Title

Rehabilitation Of Atrophic Posterior Maxilla With Zygomatic Implants

Clinical Question

Are Zygomatic implants a viable option for the treatment of atrophic maxilla?

Clinical Bottom Line

Zygomatic implants have a high success rate and constitute a suitable alternative to treat severe posterior maxillary atrophy.

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
21332329	Candel/2011	NA	Review
Key results	941 zygomatic implants were reviewed in 16 retrospective studies with a follow-up period of 12-120 months. The implants that had delayed loading (after 3-6 months) had a 89-100% success rate, and the implants that were immediately loaded had a success rate of 96.5-100%. The Weighted average success was 97.05%. A cement or screw retained fixed prosthesis was used to restore the majority of the cases. Complications included maxillary sinusitis, fracture of prosthesis, paresthesia, peri-implantitis and fistula formation. Maxillary sinusitis was cited as the most common reason for failure.

Evidence Search

(("rehabilitation"[Subheading] OR "rehabilitation"[All Fields] OR "rehabilitation"[MeSH Terms]) AND ("atrophy"[MeSH Terms] OR "atrophy"[All Fields] OR "atrophic"[All Fields]) AND POSTERIOR[All Fields] AND ("maxilla"[MeSH Terms] OR "maxilla"[All Fields]) AND ZYGOMATIC[All Fields] AND IMPLANTS[All Fields])

Comments on
The Evidence

Zygomatic implant procedures result in shorter treatment times compared to bone augmentation procedures such as sinus grafts and onlay grafts. It also has the potential to have less morbidity than bone augmentation procedures.

Applicability

Zygomatic implants are a viable option for the treatment of atrophic maxilla and should be considered.

Specialty

(Oral Surgery) (Orthodontics) (Periodontics) (Prosthodontics)

Keywords

zygomatic Implants, Survival,

ID#

2145

Date of submission

11/22/2011

E-mail

mullanes@livemail.uthscsa.edu

Author

Shane Mullane, DDS

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Stephan Haney, DDS

Faculty mentor e-mail

haneys2@uthscsa.edu

Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

by Jared Hope, Parker Wentz (San Antonio, Texas) on 12/04/2017
A PubMed database search was conducted on 11/27/17 looking at zygomatic implants and their effectiveness in restoring atrophic maxillas. Additional support for the assigned CAT conclusion is provided by Wang et al. in an April 2015 publication (PMID: 25830389) and by Coppede et al. in a July 2017 publication (PMID: 28703481). In the Wang study, a systematic review was conducted from September 2000 to November 2013 in which oral rehabilitation was achieved using four zygomatic implants. The weighted mean zygomatic implant survival rate was 96.7%. The Coppede study, a 3-year clinical prospective follow-up of zygomatic implants for rehabilitation of atrophic maxillas, concluded a similar implant survival rate (98.9%) as that of Wang et al.