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Di Cosola M, Ballini A, Zhurakivska K, Ceccarello A, Nocini R, Malcangi A, Mori G, Lo Muzio L, Cantore S, Olivo A. Retrospective Analysis of Clinical and Radiologic Data Regarding Zygomatic Implant Rehabilitation with a Long-Term Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12963. [PMID: 34948572 PMCID: PMC8701901 DOI: 10.3390/ijerph182412963] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Zygomatic implants have been introduced to rehabilitate edentulous patients with severely atrophic maxillae. Their use has been reported by several studies, describing high overall survival rates at medium-long follow-up. The aim of this study was to retrospectively analyze if a few patient-related and implant-related features are correlated with implant success or the onset of complications. MATERIALS AND METHODS Data of patients treated with zygomatic implants between May 2005 and November 2012 at three private clinics were collected and retrospectively analyzed. For each implant, the following data were collected: implant length, insertion path, ridge atrophy and sinus characteristics (width, pneumatization, thickness of mucosae, patency of sinus ostium). General patient characteristics and health status data were also recorded. The outcomes evaluated were implant failure, infective complications, early neurologic complications and overall complications. RESULTS A total of 33 patients (14 men, 17 women, mean age 59.1) that received 67 zygomatic implants were included in the study. The mean duration of the follow-up was of 141.6 months (min 109; max 198). In this period, a total of 16 (23.88%) implants in 8 (24.24%) patients were removed and 17 (51.51%) patients with 36 (53.73%) implants reported complications. Immediate loading resulted in a significantly lower risk of complications compared with the two-stage prosthetic rehabilitation (OR: 0.04, p = 0.002). A thickness of the sinus mucosa > 3 mm emerged to be correlated with a greater occurrence of infective complications (OR: 3.39, p = 0.019). Severe and extreme pneumatization of the sinus was significantly correlated with the incidence of overall complications (p = 0.037) and implant failure (p = 0.044). A large sinus width was predisposed to a higher risk of neurologic complications, infective complications and implant failure (p = 0.036, p = 0.032, p = 0.04, respectively). CONCLUSIONS zygomatic implants are an alternative procedure for atrophic ridge rehabilitation when a conventional implant placement is not possible. Several clinical and anatomical factors can have a significant role in complication occurrence.
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Affiliation(s)
- Michele Di Cosola
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy; (M.D.C.); (K.Z.); (G.M.); (L.L.M.)
| | - Andrea Ballini
- School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Faculty of Dentistry (Fakulteti i Mjekësisë Dentare-FMD), University of Medicine, 1001 Tirana, Albania
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy; (M.D.C.); (K.Z.); (G.M.); (L.L.M.)
| | - Alberto Ceccarello
- Medical Center Padova, Private Practice, 3513 Padova, Italy; (A.C.); (A.O.)
| | - Riccardo Nocini
- Section of Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatric, University of Verona, 37126 Verona, Italy;
| | - Annarita Malcangi
- Public Local Health Company (Azienda Sanitaria Locale, ASL), B.A.T, 76125 Trani, Italy;
| | - Giorgio Mori
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy; (M.D.C.); (K.Z.); (G.M.); (L.L.M.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy; (M.D.C.); (K.Z.); (G.M.); (L.L.M.)
| | - Stefania Cantore
- Faculty of Dentistry (Fakulteti i Mjekësisë Dentare-FMD), University of Medicine, 1001 Tirana, Albania
- Department Interdisciplinary of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Olivo
- Medical Center Padova, Private Practice, 3513 Padova, Italy; (A.C.); (A.O.)
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D'Agostino A, Lombardo G, Favero V, Signoriello A, Bressan A, Lonardi F, Nocini R, Trevisiol L. Complications related to zygomatic implants placement: A retrospective evaluation with 5 years follow-up. J Craniomaxillofac Surg 2021; 49:620-627. [PMID: 33581959 DOI: 10.1016/j.jcms.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/03/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022] Open
Abstract
This retrospective study assessed zygoma implants in patients treated for upper maxilla extreme atrophy, trauma, cleft palate, or failed reconstruction. The implants were placed using Quad (4 zygoma implants) or mixed (zygoma and conventional implants in premaxilla) surgical technique, with intra-sinus or extra-sinus approach, followed by immediate or deferred loading. Clinical and radiographic evaluations were carried out at 5-year follow-up from loading. Implant survival, symptoms and signs of sinusitis, radiological alterations in terms of mucosal thickening or obliteration of the maxillary sinuses, oroantral communications, and peri-implant soft tissues were examined. A total of 42 patients, with 116 zygoma implants, were included in the study. The cumulative survival rate was 97.41%. One zygomatic bone fracture was assessed. Eight patients reported sinusitis, and two showed oro-antral communications. A comparison between mean pre- and post-operative Lund-Mackay scores showed a statistically significant increase of sino-nasal disease in the post-operative scores (p = 0.0019). Mucositis and gingival recession was observed in 21 and 8 implants respectively. Average recession was 2.52 ± 2.35 mm. According to our results, placement of zygoma implants has proved to be a predictable procedure, with a lower rate of severe complications compared to other treatment options in extreme upper jaw atrophy.
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Affiliation(s)
- Antonio D'Agostino
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Giorgio Lombardo
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Vittorio Favero
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy.
| | - Annarita Signoriello
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Anna Bressan
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Fabio Lonardi
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Riccardo Nocini
- Unit of Otolaryngology, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Lorenzo Trevisiol
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
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Lombardo G, Signoriello A, Simancas-Pallares M, Marincola M, Nocini PF. Survival of Short and Ultra-Short Locking-Taper Implants Supporting Single Crowns in the Posterior Mandible: A 3-Year Retrospective Study. J ORAL IMPLANTOL 2020; 46:396-406. [PMID: 32315035 DOI: 10.1563/aaid-joi-d-19-00190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this retrospective study was to determine survival and peri-implant marginal bone loss of short and ultra-short implants placed in the posterior mandible. A total of 98 patients received 201 locking-taper implants between January 2014 and January 2015. Implants were placed with a 2-stage approach and restored with single crowns. Clinical and radiographic examinations were performed at 3-year recall appointments. At that time, the proportion of implant survival by length, and variations of crestal bone levels (mean crestal bone loss and mean apical shift of the "first bone-to-implant contact point" position) were assessed. Significance level was set at 0.05. The total number of implants examined 36 months after loading included: 71 implants, 8.0 mm in length; 82 implants, 6.0 mm in length; and 48 implants, 5.0 mm in length. Five implants failed. The overall proportion of survival was 97.51%, with 98.59% for the 8.0-mm implants, 97.56% for the 6.0-mm implants, and 95.83% for the 5.0-mm implants. No statistically significant differences were found among the groups regarding implant survival (P = .73), mean crestal bone loss (P = .31), or mean apical shift of the "first bone-to-implant contact point" position (P = .36). Single-crown short and ultra-short implants may offer predictable outcomes in the atrophic posterior mandibular regions, though further investigations with longer follow-up evaluations are necessary to validate our results.
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Affiliation(s)
- Giorgio Lombardo
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| | - Annarita Signoriello
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| | - Miguel Simancas-Pallares
- Division of Oral & Craniofacial Health Sciences. Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mauro Marincola
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Pier Francesco Nocini
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
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Procacci P, Lanaro L, Molteni G, Marchioni D, Lonardi F, Fusetti S, Nocini PF, Albanese M. Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts. ACTA ACUST UNITED AC 2019; 38:439-444. [PMID: 30498272 PMCID: PMC6265665 DOI: 10.14639/0392-100x-1915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 02/23/2018] [Indexed: 11/23/2022]
Abstract
Maxillary cysts are a common finding in maxillofacial surgery, dentistry and otolaryngology. Treatment is surgical; a traditional approach includes Caldwell-Luc and other intra-oral approaches. In this article, we analyse the outcomes of 9 patients operated on using a combined intra-oral and trans-nasal approach to the aforementioned disease. Although the number of patients is small, the good results of this study suggest that the combined approach might be a reliable treatment option.
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Affiliation(s)
- P Procacci
- Section of Dentistry and Maxillo-facial Surgery, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
| | - L Lanaro
- Section of Dentistry and Maxillo-facial Surgery, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
| | - G Molteni
- Section of Otolaryngology, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
| | - D Marchioni
- Section of Otolaryngology, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
| | - F Lonardi
- Section of Dentistry and Maxillo-facial Surgery, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
| | - S Fusetti
- Section of Dentistry and Maxillo-facial Surgery, Department of Neuroscience, University of Padova, Italy
| | - P F Nocini
- Section of Dentistry and Maxillo-facial Surgery, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
| | - M Albanese
- Section of Dentistry and Maxillo-facial Surgery, Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Italy
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Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study. Int J Dent 2017; 2017:8434281. [PMID: 28751913 PMCID: PMC5511658 DOI: 10.1155/2017/8434281] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/23/2017] [Indexed: 12/14/2022] Open
Abstract
AIM To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. PATIENTS AND METHODS We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. RESULTS 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4-98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). CONCLUSIONS Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.
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