For patients with signs indicating maxillary sinusitis, a quality of life questionnaire was administered and video-assisted nasal fibroscopy was performed.

The aim of the clinical exam was to investigate signs of sinusitis: (a) nasal obstruction, using a visual analog scale (VAS) ranging from 0 to 10 points, on which the patient marked his/her degree of obstruction, with the examiner’s subsequent delineation of mild, moderate, or intense obstruction based on the patient’s mark; (b) periorbital edema with or without hyperemia; (c) halitosis, which could be caused by purulent secretions from the nasal fossae; and (d) facial pain (spontaneous or upon palpation) in the region of the maxillary sinuses.

Cone-beam computed tomography (I-CAT™) was used for the analysis of the maxillary sinus (coronal and axial cuts of 1.0 mm in thickness). Panoramic reconstruction was used to determine the presence of opacification of the sinus (Fig. 2) and obstruction of the ostium (Fig. 4). The Lund-McKay scoring system was used for the assessment of maxillary sinus abnormalities on the tomograms: 0 = absence of abnormalities; 1 = partial opacification; and 2 = complete opacification.

In cases of findings suggestive of maxillary sinusitis, video-assisted nasal nasofibroscopy (Fig. 5) was performed to determine the presence of edema and hyperemia of the nasal conchae, secretion in the region of the middle meatus with posterior drainage, and obstruction of the ostium. Moreover, a disease-specific questionnaire was administered to those with signs suggestive of maxillary sinusitis for complementary information to make the differential diagnosis.

Patient satisfaction rate after oral rehabilitation

In the last stage of this study, the degree of satisfaction after oral rehabilitation, comparing patients rehabilitated with fixed prosthesis over zygomatic implants with fixed prosthesis supported by conventional implants only was estimated. A VAS was used, considering the stability, comfort, ability to speak, cleanability, aesthetic, self-esteem, and function as parameters (Figs. 7 and 8). Patients answered questions giving values from 0 (completely dissatisfied) to 10 (completely satisfied) for each item.

Result analysis

The first, second, and third stages of the study were presented descriptively. The data of the fourth stage were statistically evaluated to detect the differences in the degree of satisfaction of patients rehabilitated with a combination of conventional and zygomatic implants compared with those rehabilitated only with conventional implants. The data were entered into Excel spreadsheets (Microsoft ® Office XP Professional), exported to DBF format (Data Base Format), and subsequently analyzed and statistically treated by (Statistical Package for the Social Sciences version 1.7 for Windows XP ® SPSS; Chicago, IL, USA). T test for independent samples, considering the level of significance of 5 % (p < 0.05), was used.