Zygoma implant and cleft palate

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