konstantinovic VS, Abd-UI-Salam H, Jelovac D, Ivanjac F, Milicic B. Pterygoid and tuberosity implants in the atrophic posterior maxilla: A restrospective cohort study. J Prosthet Dent. 2023;130(2): 219.e1-2019.e10.
• - Maló P, Nobre M, Lopes A. Immediate loading of 'All-on-4' maxillary prostheses using trans-sinus tilted implants without sinus bone grafting: a retrospective study reporting the 3-year outcome. Eur J Oral Implantol. 2013 Autumn; 6(3): 273-83.
• - Camargo VB, Baptista D, Manfro R. Implante transnasal (Técnica Vanderlin) como opção ao segundo implante zigomático. In: Coppedê A. Soluções clínicas para reabilitações totais sobre implantes sem enxerto ósseos. São Paulo: Quintessence, 2019:198-214.
• - Almeida PHT, Cacciane SH, Arcazas Junior A. Extra-long transnasal implants as alternative for Quad Zygoma: Case report. Ann Med Surg. 2021;68:102635.
• - Camargo VB, Baptista D, Grossi JRA. Implantes transnasais: técnica Vanderlim como alternativa à técnica Zygoma Quad em maxilas totais atróficas – série de 12 casos em carga imediata e acompanhamento de 2 a 26 meses. Implant News. 2021; 6(5).
• - Bedrosian E. Implant treatment planning for edentulous patient. A graft lees approach to immediate loading. Missouri: Mosby Elsevier.2011:37-40.
• - Sales PHH, Gomes MVSW, Oliveira-Neto OB, de Lima FJC, Leão JC. Quality assessment of systematic reviews regarding the effectiveness of zygomatic implants: an overview of systematic reviews. Med Oral Patol Oral Cir Bucal. 2020;25:e541-e548.
• - Esposito M, Grusovin MG, Achille H, Couthard P, Worthington HV. Interventions for replacing missing teeth: Different times for loading dental implants. Cochrane Database Syst Rev. 2009;21:CD003878.
• - Sahin O. Treatment of Severely Atrophic Maxilla by Using Zygomatic, Pterygoid, and Transnasal Implants. J CraniofacSurg. 2023 Nov 20. doi: 10.1097/SCS.0000000000009896. Online ahead of print.
• - Oh S, Zelig D, Aalam AA, Kurtzman GM. Case report: utilization of Z-Point fixture "Trans- nasal" implants. Ann Med Surg (Lond). 2023; 85(5): 1959-1965.
• - Simmen D, Veerasigmani N, Briner HR, Jones N, Schuknecht. Anterior maxillary wall and lacrimal duct relationship - CT analysis for prelacrimal access to the maxillary sinus. Rhinology. 2017;55(2):170-174.
• - Da Silva MFH, Biagi LA, Castro GFS, Elizeu BO, Alcantara ABA. Instrumentação ultrassônica para a realização de implante Transnasal: Revisão Integrativa. Ver Ciên Saúde. 2022;7(3): 62-71.

License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Metrics

Categories

• Implantology

Paper information