Discussion : Evaluation of patients undergoing placement of zygomatic implants (6)
Becktor et al. report that patients with oral-sinus communication may develop suppuration with or without sinusitis. In such cases, treatment consists of the administration of antibiotics and/or the repositioning of the soft tissue and maintenance of a stable zygomatic implant, with no reports of the recurrence of sinusitis. Brånemark found fistula in five patients both before and after the connection of the abutment in 1 year of follow-up. Three patients exhibited specific symptoms of sinusitis, such as nighttime pain, unilateral pain in bad weather, and obstruction of the sinus. The existence of a small amount of residual bone in the alveolar crest associated with an implant placement technique with minor destruction of the sinus region can determine a more favorable prognosis for these complications.
The risk of the development of maxillary sinusitis associated with zygomatic implants installed using the original technique is reported to be low to moderate. Few data have been published regarding this risk in relation to the Stella and Warner’s technique. According to Peñarrocha et al., the small slot in the zygomatic-maxillary region diminishes the likelihood of maxillary sinusitis, reporting a 4.7 % rate of occurrence of this complication in 12 months of follow-up. In the present study, the implants had two position patterns: those that partially invaded the maxillary sinus and those that were positioned alongside but completely outside the sinus due to the anatomy of the zygomatic-maxillary region encountered. However, the slot that characterizes this technique was made in both cases. The clinical and imaging findings demonstrated no cases of maxillary sinusitis in the follow-up.
According to the Brazilian Guidelines for Sinusitis, the clinical exam has sensitivity and specificity of 69 and 79 %, respectively, which makes the use of complementary diagnostic tools necessary. A number of authors report the use of computed tomography for the diagnosis of sinusitis.
Serial posts:
- Evaluation of patients undergoing placement of zygomatic implants using sinus slot technique
- Background : Evaluation of patients undergoing placement of zygomatic implants
- Methods : Evaluation of patients undergoing placement of zygomatic implants (1)
- Methods : Evaluation of patients undergoing placement of zygomatic implants (2)
- Methods : Evaluation of patients undergoing placement of zygomatic implants (3)
- Methods : Evaluation of patients undergoing placement of zygomatic implants (4)
- Methods : Evaluation of patients undergoing placement of zygomatic implants (5)
- Results : Evaluation of patients undergoing placement of zygomatic implants (1)
- Results : Evaluation of patients undergoing placement of zygomatic implants (2)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (1)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (2)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (3)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (4)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (5)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (6)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (7)
- Discussion : Evaluation of patients undergoing placement of zygomatic implants (8)
- Reference : Evaluation of patients undergoing placement of zygomatic implants (8)
- Figure 1. a Brånemark technique. b Sinus slot technique. c Extrasinus technique
- Figure 2. Periapical radiographs using the parallelism technique
- Figure 3. Panoramic radiograph showing bone level maintenance around the conventional implants
- Figure 4. Coronal slice from the CBCT showing implant apical third inside the zygomatic bone
- Figure 5. Coronal slice from the CBCT showing small exteriorization of a zygomatic implant apex
- Figure 6. Zygomatic implant probing using a WHO periodontal probe
- Figure 7. Visual analog scale—patient version
- Figure 8. Visual analog scale—evaluator version
- Table 1 Statistical analysis of individual parameters