Statement of the problem: Traditional removable dentures in patients who suffered maxillectomy are unstable, the size and weight produce unfavorable axial forces to the remnant dentition with progressive periodontal bone loss, teeth mobility and edentulism.
We analyzed the use of zygoma implant protocols to biomechanically distribute the mastication forces in patients after maxillectomy with or without oro-sinus-nasal reconstruction closure.
Materials and methods: Eight patients, 5 F/3 M, ages 15–62 (ave. 43,6 y.o.) underwent maxillectomy for tumor resection intraorally via mid-face degloving. Two patients required a metal frame anchoraged to zygoma and standard dental implants to fix an obturator and dental rehabilitation, both patients underwent radiotherapy after carcinoma resection. The other 6 were diagnosed with benign tumors and successfully reconstructed with either local flaps (4 patients) or temporal muscle flap (2 patients).
A minimum combination of 3 implants of standard and zygoma implants were utilized, up to 5 zygoma implants; an anterior alveolar bone through the piriform rim ending at the medial infraorbital rim was indicated in 5/8 patients. A minimum follow up of 12 months was required (12–60 months, ave. 24.5).
Results: Either hybrid dentures for the benign group or a combination of an obturator and dental rehabilitation fixing the infra-structure to the prosthesis with a coupling system, were constructed. No implants were loss during the post-operative evaluations.
Conclusions: This new protocol offers predictable, esthetic and functional rehabilitations as well as stability in the long-term, avoiding the use of bone grafting.
Conflict of interest : None declared.