Zygomatic Implants in Severe Maxillary Atrophy: 5.5-Year Retrospective Analysis of 262 Cases

Abstract

This retrospective study evaluates the survival rates, complications, and patient satisfaction associated with zygomatic implants in severe maxillary atrophy, focusing on 2 approaches: Quad Zygoma (4 zygomatic implants) and Hybrid Zygoma (2 zygomatic and 2 standard implants). A total of 76 patients classified as Cawood Grade VI, treated between 2007 and 2021, were included in this study. The primary outcome measure assessed was implant survival rate, while secondary outcomes included complications, patient satisfaction, and willingness to undergo the procedure again. The study included 69 patients with atrophic maxilla and 8 with tumor resection, receiving a total of 262 zygomatic implants, 220 in the Quad Zygoma group and 42 in the Hybrid Zygoma group. The mean follow-up duration was 67.6 ± 49.7 months. Eight implant failures were recorded (3 early and 5 delayed), resulting in an overall survival rate of 96.9%. Biological complications were observed in 27.6% of patients, with sinusitis in 16 patients and soft tissue issues in 5. Technical complications occurred in 6.5% of cases, including screw fractures and loosening of the screws. A patient satisfaction survey of 40 patients indicated high levels of satisfaction, with most expressing a willingness to undergo the procedure again. In conclusion, Zygomatic implants have been shown to have favorable outcomes in patients with severe upper Maxillary atrophies. Both the Quad and Hybrid techniques have shown promising long-term results. However, some complications can occur due to the implants' proximity to important anatomical areas.