Endoscopically-Assisted Zygomatic Implant Placement: A Novel Approach.
BACKGROUND
Zygomatic implants (ZIs) have been proposed as a valid alternative to advance bone-grafting procedures in the rehabilitation of the severe atrophied upper maxilla, with a reported overall success rate of more than 95 %. Otherwise, the use of the endoscope has been described for the treatment of maxillofacial trauma, orthognatic surgical procedures, sinonasal pathology, salivary gland disease, and TMJ internal derangement. A careful identification of anatomical landmarks is of utmost importance while trying to avoid potential complications during the insertion of ZIs. Several approaches for ZI insertion have been reported, such as the classical approach; the sinus slot technique; and the exteriorized approach.


METHODS
The authors first introduce in the literature the endoscopically-assisted approach for the insertion of ZIs in the extremely severe atrophic maxilla.


RESULTS
Optimal results in terms of ZIs positioning with no damage to surrounding structures were obtained.


CONCLUSIONS
By means of this new technique the surgeon may minimize the risk of complications related to the damage of neighbouring anatomic structures, such as orbital disruption or infraorbitary nerve damage, while ensuring an adequate drill positioning and angulation for the placement of one or two implants into the zygomatic bone.
Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, 06080 Badajoz, Spain ; FEDICOM, Foundation for the Study and Development in Implantology, Oral and Maxillofacial Surgery, Badajoz, Spain ; Calle Los Yébenes, 35, 8C, 28047 Madrid, Spain.
Raúl
R
González-García
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI USA ; FEDICOM, Foundation for the Study and Development in Implantology, Oral and Maxillofacial Surgery, Badajoz, Spain.
Alberto
A
Monje
Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, 06080 Badajoz, Spain ; FEDICOM, Foundation for the Study and Development in Implantology, Oral and Maxillofacial Surgery, Badajoz, Spain.
Carlos
C
Moreno-García
Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, 06080 Badajoz, Spain ; FEDICOM, Foundation for the Study and Development in Implantology, Oral and Maxillofacial Surgery, Badajoz, Spain ; CICOM, Centre for Implantology, Oral and Maxillofacial Surgery, Badajoz, Spain.
Florencio
F
Monje
Complications; Endoscopically-assisted approach; Severe atrophic maxilla; Zygomatic bone; Zygomatic implants