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

Abstract

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.

Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up

“…A recent systematic review including data of 4556 ZIs with a follow-up of 12 years found a cumulative survival rate of 95.21% [ 26 ]. Another review with a shorter average follow-up reported a success rate of 98.22% [ 10 ]. The data of our study referred to an average follow-up of 12 years and the survival rate of the placed implants was around 76% (51/67), being significantly lower compared with those published by the majority of the studies.…”

“…Antibiotic prophylaxis was made in all cases with Amoxicillin 3 g per day for 10 days. All patients were recommended rinses with 0.2% chlorhexidine and the use of a thermoplastic elastomeric (TPE) bristle during the first two weeks after the implant placement [ 10 , 14 ]. A full thickness flap was raised and the central/posterior part of the zygomatic complex was exposed, avoiding interference with the orbit.…”

“…Over the past three decades, several techniques and approaches have been described for ZI placement in order to improve performance and prosthetic rehabilitation [ 8 , 9 ]. In particular, special attention has been paid to the anatomy-guided approach for the implant insertion pathway [ 10 ].…”

“…Data about the complications and success of ZI rehabilitations vary significantly among studies. A recent systematic review summarized the available data, presenting a high overall survival rate (98.22%) with a minimum follow-up of 1 month and a maximum of 228 months reported in the included studies [ 10 ]. Nevertheless, only a few studies with long-term data are available in the literature [ 9 , 11 , 12 , 13 ].…”

Informed Consent from a Historical, Societal, Ethical, Legal, and Practical Perspective

“…34 While more zygomatic implants are available, they are still a relatively new implant solution. Therefore, what data is available should be shared 35,36 with patients as to complications 37,38 and survival rates for this type of implant.…”