Retreatment of failed bonegrafts for maxillary reconstruction
Treated with Quad zygoma and an overdenture Author: Luc@Vrielinck.be
Situation • Patient desires: fixed prosthesis in Upper Jaw • Diagnosis: – Situation after failed iliac crest reconstruction – Ill- fitting prosthesis
• Treatment plan: – Quad zygoma, – delayed loading, – bar supported overdenture
Chronology • 26/01/2010: • 23/08/2010: • 11/10/2010:
Surgery placement Quad zygoma second stage QZ Prosthesis placed
Parameters • #Failureheupkamgreffe • #quadzygoma • #overkappingsprothese
Intake
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
Surgery Lefort I advancement & Iliac crest interpositioning
08/10/2008: postoperative after bone reconstruction
08/10/2008: postoperative after bone reconstruction
08/10/2008: postoperative after bone reconstruction
05/11/2008: wounddehiscence finally resulting in total reconstruction failure
05/11/2008: wounddehiscence finally resulting in total reconstruction failure
Zygoma Treatment Rescue therapy after failed bone grafts
19/03/2009: before zygoma treatment
Still s ome b o osteo synth ne seques esis m te ateria rs and l pres ent
19/03/2009: before zygoma treatment
19/03/2009: before zygoma treatment
19/03/2009: before zygoma treatment
02/07/2009: Removal of bone sequesters and osteosynthesis material
03/10/2009: Situation after removal of sequesters and osteosynthesis material
Treatment
01/12/2009: Conebeamscan
21
11
22
12
23
13
24
14
25
26
15
16
16
15
14
13
12
11
21
22
23
24
25
26
H
1.2
4.05 2.25 2.84 5.54 4.68 4.05 6.21 6.39 2.98 2.37 2.78
W
2.5
3.41 2.78 1.92 4.26 5.54 4.47
3.5
6.00 2.35 3.62 5.33
In all teeth location insufficient bone for standard implants Minimum e.g. H: 8 mm, width 6 mm
19/01/2010: Planning for Quad zygoma
19/01/2010: Planning for Quad zygoma
19/01/2010: Planning for Quad zygoma
26/01/2010: Postoperative
26/01/2010: Postoperative
26/01/2010: Postoperative
26/04/2010 Wounddehiscence removal of a membrane (Synpor™) Resulting in a huge buccosinusal communiation‌.
23/08/2010: Just before second stage
23/08/2010: Just before second stage
The b comm uccosin us unica tion h al as we heale ll d
23/08/2010: Just before second stage
23/08/2010: Second stage QZ
23/08/2010: Second stage QZ
23/08/2010: Second stage QZ
23/08/2010: Second stage QZ
02/09/2010: Placing multiunit abutments and impression taking
09/09/2010: Pasbalk
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Check of the occlusion
11/10/2010: Check of the occlusion
11/10/2010: Check of the occlusion
• In the right lower jaw one short implant (Bicon) will be placed as support for a removable partial prothesis