Hello! Last week, on invitation of the American R & D Institute of Implantology (ARDII) in Toronto, Canada, I held a lecture on zygomatic implants at a scientific symposium, where I shared my knowledge and experience. I hope that I have represented our country to the dentists from all over the world in the best way.
ARDII is an international community that brings together dentists and scientists from many countries and aims to develop implantology by developing new research projects. R & D is the abbreviation for Research and Development. Implants used in dentistry have been used for decades. In order to be able to offer patients simpler, more compatible solutions, research and development work is constantly being carried out and as a result of this work patients can be offered different types of implant and applications.
In my presentation in Toronto, I treated zygomatic implants. If you wish, let's go through the treatment protocol in the form of questions and answers.
What are zygomatic implants?
In short, zygomatic implants are implants that are placed in the zygomatic bone. The zygomatic bone, also known as the cheekbone, is a curved bone that begins at the lateral margin of the eye sockets and joins the skull. At the inner and lower edge it is connected to the upper jaw. Implants with a length between 35 mm and 50 mm (normal dental implants are between 7 and 13 mm long), which are implanted through the upper jaw into the zygomatic bone, are called zygomatic implants.
Why are the implants applied to the zygomatic bone instead of the upper jaw?
The answer is very simple. There is not enough bone in the upper jaw to insert an implant. We do not always find adequate bone mass among the patients who visit us to get dental implants, especially those that have lost all their teeth and have been without teeth for a long time. Furthermore, a massive loss of bone mass due to traffic accidents, firearms injuries and pathologies such as cancer or cysts can be observed. Until a few years ago, it was first necessary to prepare bone in patients in such cases by e.g. performing a sinus lift or bone block transfer from the pelvic bone before starting to place implants. The increase in the number of surgical procedures not only increased the risk of complications, but also led to lower success rates and could result in very long-term therapies.
How many implants should be placed?
With the option of zygomatic implants, we can spare the patient many different surgical procedures and use the implants at the same time, attach the fixed temporary prosthesis in 1-2 days and finish the treatment in a short time. We can support the treatment with two zygomatic implants in the back of the jaw and complete our treatments with standard anterior implants. We can complete the treatment with 4 or 6 zygomatic implants if there is no bone into which we can place the implant.
Is everybody eligible to get a zygomatic implant treatment?
As with any surgery, there are situations in which the application of zygomatic arch implants is contraindicated. The absence of the zygomatic bone: In some cases, such as accidents and cancer surgery, the zygomatic bone may be damaged or completely removed. Sinus infections and pathologies: When applying zygomatic implants, sinus infections must be eliminated prior to surgery as they often have to pass through the sinus depending on their position. Conditions that affect healing: Conditions that slow down or hinder healing, such as uncontrolled diabetes, liver problems, radiation therapy or chemotherapy.
How are zygomatic implants applied?
Surgical interventions to apply zygomatic implants are performed under general anesthesia. It is possible that postoperative conditions such as edema and swelling may occur for 4-5 days. The regular use of prescribed medications and the correct postoperative care ensure that these symptoms disappear quickly.
What will the produced teeth look like?
For zygomatic implants, a special prosthesis - a so-called hybrid prosthesis - must be manufactured. Furthermore, zygomatic implants must be occupied immediately. So, a temporary prosthesis is attached. Zygomatic implants that heal without attaching a prosthesis are more likely to fail. Hybrid prostheses are prostheses which are fastened to the implants by means of screws and supplement the lost gum tissue. Hybrid prostheses are designed on the computer and made of zirconia or metal blocks by scraping. This is a factor that greatly increases costs. I'm sure that lowering the cost of technical equipment and software and proliferation of expert technicians will further reduce costs over the next five to ten years. At this time, however, a single jaw costs about 5000-10000 euros.
In short, zygomatic arch implants are an innovative and more predictable solution for patients who were in the past found uneligible for implant treatment or where the treatment would have been involved with heavy transplant surgery and long waiting times. If you have further questions about zygomatic implants or need advice, we are always at your disposal.
Dr. Dt. A. Natuk UYUMAZ