Fixed teeth with zygomatic implants in extreme cases of lack of bone.
For several years now, I have been performing in Las Palmas, in the Caballero de Rodas Dental Clinic, very complex surgeries due to lack of bone. Many patients come to the clinic with the illusion of recovering their smile.
In the following case, I am talking about a very young and beautiful lady who came to the clinic because her mouth was in very bad conditions. Almost all the teeth she still had in her upper jaw were very periodontal and were moving. She had visited several clinics, but in all of them she was told that her only solution was to have a complete removable prosthesis because she had no bone to place implants.
We did an orthopantomography, a two-dimensional X-ray, and indeed we confirmed that she had no bone. The maxillary sinuses (air pockets above the maxilla) were huge, and there was hardly any bone to anchor the implants. The only possible solution to rehabilitate her maxilla with fixed teeth was to place zygomatic implants. To confirm the treatment plan we needed to do a dental CAT scan, an X-ray that gives us the three dimensions of the bone structure (height, width and thickness), which makes it possible to plan the case well. With this test, which we performed at the clinic, we were able to confirm that she needed 4 zygomatic implants, but that despite the complexity of the surgery, it was possible to remove the teeth she had in his mouth and place the implants and screw-retained fixed teeth on the same day of the surgery.
This process had a small variation and that is that the surgeries with 4 zygomatic implants, known as ALL-ON-4TM QUAD ZYGOMAS, were performed in an external clinic/hospital, always under general anesthesia. We were the only clinic that had given her a solution to her problem, and her desperation made her accept as she went along. It was clear to her that she wanted fixed teeth, and as she felt confident and safe enough, she was encouraged to have the surgery. We took a blood test for her for the preoperative general anesthesia, as well as all the necessary tests for the intervention. We made an appointment with the patient a week before to take models and make the provisional screw-retained prosthesis that we would place on the afternoon of the surgery. We spoke with the clinic, in this case the Paloma, and arranged a date according to the availability of the clinic, the doctor and the anesthesiologist.
The surgery was a success. The zygomatic implants, longer than normal (between 35mm-52mm) were anchored as planned in the malar bone. We took measurements to adapt the provisional prosthesis to the definitive position of the zygomatic implants, and that same evening, at around 18.00h, we placed the screwed fixed teeth that she had always wanted. The patient went home obviously delighted. She had avoided to face the unpleasant situation of having to endure a removable set of teeth, which she did not even want to imagine having to take out to clean and see herself without teeth in her daily life.