Reconstruction of extensive maxillary defects using zygomaticus implants.
OBJECTIVE
Maxillary reconstruction after maxillectomy remains a great challenge for the reconstructive oral and maxillofacial surgeon. This article is a clinical retrospective analysis of patients reconstructed with zygomaticus implants after maxillary ablation.


METHODS
The design of the study was a retrospective review of 9 patients requiring near-total or total maxillectomy for pathologic reasons. Clinical records, photographs, and radiographs were studied. Financial billing statements were reviewed to determine charges for implant reconstruction and method of payment.


RESULTS
Maxillary reconstruction using zygomaticus and standard endosseous implants was performed in 9 patients. Maxillary resection was performed for the following reasons: salivary gland malignancy (n = 2), squamous cell carcinoma (n = 5), maxillary mucormycosis (n = 1), and extensive maxillary atrophy and infection secondary to subperiosteal maxillary implant placement (n = 1). A total of 28 zygomaticus implants and 10 standard endosseous implants were used to reconstruct the 9 patients. Six zygomaticus implants and 3 standard endosseous implants failed. The time of zygomaticus implant placement ranged from placement at the time of resection to 3.2 years after the resection. Five patients received radiation therapy. Five patients have been reconstructed with a maxillary obturator and have been functioning with the prosthesis for a minimum of 2 years.


CONCLUSIONS
The combination of zygomaticus and standard endosseous implants can be used to reliably reconstruct patients after extensive resection of the maxilla.
Schmidt
Brian L
BL
Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 94143-0440, USA. briansc@itsa.ucsf.edu
Pogrel
M A
MA
Young
Carl W
CW
Sharma
Arun
A
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001424:Bacterial Infections / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019232:Dental Restoration Failure; D005250:Fees, Dental; D005500:Follow-Up Studies; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D008439:Maxillary Diseases / Q000601:surgery; D008441:Maxillary Neoplasms / Q000601:surgery; D008875:Middle Aged; D009091:Mucormycosis / Q000601:surgery; D010158:Palatal Obturators; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D015050:Zygoma / Q000601:surgery*
D015921:Dental Implants