Analog-digital workflow for complex rehabilitation of severe maxillary atrophy with zygomatic implants: a clinical case

Abstract

Patients with a complete lack of teeth, severe maxillary atrophy and midface deformity create the most unfavorable conditions for their rehabilitation according to traditional protocols, including bone grafting, sinus lifting and implantation, which forms a complex clinical challenge. Today, zygomatic implants are successfully used as an alternative option for rehabilitation of patients with severe upper jaw atrophy, allowing to reduce the volume of surgical interventions, as well as to shorten the rehabilitation period. Until now, the question of finding an optimal treatment protocol with the use of zygomatic implants remains relevant. We proposed an integrated protocol of rehabilitation of patients with severe maxillary atrophy, based on the use of analog-digital diagnostic tools and treatment outcome planning, as well as including the stages of surgical and prosthetic treatment using the developed technology of zygomatic implant placement and immediate loading with prosthetic jaw prosthesis constructions. This work presents a clinical case of the patient (62 years old), whose rehabilitation was performed in accordance with her own protocol: preoperative digital planning according to computer tomography data (Blue Sky Bio Plan, USA), virtual modeling and manufacturing of surgical template for positioning four zygomatic implants (Nobel Biocare, USA), installation of zygomatic implants and immediate fixation of temporary dental prosthesis. Based on the results of follow-up examinations, including X-ray assessment of the zygomatic bones over a period of 6 years, no complications were detected.