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Guided Zygomatic and Pterygoid Implants using EZgoma® Noris Medical

clinical case
Performed by Surgeon: Dr. Roman Mirochnik, DMD OMFS, Israel
Surgery Planning / Digital Planning – Noris Medical
Author: Dr. Fadi Obeid, DMD, Clinical Advisor – Noris Medical

EZgoma® – Zygomatic Guided Technology enabling a quick precise minimally invasive Extra Maxillary and Intra Sinus drilling protocol execution for Zygomatic implants placement as well as Pterygoid and regular implants.
All components, Implants, and Prosthetics are directed by the guide to an accurate pre-determined position and orientation.


Introduction

Bone resorption of the alveolar processes is a major problem in edentulous and semi edentulous patients. It is considered a chronic, progressive, and irreversible process in all patients.

Numerous bone augmentation methods have been described, but most of them need two-step surgical procedures with relatively high rates of resorption or failure. So, Zygomatic implants placement considered a solution for these patients.

Noris Medical Zygomatic implant is specially designed for the extra-maxillary technique. Noris instrumentation greatly simplifies the implant placement and protects the sinus membrane.  High torque is consistently achieved, which allows immediate placement of a screw-retained prosthesis.

Moreover, Zygomatic Guided Technology (EZgoma®) enables a quick, precise and minimally invasive Extra Maxillary and Intra Sinus drilling protocol execution for Zygomatic implants placement as well as Pterygoid and regular implants.

As a result of the introduction of computer software technology, that integrates the information from various 3D imaging tools, we got a major revolution in virtual implant treatment planning that takes into consideration both surrounding vital anatomic structures and prosthetic requirements.

Noris Medical EZgoma® technology, based on computer software, provides us an appropriate prosthetic platform position that enhances the restoration result.

Clinical case

70 years old female with controlled high blood pressure.

Presents partial edentulous maxilla, with severe bone resorption, and tooth mobility due to periodontal disease and infections.

After radiological and CBCT assessments it was decided to extract all the remaining teeth followed with immediate implantation and immediate restoration. The surgical plan is to install a bilateral Pterygoid implant, 3 Zygomatic implants (two on the right side and one on the left side), and 3 regular implants.

Pre-Op panoramic x-ray

Pre-Op panoramic x-ray

 

Zygomatic, Pterygoid and regular implants planned positions

Zygomatic, Pterygoid and regular implants planned positions

 

After teeth extraction and Curettage, ready for raising the flap

After teeth extraction and Curettage, ready for raising the flap

 

Placing the EZgoma® bone-anchored surgical guide

Placing the EZgoma® bone-anchored surgical guide

 

Noris Medical angled Multi-Unit abutments (45˚, 52˚ and 60˚) provide the angle correction needed.

Noris Medical angled Multi-Unit abutments (45˚, 52˚ and 60˚) provide the angle correction needed

 

Implants were positioned, as planned, Transfers were placed on the Multi-Units

Implants were positioned, as planned, Transfers were placed on the Multi-Units

 

Bone graft augmentation and buccal fat pad advancement was done

Bone graft augmentation and buccal fat pad advancement was done

 

Suturing and taking impressions using Noris Medical Snap-On Transfers

Suturing and taking impressions using Noris Medical Snap-On Transfers

 

Immediate post-operative Panoramic X-Ray

Immediate post-operative Panoramic X-Ray

 


The EZgoma® technology enables quick accurate and predictable Zygomatic / Pterygoid implant positioning locations thus providing solutions for the most extreme cases.

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