En retrospektiv undersøgelse af zygomaimplantater
Formål
En retrospektiv undersøgelse af 19 patienter behandlet med en kombination af zygomaimplantater og standardimplantater i maksillen. Implantatoverlevelse og komplikationer blev anvendt som effektparametre, hvorimod biologiske og tekniske/mekaniske komplikationer ikke blev vurderet.
Materiale og metoder
Fra januar 2001 til januar 2008 fik 19 tandløse patienter indsat 48 zygomaimplantater og 72 standardimplantater i maksillen på Kæbekirurgisk Afdeling, Aalborg Universitetshospital. I de tilfælde, hvor der fandtes udtalt atrofi af maksillen og pneumatisering af sinus maxillaris, blev der foretaget forudgående sinusopbygning med autologt knogletransplantat fra hoftekammen. Ligeledes fik fire patienter foretaget nasalløft i forbindelse med indsættelse af standardimplantater. Den efterfølgende protetiske rekonstruktion inkluderede en skrueretineret fuldbro hos 10 patienter og en hybridprotese hos ni patienter.
Resultater
I alt blev der mistet fire zygomaimplantater og seks standardimplantater, resulterende i en implantatoverlevelse på 92 % for begge implantattyper efter en gennemsnitlig observationsperiode på 59 måneder. Postoperativ infektion opstod hos ni patienter, som blev sufficient behandlet med antibiotika uden behov for kirurgisk behandling. Persisterende dobbeltsyn forekom hos en patient, sandsynligvis som følge af beskadigelse af indholdet i orbita under udboring til zygomaimplantatet. Dobbeltsynet blev behandlet med kirurgisk korrektion ved øjenafdeling og korrektiv brille.
Konklusioner
Overlevelsen af zygomaimplantater synes sammenlignelig med overlevelsen af standardimplantater og implantater indsat i forbindelse med sinusløftprocedure. Imidlertid er indsættelse af zygomaimplantater forbundet med en øget komplikationsrisiko sammenlignet med de øvrige behandlingsmodaliteter, hvorfor zygomaimplantaterne i dag fortrinsvis anvendes til traume- og resektionspatienter.
A retrospective study of zygoma implants
Purpose – A retrospective study of 19 patients treated with zygoma implants and conventional implants inserted in the upper jaw. Outcome measures were implant survival and complications, whereas biological and technical/mechanical complications were not evaluated.
Material and methods – From January 2001 to January 2008, 19 patients with edentulous upper jaws were treated with 48 zygoma implants and 72 conventional implants at the Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Denmark. In cases with severe atrophy of the upper jaw or pneumatisation of the maxillary sinus, a sinus graft augmentation procedure with autogenous iliac bone graft was performed prior to implant placement. Nasal floor argumentation was performed in four patients concomitant with installation of conventional implants. The prosthetic rehabilitation involved a fixed full-arch denture in ten patients and a removable denture in nine patients.
Results – Four zygoma implants and six conventional implants were lost after a mean follow-up period of 59 months. Consequently, the survival for both implant types was 92 % Postoperative infection occurred in nine patients and was adequately treated with antibiotics without the need for surgical intervention. One patient experienced persistent diplopia, probably due to damage of the orbit during zygoma implant site preparation. The diplopia was treated with surgery and prismatic correction at the Department of Ophthalmology.
Conclusions – The current study revealed survival rates of zygoma implants comparable to those of conventional implants and implants placed in conjunction with sinus graft procedure. However, zygoma implants are associated with an increased risk of complications compared to other treatment options. Therefore, zygoma implants should only be used in selected patients.