title: The establishment of a protocol for the total rehabilitation of atrophic maxillae employing four zygomatic fixtures in an immediate loading system--a 30-month clinical and radiographic follow-up.
abstract: BACKGROUND
  The existing approaches to the treatment of the atrophic maxilla are difficult and involve an element of risk.
  
  
  OBJECTIVE
  The aim of the present study was to establish a new surgical/prosthetic protocol for the treatment of extremely atrophic maxillae using four zygomatic implants (ZIs) in an immediate loading system.
  
  
  METHODS
  Twelve patients were treated with the surgical placement of 48 ZIs, and the totally edentulous maxillae were rehabilitated with protocol-type maxillary prostheses rigidly fixed to the ZIs in an immediate loading system. Follow-up was conducted at 6 months and again at 30 months.
  
  
  RESULTS
  Of the 48 ZIs inserted, one implant failed to achieve osseointegration. The prosthetic components fitted well and no sinus pathology was detected in any of the patients.
  
  
  CONCLUSIONS
  The surgical/prosthetic protocol showed that it was possible to insert four ZIs in an immediate loading system and achieve stability for up to 30 months.
authors.affiliation: Postgraduate Implantology Program, Federal University of Bahia, Salvador, Bahia, Brazil. luisrogerioduarte@mac.com
authors.forename: Luis Rogério
authors.initials: LR
authors.lastname: Duarte
authors.forename: Hugo Nary
authors.initials: HN
authors.lastname: Filho
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Francischone
authors.forename: Luiz Guillermo
authors.initials: LG
authors.lastname: Peredo
authors.forename: Per-Ingvar
authors.initials: PI
authors.lastname: Brånemark
mesh_terms: D016301:Alveolar Bone Loss / Q000534:rehabilitation*; D002985:Clinical Protocols; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003825:Denture, Complete, Immediate; D003827:Denture, Complete, Upper; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008437:Maxilla; D008953:Models, Anatomic; D011862:Radiography, Panoramic; D016896:Treatment Outcome; D015050:Zygoma / Q000601:surgery*