title: Zygomatic implants--protocol for immediate occlusal loading: a preliminary report.
abstract: OBJECTIVE
  To investigate the modified protocol for immediate occlusal loading of the zygomatic implants and to report the preliminary results of this modified protocol.
  
  
  METHODS
  Four male patients and 1 female patient with edentulous maxillae were consecutively treated with the zygomatic implants under general anesthesia. All 5 patients were examined by computed tomography and investigated by the SimPlant software (Materialise NV, Leuven, Belgium). Based on the virtual surgical plans, mucosa-supported surgical guides were manufactured by rapid prototyping technique before implant operation. Instead of making a Le Fort I Osteotomy incision or a crestal incision, buccal vestibular incision was used to expose the surgical site for the zygomatic implant osteotomy and placement. Three patients had their remaining upper teeth removed on the same day as implant placement. One patient had undergone simultaneous placement of upper and lower implants followed by immediate loading. The immediate loading protocol was a 2-stage method using a customized provisional fixed prosthesis.
  
  
  RESULTS
  Ten zygomatic implants and 20 normal implants were installed in these 5 patients. These 5 patients were reviewed regularly for 6 to 10 months after immediate loading. The zygomatic implants were considered to be successful when they were asymptomatic with no clinical mobility and no sign of infection. All the zygomatic implants and normal implants were investigated individually after removing the provisional prosthesis and were found to be clinically stable and asymptomatic.
  
  
  CONCLUSIONS
  According to our observation, immediate occlusal loading of the zygomatic implants has a very good potential for success, as much as immediate occlusal loading of normal dental implants. The surgical placement of the zygomatic implant is simplified and facilitated by making use of the computer-assisted planning and the rapid-prototyping surgical guides.
authors.affiliation: Oral and Maxillofacial Surgery, Associated Brånemark Osseointegration Center, Hong Kong SAR, China. jameskfchow@hotmail.com
authors.forename: James
authors.initials: J
authors.lastname: Chow
authors.forename: Edward
authors.initials: E
authors.lastname: Hui
authors.forename: Philip K M
authors.initials: PK
authors.lastname: Lee
authors.forename: William
authors.initials: W
authors.lastname: Li
mesh_terms: D016301:Alveolar Bone Loss / Q000534:rehabilitation / Q000601:surgery; D002985:Clinical Protocols; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003799:Dental Stress Analysis; D003779:Denture Design; D003825:Denture, Complete, Immediate; D003827:Denture, Complete, Upper; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D003765:Models, Dental; D010865:Pilot Projects; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016474:Weight-Bearing; D015050:Zygoma / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D015921:Dental Implants