Zygomatic implant for the rehabilitation of the oncologic patient using a computer-aided technique. Preliminary results of a cohort study at 6 years follow-up

03PMI ePOSTER CLINICAL RESEARCH – SURGERY

Background: The rehabilitation of patients with defects of the upper jaw due to resection for cancer has always been a challenging procedure. The use of zygomatic implants can be considered a reliable method in case of bone reconstruction is not indicated. The latest three-dimensional technologies can further contribute to increasing the safeness and predictability of the procedure.

Aim/Hypothesis: The aim of this study is to evaluate the clinical results of oncologic patient rehabilitations supported by zygomatic implants placed with a computer-aided method. The secondary objectives were the evaluation of the major and minor complications as well as the quality of life for the patient.

Materials and Methods: Since 2013, ten fully and partially edentulous patients who underwent unilateral or bilateral maxillectomy for an oncologic reason, were treated in a delayed rehabilitation supported by zygomatic implants (Southern Implants, Irene, South Africa). Each patient carried out a 3D virtual planning to choose the implant length and the surgeon could use a dynamic navigation system (Implanav) for implant positioning. A screw-retained prosthesis was finally delivered. Clinical and radiographic outcomes and correspondence between planned implant length and the postoperative one were evaluated. The major and minor complications were recorded. All the patients filled the quality of life questionnaire before the surgery, after the prosthetic rehabilitation and during the follow-up period.

Results: The mean follow-up period was 36.7 months (12-71 months). The patient's age ranged from 48 to 88 years (mean 66.5 years). 35 zygomatic implants were placed. The implant survival rate was 97.14%. The prosthetic survival rate was 100%. The mean difference between the planned implant length and the positioned implant length was 0.92 ± 1.36 mm. One implant failure occurred in the first year. Some minor biological complications (mucositis) occurred but were easily solved. The OHIP14 score increased by 82.9% in terms of satisfaction.

Conclusions and Clinical Implications: Rehabilitation with zygomatic-implants seems to be a reliable technique in patients with maxillary defects due to oncologic issues. The three-dimensional computer-aided approach could facilitate the planning and increase the predictability of the surgical and prosthetic outcomes. However, other clinical trials with longer follow-ups are necessary to definitively assure the reliability of this technique also in this category of patients.

Acknowledgements: Dt. Claudio Carboni (University of Bologna), Prof. Paolo Pisi (Dental Radiology, University of Bologna), S.I.R. S.r.l. (Verona, Italy), Southern Implants (Irene, South Africa), Esacrom (Imola, Italy), BresMedical (Sydney, Australia)

Keywords: zygomatic implant, oncologic patient, immediate loading, computer-aided, 3D planning