CHAPTER 17 Zygomatic Implant Surgery and Prosthodontics
The TiUnite surface on Nobel Biocare implants has been shown to support the healing process and to maintain initial implant stability better than machined titanium implants. TiUnite is a highly osseoconductive surface.
Many factors contribute to the long-term success of zygomatic implant surgery. As many of these factors as possible must be carefully evaluated before the surgical procedure is started. An effective team approach must be established for proper treatment planning and long-term success. The preoperative prosthetic examination and evaluation should include the following:
The tooth positions for the planned restoration should be decided preoperatively. The ideal length and angulation of implants are best achieved by using the NobelGuide (see Chapter 4). This allows selection of the most appropriate position and angulation for each implant. The existing removable prosthesis often serves as a guide for these positions. In some cases, a diagnostic wax-up is necessary. The prosthetic team must ensure that the surgical team clearly understands the tooth positions required for the final prosthesis. A good means of doing this is to provide a surgical guide. A surgical guide can be fabricated quickly and simply by making a clear acrylic resin replica of the existing removable denture or the waxed-up try-in (see Chapter 4). Except for a supporting posterior connection, the palatal area of the replica is cut away, leaving only the buccal contours of the teeth.