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
6 implants planned
3 4 2
5
1
6
06/03/2001: Implantplanning Simplant
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
Drill guide reinforcement of Guiding cilinders
SurgiGuide™ drill guide attached with osteosynthesis screws
12/04/2001: Implant placement
12/04/2001: Implant placement
After removal of drill guide
12/04/2001: Implant placement
12/04/2001: Implant placement
1
2
3
4
5
X
13/04/2001: RX postoperatief
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
Bucconasal communication is closed effectively by the prosthesis
20/12/2005: Follow-up 4 year
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
17/02/2011: Follow-up 8 year
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
Further measures • Retreat the case prosthetically – Add multiunit abutments – CAD/CAM milled bar – Overdenture
17/02/2011: Follow-up 8 year