[Zygomatic implants anchorage for the rehabilitation of maxillary defects]

Prosthetic reconstruction of the upper jaw in patients with extensive bone and soft tissue defects is still a significant challenge. This study evaluated the functional results of zygomatic implants and vascularized bone graft reconstruction of the maxillary defects in 4 patients.

Complex resections of the maxilla produced a three-dimensional defect in 4 patients. On the basis of an axial spiral CT data, anatomical models of natural size by CAD/CAM system was manufactured to enable preoperative measurements of relevant parameters. After tumor resection, reconstruction using the fibula or iliac osteocutaneous flap with titanium osseointegrated implants was performed. Maxillary and zygomatic measurements were also used to obtain information for installing 6 zygomatic implants and 7 dental implants.

The bone from the fibula or iliac osteocutaneous flap was contoured to recreate the maxillary arch in 4 patients. The anatomical model and surgical palate was used for preoperative planning and intraoperative control of the insertion of 6 zygomatic fixtures after subtotal maxillectomy. The implants could be positioned precisely as preoperatively planned.

The use of zygomatic fixtures after ablative tumor surgery with resection of the maxillary bone is valuable in providing new zygomatic buttresses that play a key role in the form of the midface. Maxillary rehabilitation can be further improved by using the vascularized bone graft and zygomatic implants. Reconstitutions of the buttresses system ensure a stable base for occlusion, which is essential to optimal functional and esthetic maxillary rehabilitation. Supported by Research Fund (No. 2004BA720A27) of National Tenth Five-Year Project.