Zygoma implant in a patient with

cleft palate and 10 year follow-up

Luc@Vrielinck.be

Situation (1)

• Before 2000: Iliac crest reconstruction and 6 implants with failure of all implants

• Referral to our Clinic 2001: patient desires fixed prosthesis

• Diagnosis

– Class III

– Cleft palate right side

– Buccosinusal fistula

– Situation after failed bonegrafts and implants

Situation (2)

• Treatment plan:

– Cleft palate right side

– 2 zygoma implants

– 2 pterygoid implant

– 1 implant left canine

Chronology

• Before 2000: iliac crest reconstruction and 6

implants with failure of all implants

• 2001: referral to our clinic

• 12/04/2001: Implant placement UJ

• 15/10/2001: Second stage

• 17/02/2011: > 9 year follow-up

Intake

23/01/2001: Intake

Treatment planning

06/03/2001: study casts

06/03/2001: study casts

06/03/2001: Implantplanning Simplant

06/03/2001: Implantplanning Simplant

06/03/2001: Implantplanning Simplant

06/03/2001: Implantplanning Simplant

06/03/2001: Implantplanning Simplant

06/03/2001: Implantplanning Simplant

2

1

3

4

5

6

6 implants planned

06/03/2001: Stereolithographic model with simulation of implant positions

06/03/2001: Stereolithographic model with simulation of implant positions

06/03/2001: Stereolithographic model with simulation of implant positions

12/04/2001: Implant placement

12/04/2001: Implant placement

SurgiGuide™ drill

guide attached

with

osteosynthesis

screwsDrill guide reinforcement of

Guiding cilinders

12/04/2001: Implant placement

12/04/2001: Implant placement

After removal of drill guide

12/04/2001: Implant placement

X

13/04/2001: RX postoperatief

1 2 3 4 5

6

Postoperative after loss of implant (6)

12/04/2001: second stage

12/04/2001: second stage

Prosthetic phase

Prosthetic phase

Prosthetic phase

Prosthetic phase

Follow-up 4 year

20/12/2005

20/12/2005: Follow-up 4 year

20/12/2005: Follow-up 4 year

Bucconasal communication is closed effectively by the prosthesis

20/12/2005: Follow-up 4 year

20/12/2005: Follow-up 4 year

Follow-up 8 year

17/02/2011

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

15 15 13 23 25

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

17/02/2011: Follow-up 8 year

Further measures

• Retreat the case prosthetically

– Add multiunit abutments

– CAD/CAM milled bar

– Overdenture