A protocol for maxillary reconstruction following oncology resection using zygomatic implants.
The purpose of this clinical report is to present a surgical and prosthodontic reconstructive protocol for 20 patients who underwent maxillary resection following malignancy to the head and neck region. This protocol was developed over a period of 7 years while treating a series of 20 maxillary resections due to oncology. Patients were reconstructed prosthodontically using fixed-removable overdentures or fixed prostheses, with and without separate obturators. The treatment protocol includes a comprehensive diagnostic phase, resection surgery with immediate implant placement and temporary obturation, post resection evaluation, and prosthodontic rehabilitation. Treatment periods ranged from 6 to 96 months and success was evaluated using strict clinical, radiologic, esthetic, and functional criteria. Postsurgical radiology was undertaken at 6 monthly intervals. Almost all maxillary defects resulting from anatomic disruption of the maxillofacial complex can be well rehabilitated functionally and esthetically using this protocol in conjunction with standard implantology and fixed/fixed-removable prosthodontic principles. This protocol simplifies the rehabilitation and management of these defects by reducing surgical intervention, hosptilization, postoperative morbidity and treatment time, and prosthodontic procedural complications.
Boyes-Varley
John G
JG
Division of Maxillo-Facial and Oral Surgery, Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa. boyesvarley@morningsidemfos.co.za
Howes
Dale G
DG
Davidge-Pitts
Keith D
KD
Brånemark
Ingvar
I
McAlpine
John A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002985:Clinical Protocols; D003198:Computer Simulation; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000534:rehabilitation*; D008447:Maxillofacial Prosthesis; D019931:Maxillofacial Prosthesis Implantation / Q000379:methods*; D008875:Middle Aged; D008953:Models, Anatomic; D010158:Palatal Obturators; D019651:Plastic Surgery Procedures / Q000379:methods*; D015050:Zygoma / Q000601:surgery*