Chronology • 11/04/2006: Intake • 14/11/2006: Iliac crest reconstruction onlay bonegraft frontal and bilateral sinus lifting • 22/06/2007: Upper jaw: placement of 2 standard implants frontally and 4 long implants (zygoma (2) and pterygoid (2)) • 03/12/2007: Final control • Yearly follow up until today (Jan 2015)
Discussion (1) Right Zygoma Bone resorption Horizontally exposing the zygoma implant, creating buccosinusal fistula requiring removal of the zygoma implant
14/11/2006: Situation after iliac crest reconstruction
09/02/2007: 3D simulation of implant planning
St Z
03/12/2007 @1y
26/03/2008 @2y
18/02/2009 @3y
09/01/2012 @5y
23/10/2013 @6y
18/12/2014 @7y
18/12/2014: Buccosinusal fistula on the right side requiring removal of right zygoma implant
Standard implant with fenestration due to bone graft resorption
Complete bone loss over the right zygoma implant
18/12/2014: Buccosinusal fistula on the right side requiring removal of right zygoma implant
Discussion 2 Left pterygoid Bone resotpion vertically
11/2006
06/2007
12/2007
03/2008
02/2009
01/2012
10/2013
Look at next image for a tentative outline of the bone height
12/2014
11/2006
06/2007
12/2007
03/2008
02/2009
01/2012
10/2013
12/2014
26/03/2008
18/12/2014 Clinical images of the left pterygoid implant
Long-term findings • 1) Progressive bone loss on the buccal side around standard implant on right canine implant • 2) Progressive resorption of the bone graft on the right side, leading to lateral exposure of the zygoma implant and development of buccosinusal fistula and sinusitis requiring removal of the zygoma implant after 6 year • 3) Vertical and horizontal bone loss/ remodeling around the left (pterygoid implant) leading to progressive exposure of the implant