Zygoma implants for midfacial prosthetic rehabilitation using telescopes: 9-year follow-up

This study presents successful maxillofacial prosthetic rehabilitation using telescopic and crowns on zygoma implants as abutments.

Fifteen patients received 36 zygomatic and 24 dental implants and were followed-up for an average of 65 months (range: 13 to 102 months). Machined zygoma implants were positioned classically in the maxillary molar region. In larger defects, premolar and canine implants were also used. Follow-up included implant and prosthetic success parameters as well as the completion of the Oral Health Impact Profile (OHIP14G).

Seventy-three percent of patients during the study period did not encounter notable complications after prosthetic rehabilitation. There was an 89% cumulative 8-year zygoma implant survival rate and a 100% survival rate for the dental implants. Three losses occurred due to overloading and persistent infection; each was immediately replaced. Five successfully osseointegrated implants had to be removed in two patients due to recurrences of disease; one patient died. Peri-implant bleeding and plaque index scores decreased. After prosthetic treatment with electroplated gold or galvanotelescopes, all patients who had participated in the follow-up declared function (i.e., retention, speech, and mastication) and esthetics as having improved. Other positive aspects mentioned were good hygiene, comfortable usage, and a decrease in sore spots. OHIP scores were 25 +/- 12 on a scale of 0 (no impairment) to 56 (maximum impairment).

Within the limitations of this study (a variable evaluation period), it was observed that zygomatic implants are reliable retention for maxillofacial prostheses. Losses were diagnosed as occuring primarily from chronic infection and overloading. A trapezoid prosthesis design support is recommended with a sufficient number of implants.