Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Participants
2.3. Surgical Procedures and Postoperative Care
2.4. Implants
2.5. Variables and Outcomes
2.6. Statistical Analysis
3. Results
3.1. Study Population
3.2. Outcomes
3.3. Main Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Corbella, S.; Taschieri, S.; Del Fabbro, M. Long-term outcomes for the treatment of atrophic posterior maxilla: A systematic review of literature. Clin. Implant. Dent. Relat. Res. 2015, 17, 120–132. [Google Scholar] [CrossRef] [PubMed]
- Van der Weijden, F.; Dell’Acqua, F.; Slot, D.E. Alveolar bone dimensional changes of post-extraction sockets in humans: A systematic review. J. Clin. Periodontol. 2009, 36, 1048–1058. [Google Scholar] [CrossRef] [PubMed]
- Merli, M.; Moscatelli, M.; Pagliaro, U.; Mariotti, G.; Merli, I.; Nieri, M. Implant prosthetic rehabilitation in partially edentulous patients with bone atrophy. An umbrella review based on systematic reviews of randomised controlled trials. Eur. J. Oral Implantol. 2018, 11, 261–280. [Google Scholar] [PubMed]
- Graves, S.L. The pterygoid plate implant: A solution for restoring the posterior maxilla. Int. J. Periodontics Restor. Dent. 1994, 14, 512–523. [Google Scholar]
- Fernández Valerón, J.; Fernández Velázquez, J. Placement of screw-type implants in the pterygomaxillary-pyramidal region: Surgical procedure and preliminary results. Int. J. Oral Maxillofac. Implant. 1997, 12, 814–819. [Google Scholar]
- Aparicio, C.; Brånemark, P.-I.; Keller, E.E.; Olivé, J. Reconstruction of the premaxilla with autogenous iliac bone in combination with osseointegrated implants. Int. J. Oral Maxillofac. Implant. 1993, 8, 1–15. [Google Scholar]
- Brånemark, P.I.; Gröndahl, K.; Ohrnell, L.O.; Nilsson, P.; Petruson, B.; Svensson, B.; Engstrand, P.; Nannmark, U. Zygoma fixture in the management of advanced atrophy of the maxilla: Technique and long-term results. Scand. J. Plast Reconstr. Surg. Hand. Surg. 2004, 38, 70–85. [Google Scholar] [CrossRef]
- Aparicio, C. A proposed classification for zygomatic implant patient based on the zygoma anatomy guided approach (ZAGA): A cross-sectional survey. Eur. J. Oral Implantol. 2011, 4, 269–275. [Google Scholar]
- Aleksandrowicz, P.; Kusa-Podkańska, M.; Grabowska, K.; Kotuła, L.; Szkatuła-Łupina, A.; Wysokińska-Miszczuk, J. Extra-Sinus Zygomatic Implants to Avoid Chronic Sinusitis and Prosthetic Arch Malposition: 12 Years of Experience. J. Oral Implantol. 2019, 45, 73–78. [Google Scholar] [CrossRef]
- Gracher, A.H.P.; de Moura, M.B.; da Silva Peres, P.; Thomé, G.; Padovan, L.E.M.; Trojan, L.C. Full arch rehabilitation in patients with atrophic upper jaws with zygomatic implants: A systematic review. Int. J. Implant. Dent. 2021, 7, 17. [Google Scholar] [CrossRef]
- Aparicio, C.; Manresa, C.; Francisco, K.; Ouazzani, W.; Claros, P.; Potau, J.M.; Aparicio, A. The long-term use of zygomatic implants: A 10-year clinical and radiographic report. Clin. Implant. Dent. Relat. Res. 2014, 16, 447–459. [Google Scholar] [CrossRef]
- Alzoubi, F.; Bedrossian, E.; Wong, A.; Farrell, D.; Park, C.; Indresano, T. Outcomes Assessment of Treating Completely Edentulous Patients with a Fixed Implant-Supported Profile Prosthesis Utilizing a Graftless Approach. Part 1: Clinically Related Outcomes. Int. J. Oral Maxillofac. Implant. 2017, 32, 897–903. [Google Scholar] [CrossRef] [Green Version]
- Chana, H.; Smith, G.; Bansal, H.; Zahra, D. A Retrospective Cohort Study of the Survival Rate of 88 Zygomatic Implants Placed Over an 18-year Period. Int. J. Oral. Maxillofac. Implant. 2019, 34, 461–470. [Google Scholar] [CrossRef]
- Ballini, A.; Di Cosola, M.; Saini, R.; Benincasa, C.; Aiello, E.; Marrelli, B.; Rajiv Saini, S.; Ceruso, F.M.; Nocini, R.; Topi, S.; et al. Comparison of Manual Nylon Bristled Versus Thermoplastic Elastomer Toothbrushes In Terms of Cleaning Efficacy And Biological Potential Role On Gingival Health. Appl. Sci. 2021, 11, 7180. [Google Scholar] [CrossRef]
- Cawood, J.I.; Howell, R.A. A classification of the edentulous jaws. Int. J. Oral Maxillofac. Surg. 1988, 17, 232–236. [Google Scholar] [CrossRef]
- Merli, M.; Migani, M.; Bernardelli, F.; Esposito, M. Vertical bone augmentation with dental implant placement: Efficacy and complications associated with 2 different techniques. A retrospective cohort study. Int. J. Oral Maxillofac. Implant. 2006, 21, 600–606. [Google Scholar]
- Chan, H.L.; Suarez, F.; Monje, A.; Benavides, E.; Wang, H.L. Evaluation of maxillary sinus width on cone-beam computed tomography for sinus augmentation and new sinus classification based on sinus width. Clin. Oral Implant. Res. 2014, 25, 647–652. [Google Scholar] [CrossRef] [Green Version]
- Tolstunov, L.; Thai, D.; Arellano, L. Implant-guided volumetric analysis of edentulous maxillary bone with cone-beam computerized tomography scan. Maxillary sinus pneumatization classification. J. Oral Implantol. 2012, 38, 377–390. [Google Scholar] [CrossRef]
- Lana, J.P.; Carneiro, P.M.; Machado Vde, C.; de Souza, P.E.; Manzi, F.R.; Horta, M.C. Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants. Clin. Oral Implant. Res. 2012, 23, 1398–1403. [Google Scholar] [CrossRef]
- Rehl, R.M.; Balla, A.A.; Cabay, R.J.; Hearp, M.L.; Pytynia, K.B.; Joe, S.A. Mucosal Remodeling in Chronic Rhinosinusitis. Am. J. Rhinol. 2007, 21, 651–657. [Google Scholar] [CrossRef]
- Janovic, N.; Janovic, A.; Milicic, B.; Djuric, M. Relationship between nasal septum morphology and nasal obstruction symptom severity: Computed tomography study. Braz. J. Otorhinolaryngol. 2020, S1808-8694, 30157–30159. [Google Scholar] [CrossRef]
- Posa, F.; Colaianni, G.; Di Cosola, M.; Dicarlo, M.; Gaccione, F.; Colucci, S.; Grano, M.; Mori, G. The Myokine Irisin Promotes Osteogenic Differentiation of Dental Bud-Derived MSCs. Biology 2021, 10, 295. [Google Scholar] [CrossRef]
- Charitos, I.A.; Ballini, A.; Cantore, S.; Boccellino, M.; Di Domenico, M.; Borsani, E.; Nocini, R.; Di Cosola, M.; Santacroce, L.; Bottalico, L.; et al. Stem Cells: A Historical Review about Biological, Religious, and Ethical Issues. Stem Cells Int. 2021, 2021, 9978837. [Google Scholar] [CrossRef]
- Stevenson, A.R.; Austin, B.W. Zygomatic fixtures—The Sydney experience. Ann. R. Australas Coll. Dent. Surg. 2000, 15, 337–339. [Google Scholar]
- Esposito, M.; Worthington, H.V.; Coulthard, P. Interventions for replacing missing teeth: Dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla. Cochrane Database Syst. Rev. 2005, 4, Cd004151. [Google Scholar] [CrossRef]
- Chrcanovic, B.R.; Abreu, M.H. Survival and complications of zygomatic implants: A systematic review. Oral Maxillofac. Surg. 2013, 17, 81–93. [Google Scholar] [CrossRef]
- Rodríguez-Chessa, J.G.; Olate, S.; Netto, H.D.; Shibli, J.; de Moraes, M.; Mazzonetto, R. Treatment of atrophic maxilla with zygomatic implants in 29 consecutives patients. Int. J. Clin. Exp. Med. 2014, 7, 426–430. [Google Scholar]
- Yates, J.M.; Brook, I.M.; Patel, R.R.; Wragg, P.F.; Atkins, S.A.; El-Awa, A.; Bakri, I.; Bolt, R. Treatment of the edentulous atrophic maxilla using zygomatic implants: Evaluation of survival rates over 5–10 years. Int. J. Oral Maxillofac. Surg. 2014, 43, 237–242. [Google Scholar] [CrossRef]
- Della Nave, P.; Queralt, A.V. Zygomatic Implants for the Rehabilitation of Atrophic Maxillae: A Retrospective Study on Survival Rate and Biologic Complications of 206 Implants with a Minimum Follow-up of 1 Year. Int. J. Oral Maxillofac. Implant. 2020, 35, 1177–1186. [Google Scholar] [CrossRef]
- Nocini, P.F.; Trevisiol, L.; D’Agostino, A.; Zanette, G.; Favero, V.; Procacci, P. Quadruple zygomatic implants supported rehabilitation in failed maxillary bone reconstruction. Oral Maxillofac. Surg. 2016, 20, 303–308. [Google Scholar] [CrossRef]
- D’Agostino, A.; Trevisiol, L.; Favero, V.; Pessina, M.; Procacci, P.; Nocini, P.F. Are Zygomatic Implants Associated With Maxillary Sinusitis? J. Oral Maxillofac. Surg. 2016, 74, 1562–1573. [Google Scholar] [CrossRef]
- Bavetta, G.; Bavetta, G.; Randazzo, V.; Cavataio, A.; Paderni, C.; Grassia, V.; Dipalma, G.; Gargiulo Isacco, C.; Scarano, A.; De Vito, D.; et al. A Retrospective Study on Insertion Torque and Implant Stability Quotient (ISQ) as Stability Parameters for Immediate Loading of Implants in Fresh Extraction Sockets. Biomed. Res. Int. 2019, 2019, 9720419. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zhao, K.; Lian, M.; Fan, S.; Huang, W.; Wang, F.; Wu, Y. Long-term Schneiderian membrane thickness changes following zygomatic implant placement: A retrospective radiographic analysis using cone beam computed tomography. Clin. Oral Implant. Res. 2018, 29, 679–687. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Patients (n) | Implants (n) | Mean Age at Enrolment (Years ± sd) | Hypertension (Yes:No) | Diabetes (Yes:No) | Smoking (Yes:No) | Follow-Up (Months ± sd) | Failures (n Patients (n Implants)) | |
---|---|---|---|---|---|---|---|---|
Total | 33 | 67 | 59.1 ± 8.68 | 6:27 | 5:28 | 7:26 | 141.6 ± 25.34 | 8 (16) |
Sex (%) Male | 14 | 28 | 60.2 ± 9.26 | 3:11 | 3:11 | 6:8 | 136.92 ± 26.48 | 5 (10) |
Female | 19 | 39 | 58.4 ± 8.41 | 3:16 | 2:17 | 1:18 | 145.05 ± 24.62 | 3 (6) |
Implant Level Variables | n = 67 n % | |
---|---|---|
Implant path | ||
Completely intrasinusal | 47 | 70.15 |
Not completely intrasinusal | 20 | 29.85 |
Ridge atrophy | ||
IIc | 26 | 38 |
IIIc–IVc | 21 | 31.34 |
Vc | 20 | 29.85 |
Sinus width | ||
Narrow | 12 | 17.91 |
Medium | 16 | 23.88 |
Large | 39 | 58.20 |
Sinus pneumatization | ||
A | 32 | 47.76 |
B | 35 | 52.23 |
Thickness of the sinus mucosa | ||
≤3 mm | 40 | 59.7 |
>3 mm | 27 | 40.3 |
Patency of sinus ostium | ||
Yes | 49 | 73.13 |
No | 18 | 26.86 |
Implantslength | ||
<45 mm | 44 | 65.67 |
≥45 mm | 23 | 34.33 |
Implant brand | ||
Nobel Biocare | 45 | 67.16 |
Southern Implants | 22 | 32.83 |
Prosthetic timing | ||
Immediate loading | 57 | 85.07 |
Deferred loading | 10 | 14.92 |
Septum deviation | Average 12.11 ± 7.78 |
Outcome | Implants (n = 67) | Patients (n = 33) |
---|---|---|
Failure | 16 (23.88%) | 8 (24.24%) |
Overall complications | 36 (53.73%) | 17 (51.51%) |
Infective complications | 28 (41.79%) | 15 (45.45%) |
Early neurological complications | 11 (16.41%) | 5 (15.15%) |
Variables | Infective Complications | Early Neurologic | |||
---|---|---|---|---|---|
OR 95% (CI) | p-Value | OR 95% (CI) | p-Value | ||
Implant path | Completely intrasinusal (ref) | 1.00 | - | 1.00 | - |
Not completely intrasinusal | 0.49 (0.16−1.48) | 0.206 | 0.86 (0.20−3.64) | 0.838 | |
Prosthetic timing | Deferred loading (ref) | 1.00 | - | 1.00 | - |
Immediate loading | 0.17 (0.04−0.72) | 0.016 * | 0.06 (0.012−0.26) | 0.001 * | |
Implant length | <45 mm (ref) | 1.00 | - | 1.00 | - |
≥45 mm | 1.06 (0.37−3.03) | 0.905 | 0.18 (0.02−1.51) | 0.114 | |
Implant brand | Nobel (ref) | 1.00 | - | 1.00 | - |
SI | 1.07 (0.40−2.88) | 0.881 | 0.26 (0.05−1.29) | 0.100 | |
Sinus pneumatization | A (ref) | 1.00 | - | 1.00 | - |
B | 2.33 (0.86−6.33) | 0.097 | 2.86 (0.69−11.93) | 0.148 | |
Ridge atrophy | IIc (ref) | 1.00 | - | 1.00 | - |
IIIc–IVc | 0.68 (0.21−2.25) | 0.530 | 0.58 (0.09−3.51) | 0.553 | |
Vc | 1.36 (0.42−4.40) | 0.604 | 1.83 (0.42−7.97) | 0.604 | |
Sinus width | Narrow (ref) | 1.00 | - | 1.00 | - |
Medium | 0.69 (0.11−4.24) | 0.691 | 1.15 (0.16−8.27) | 0.887 | |
Large | 3.88 (0.91−16.6) | 0.067 | 0.91 (0.16−5.23) | 0.915 | |
Thickness of sinus mucosa | ≤3 (ref) | 1.00 | - | 1.00 | - |
>3 | 3.39 (1.22−9.44) | 0.019 * | 1.29 (0.35−4.74) | 0.703 | |
Smoking | No (ref) | 1.00 | - | 1.00 | - |
Yes | 2.72 (0.78−9.46) | 0.116 | 0.42 (0.13−1.44) | 0.314 | |
Ostium patency | No (ref) | 1.00 | - | 1.00 | - |
Yes | 2.25 (0.22−22.8) | 0.493 | 1.34 (0.47−2.11) | 0.665 | |
Septum Deviation | 1.01(0.97−1.07) | 0.521 | 1.03 (0.96−1.10) | 0.447 |
Variables | Implant Failure | Overall Complications | |||
---|---|---|---|---|---|
OR 95% (CI) | p-Value | OR 95% (CI) | p-Value | ||
Implant path | Completely intrasinusal (ref) | 1.00 | - | 1.00 | - |
Not completely intrasinusal | 0.73 (0.20−2.61) | 0.628 | 0.81 (0.28−2.3) | 0.690 | |
Prosthetic timing | Deferred loading (ref) | 1.00 | - | 1.00 | |
Immediate loading | 0.35 (0.09−1.31) | 0.120 | 0.04 (0.004−0.29) | 0.002 * | |
Implant length | <45 mm (ref) | 1.00 | - | 1.00 | - |
≥45 mm | 2.92 (0.91−9.37) | 0.071 | 0.92 (0.33−2.60) | 0.881 | |
Implant brand | Nobel(ref) | 1.00 | - | 1.00 | - |
SI | 0.55 (0.17−1.82) | 0.331 | 0.61 (0.22−1.69) | 0.345 | |
Sinus pneumatization | A (ref) | 1.00 | - | 1.00 | - |
B | 3.65 (1.04−12.86) | 0.044 * | 1.89 (1.04−3.46) | 0.037 * | |
Ridge atrophy | IIc (ref) | 1.00 | - | 1.00 | - |
IIIc–IVc | 1.31 (0.32−5.32) | 0.703 | 0.64 (0.19−2.20) | 0.478 | |
Vc | 1.8 (0.46−7.05) | 0.399 | 1.6 (0.49−5.21) | 0.435 | |
Sinus width | Narrow (ref) | 1.00 | - | 1.00 | |
Medium | 0.2 (0.02−2.22) | 0.190 | 0.46 (0.08−2.62) | 0.383 | |
Large | 1.33 (0.30−5.81) | 0.702 | 1.9 (0.49−7.36) | 0.353 | |
Thickness of sinus mucosa | ≤3 (ref) | 1.00 | - | 1.00 | - |
>3 | 1.68 (0.54−5.22) | 0.367 | 2.51 (0.91−6.92) | 0.075 | |
Smoking | No (ref) | 1.00 | - | 1.00 | - |
Yes | 2.44 (0.67−8.95) | 0.178 | 0.40 (0.10−1.64) | 0.204 | |
Ostium patency | No (ref) | 1.00 | - | 1.00 | - |
Yes | 0.94 (0.09−9.69) | 0.957 | 1.97 (0.19−20.06) | 0.565 | |
Septum deviation | 0.97 (0.91−1.03) | 0.274 | 1.01 (0.95−1.05) | 0.922 |
Variables | Infective Complications | Early Neurologic Complications | Overall Complications | Implant Failure | |||||
---|---|---|---|---|---|---|---|---|---|
OR 95 % (CI) | p-Value | OR 95 % (CI) | p-Value | OR 95 % (CI) | p-Value | OR 95 % (CI) | p-Value | ||
Prosthetic Timing | Deferred loading (ref) Immediate loading | 1.00 0.115 (0.02–0.54) | 0.007 * | 1.00 0.001 (0.00–0.20) | 0.013 * | ||||
Sinus Width | Narrow (ref) Medium Large | 1.00 1.515 (0.18–12.44) 6.400 (1.17–34.79) | 0.699 0.032 * | 1.00 1.01 (0.39–12.80) 2.421 (1.86–22.27) | 0.233 0.036 * | 1.00 4.133 (0.59–49.07) 9.320 (1.66–67.10) | 0.051 0.004 * | ||
Thickness Of Sinus Mucosa | ≤3 (ref) >3 | 1.00 2.758 (0.94–8.03) | 0.045 * | ||||||
Sinus Pneumatization | A (ref) B | 1.00 3.023 (1.04–9.46) | 0.045 * | 1.00 2.60 (1.21–5.62) | 0.014 * |
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Di Cosola, M.; Ballini, A.; Zhurakivska, K.; Ceccarello, A.; Nocini, R.; Malcangi, A.; Mori, G.; Lo Muzio, L.; Cantore, S.; Olivo, A. Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up. Int. J. Environ. Res. Public Health 2021, 18, 12963. https://doi.org/10.3390/ijerph182412963
Di Cosola M, Ballini A, Zhurakivska K, Ceccarello A, Nocini R, Malcangi A, Mori G, Lo Muzio L, Cantore S, Olivo A. Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up. International Journal of Environmental Research and Public Health. 2021; 18(24):12963. https://doi.org/10.3390/ijerph182412963
Chicago/Turabian StyleDi Cosola, Michele, Andrea Ballini, Khrystyna Zhurakivska, Alberto Ceccarello, Riccardo Nocini, Annarita Malcangi, Giorgio Mori, Lorenzo Lo Muzio, Stefania Cantore, and Antonio Olivo. 2021. "Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up" International Journal of Environmental Research and Public Health 18, no. 24: 12963. https://doi.org/10.3390/ijerph182412963
APA StyleDi Cosola, M., Ballini, A., Zhurakivska, K., Ceccarello, A., Nocini, R., Malcangi, A., Mori, G., Lo Muzio, L., Cantore, S., & Olivo, A. (2021). Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up. International Journal of Environmental Research and Public Health, 18(24), 12963. https://doi.org/10.3390/ijerph182412963