Free-hand Extra Maxillary placement technique, Noris Medical Zygomatic implants

Free-hand Extra Maxillary placement technique, Noris Medical Zygomatic implants

Carlos H. Letelier, MD, DMD,
DDS Las Vegas, NV, USA

 

Patient

73 y.o. female with failing dentition.

Medical history

Significant for history of stroke, deep vein thrombosis, pulmonary embolism, hypertension, anxiety, Status post-IVC filter placement, Status post-bariatric surgery, Status post craniotomy, back surgery.
On multiple medications, including Coumadin.

Clinical examination

Severe Gagging reflex. Unable to wear dentures.

Radiograph examination

Sinus floor extending to the alveolar ridge. Risk of oral – antral communication as Zygomatic implant would be in contact with the sinus at the level of the ridge.

Pre op. Panoramic X-ray.

Pre op. Panoramic X-ray.

 

Initial opening into the sinus.

Initial opening into the sinus.

 

Initial channel preparation with coarse grit cylindrical drill.

Initial channel preparation with a coarse-grit cylindrical drill. / Fine grit cylindrical drill use in contact with the sinus membrane.

 

Intact sinus membrane. / Sinus membrane elevated

Intact sinus membrane. / Sinus membrane elevated.

 

Coronal portion of sinus grafted. / Implant placed over grafted site.

Coronal portion of sinus grafting. / Implant placed over the grafted site.

At the end of the procedure the buccal aspect of the Zygomatic implant was also grafted, to create a buccal seal. The Pterygoid implants and mid-maxillary implants had low torque. They will be uncovered for the final restoration. The left Pterygoid implant was placed rather horizontally due to lack of more superior bone to engage the implant.

At the end of the procedure, the buccal aspect of the Zygomatic implant was also grafted, to create a buccal seal. The Pterygoid implants and mid-maxillary implants had low torque. They will be uncovered for the final restoration. The left Pterygoid implant was placed rather horizontally due to a lack of more superior bone to engage the implant.

 

The Zygomatic and anterior implants were used to secure the maxillary prosthesis. Tuff implants were used for the Pterygoid and posterior mandibular implants. On the mandible, the posterior implants had to engage the inferior border of the mandible to obtain sufficient torque for immediate loading. Maxillary and mandibular prosthesis were immediately loaded.

The Zygomatic and anterior implants were used to secure the maxillary prosthesis. Tuff implants were used for the Pterygoid and posterior mandibular implants. On the mandible, the posterior implants had to engage the inferior border of the mandible to obtain sufficient torque for immediate loading. Maxillary and mandibular prostheses were immediately loaded.

 

Immediate post operative radiograph.

Immediate postoperative radiograph.

 

Visit Dr. Letelier Website

Share and Enjoy !

Re opening Sale:

Hot deals for Noris customers

Click here and we will give you the best and most convenient offer, suitable to the finances of your practice.