Surgeon: Dr. Ori Blanc, Dr. Dekel Shilo
Department of oral and maxillofacial surgery Rambam Medical Center
Head: Prof. Adi Rachmiel

Digital surgery planning: Rami Siev

Author: Dr. Fadi Obeid, DMD, Clinical Advisor – Noris Medical

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 screw-retained prosthesis.

Introduction

Ectrodactyly–ectodermal dysplasia–cleft syndrome, or EEC syndrome, is a rare form of ectodermal dysplasia, an autosomal dominant disorder inherited as a genetic trait.

EEC is characterized by the triad of ectrodactyly, ectodermal dysplasia, and facial clefts. Other features noted in association with EEC include numerous dental anomalies, with missing or malformed teeth, enamel hypoplasia, and atrophic jaws.

This condition is considered an enormous challenge when contemplating fixed prosthetic rehabilitation.

The present case report aims to provide a prosthetic solution in the atrophic maxilla of patients diagnosed with EEC, using Noris Medical zygomatic implants, placed via the EZgoma® guide.

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

Clinical case

 Our patients are twin brothers, 20 years old, with EEC syndrome.

They present with severe bone resorption, advanced maxillary atrophy, and multiple osseous defects.

According to the clinical and radiographic examinations, for the first case, it was decided to install, eight implants in the maxilla. Thus, the case was planned for a Quad zygomatic protocol with bilateral 2 pterygoids.

For the second case, it was decided to install, a total of seven implants. A Quad zygomatic protocol with bilateral pterygoids (two in the right side and one in the left) for fixed prosthetic rehabilitation that will be complete after 3 months.

Case 1 video

Case 2 video

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-planned position and orientation.

First case Pre- operative X-ray

Second case Pre- operative X-ray

First case Post- operative X-ray

Second case Post- operative X-ray