Journal of Oral Implantology December 2012 - (Page 751)

CASE REPORT Restoration of Failing Maxillary Implant-Supported Fixed Prosthesis With Cross Arch Splinted Unilateral Zygomatic Implant: A Clinical Report Rajan Gunaseelan, FDSRCS1* Mariappan Saravanakumar, MDS2 Ramasubramanian Hariharan, MDS3 Management of one or more failing distal implants in an implant supported fixed prosthesis in a completely edentulous maxilla creates a challenging situation. Restoring immediate function with additional implants in such a situation can be a challenge considering the loss of supporting bone, need for grafting, age, and the patient’s desire for immediate fixed dental prosthesis. This clinical report describes a situation where a zygomatic implant has been placed unilaterally and splinted with osseointegrated conventional implants by an immediate fixed provisional restoration. Key Words: dental implant failure, immediate loading, zygomatic implant, edentulous maxilla INTRODUCTION estoration of completely edentulous maxillae with an implant-supported fixed prosthesis has a predictable outcome with a long-term success rate.1–7 However, a higher failure rate has been reported for implant treatment in edentulous maxillae compared with mandibles, 8,9 and its pattern is more common before loading and during the first year of function.10–15 These failures can be attributed factors including lack of bone support and/or poor bone quality, heavy smoking, periimplantitis, and overloading.14,15 Failures of one or more distal implants in a completely edentulous maxilla can jeopardize the function with fixed prosthesis. Treatment options for such failed distal implants situation can be a removable overdenture or 1 2 R Rajan Dental Institute, Chennai, Tamil Nadu, India. Rajan Dental Institute and Department of Prosthodontics, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India. 3 Department of Prosthodontics, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India. * Corresponding author, e-mail: drgunaseelan@rajandental.com DOI: 10.1563/AAID-JOI-D-10-00205 a fixed prosthesis with additional implants. Placement of additional implants poses an anatomic limitation because of loss of supporting bone in the failed implant site, which may need further bone augmentation procedures.15 Some of the drawbacks associated with these procedures may be need for hospitalization, morbidity of the distant donor site,16,17 inability to use an existing prosthesis, and delayed placement of implants for the graft consolidation time.18 In such situations the use of zygomatic implant is an alternative solution for the management of severe loss of supporting bone. 19–21 Good stability can be achieved from the zygomatic bone because of the anchorage provided in at least 4 cortical portions.22 Splinting with 2 or more conventional implants in the anterior maxilla provides an excellent foundation for an immediate fixed dental prosthesis.23–25 This clinical report describes the management of failing distal implants in a maxillary implantsupported fixed prosthesis with a zygomatic implant and an additional conventional implant to restore immediate function and esthetics. Journal of Oral Implantology 751

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2012

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Lateral Augmentation of the Maxilla and Mandible Using Framework Technique With Allogeneic Bone Grafts
Accuracy of Cone Beam Computerized Tomography and a Three-Dimensional Stereolithographic Model in Identifying the Anterior Loop of the Mental Nerve: A Study on Cadavers
Evaluation of Microgap Size and Microbial Leakage in the Connection Area of 4 Abutments With Straumann (ITI) Implant
Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs
Evaluation of Soft Tissues Around Single Tooth Implants in the Anterior Maxilla Restored With Cemented and Screw-Retained Crowns
Accuracy of a Newly Developed Cone-Beam Computerized Tomography-Aided Surgical Guidance System for Dental Implant Placement: An Ex Vivo Study
Nasopalatine Canal Position Relative to the Maxillary Central Incisors: A Cone Beam Computed Tomography Assessment
Esthetics in Implant-Supported Prostheses: A Literature Review
Reliability of Implant Surgical Guides Based on Soft-Tissue Models
Clinical Evaluation of Short and Wide-Diameter Implants Immediately Placed Into Extraction Sockets of Posterior Areas: A 2-Year Retrospective Study
Single Stage Immediate Implant Placements in the Esthetic Zone
Removal of Fractured Dental Implant Screw Using a New Technique: A Case Report
Restoration of Failing Maxillary Implant-Supported Fixed Prosthesis With Cross Arch Splinted Unilateral Zygomatic Implant: A Clinical Report
Oral Rehabilitation of Severe Dentoalveolar Trauma: A Clinical Report
Implant Installation With Bone Augmentation and Transmucosal Healing With Demineralized Human Cortical Bone in the Maxillary Anterior Region: Report of 3 Cases
Bone Morphogenic Protein: An Elixir for Bone Grafting—A Review
Orthodontic Considerations in Restorative Management of Hypodontia Patients With Endosseous Implants
Squamous Cell Carcinoma in Association With Dental Implants: An Assessment of Previously Hypothesized Carcinogenic Mechanisms and a Case Report
Indirect Osteotome Maxillary Sinus Floor Elevation: An Update
Reliability of Implant Surgical Guides Based on Soft-Tissue Models: A Methodological Mistake

Journal of Oral Implantology December 2012