Prosthetic rehabilitation of the patient after extensive maxilloectomy supported by dental implants in zygoma bone: clinical report

Introduction: Prosthetic rehabilitation of the patients, after maxilloectomy resection is challenging because of complexity of defects. Only few such clinical cases were found in literature. This study dedicate to prosthetic rehabilitation with dental implants in zygoma of the patient who underwent total maxilla and nasoetmoid resection.

Case report: Patient A.S. 38 year old female, with tumor in hard palate. Anamnesis reveled “Tumor and recurrence resection” due to certain pathology in 2000–2010. Currently tumor with hard consistency and stuck overlying mucosa was found in the region of whole maxillae. CT scan showed invasion to the total maxilla, ethmoid complex, left orbit and anterior cranial fossa with penetration of lamina cribrosae. “Total maxilla and nasoetmoid resection” by anterior craniotomy and facial degloving approach was performed. Histology identified tumor as a low-grade mucoepidermoid carcinoma. A month later 4 dental implants were placed in both zygoma bone. Six month later during preparation to prosthetic rehabilitation CT scan showed excellent osseointegration of dental implants. However tumor recurrence and metastatic neck lymph nodes was found. “Resection of tumor recurrence, left-side modified neck dissection with subsequent reconstruction of middle third of the face and surgical preparation of soft tissue part of prosthetic filed with full thickness skin graft” was done. Obturator prosthesis with dolder support bar was prepared.

Result: Postoperative clinical investigation has shown good functional and esthetic result.

Conclusion: Importance of soft tissue reconstruction around dental implants during prosthetic rehabilitation of the patients who underwent total maxilloectomy was approved within this particular case.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Prosthetic rehabilitation of the patient after extensive maxilloectomy supported by dental implants in zygoma bone: clinical report
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