Rehabilitation of severe maxillary atrophy with zygomatic implants. Clinical report of four cases

Rehabilitation of the severely resorbed maxilla poses a difficult challenge, for both restorative and surgical colleagues, as the typically large maxillary sinuses in this group of patients require extensive bone grafting if root form dental implant placement is considered. Acceptance is low, due to disadvantages associated with: i) an additional surgical procedure for an iliac bone graft harvesting and, ii) an overall delay in delivery of the final implant-supported prosthesis. The zygomatic implant placement procedure does not require any adjunctive procedures. Furthermore, the ability to immediately use existing dentures and the lack of need for bone grafting and prolonged hospitalisation makes this treatment modality more acceptable to the patient. Four cases are reported that demonstrate the successful treatment of a severely atrophic maxilla with either a fixed prosthesis supported by two zygomatic and a minimum of three standard dental implants or an over-denture supported by two zygomatic and one standard dental implant.