The Connection Between Tobacco Use and Oral Health
Tobacco use remains one of the most modifiable risk factors for oral health deterioration, yet its impact is often underestimated. Patients who smoke or use smokeless tobacco frequently present with staining, gingival recession, and advanced periodontal disease —conditions that not only compromise aesthetics but also increase systemic risks...
When Dry Mouth and Cavities Collide: A Common but Manageable Concern
A patient presents with xerostomia (dry mouth) and dental caries (cavities)—a duo that often signals an underlying condition. While these symptoms may seem alarming, they’re also an opportunity to uncover and address the root cause, paving the way for a healthier, more comfortable oral environment.
The Likely Culpr...
Early enamel lesions—often detected as white spots or subtle surface demineralization—are a common yet reversible stage of dental caries. The good news? With early intervention, these lesions can be halted or even remineralized, preserving tooth structure and preventing progression to cavities. As a proactive approach, preventive treatments focus on remineralization, fluoride therapy, and lif...
Understanding the Radiographic Clue
When a radiolucent lesion appears at the apex of a non-vital tooth, it signals an underlying pathological process that demands careful diagnosis and treatment planning. Radiolucency on a dental radiograph indicates a less dense area compared to surrounding bone, often suggesting an inflammatory or infectious response. This finding, combined with a tooth’s n...
Root canal therapy (RCT) is a transformative endodontic procedure that preserves natural dentition by removing infected pulp tissue while maintaining structural integrity. However, the restoration phase is equally critical—it ensures long-term success, restores occlusal function, and enhances aesthetics. For molars, which endure heavy masticatory forces, the choice of restoration must balance du...
What Is Excessive Vertical Overlap of Front Teeth?
When a patient presents with excessive vertical overlap of the front teeth, the condition is clinically known as deep bite (Class II Division 1 malocclusion) . This occurs when the upper front teeth cover the lower front teeth to an abnormal degree, often resulting in a pronounced "overbite." While some vertical overlap is normal, excessive c...
Abstract
Osseointegration, defined as the direct structural and functional connection between living bone and the surface of a load-bearing implant, remains a cornerstone of successful dental and orthopedic implantology. Despite significant clinical success, challenges persist in achieving predictable osseointegration, particularly in patients with compromised bone quality, systemic diseases, or ...
After the growth stops, which is after the ages of 15 for female patients and 18 for male patients, the implant should ideally be positioned.[28] The implant may need to be removed and replaced if it was positioned during active growth because it may become misaligned or displaced by further growth (extrusion of the implant may ensue from remodeling of the alveolar ridge)[13]. The patient ...
In orthodontic therapy, spaces are often created by molar distalization, incisor proclination, interdental stripping, extraction, and, finally, arch enlargement. All possibilities were thoroughly considered in this situation before settling on the best way to open the area for the lost teeth. Molar distalization needed headgear, which the patient did not want, and incisor proclination was not a po...
Alternative plan
In Phase I, additional functional appliances, such as the Activator, might be used instead of the Twin Block. Headgear therapy is another alternative, although it is not suggested in this case since it has a restraining effect on the maxilla, whereas repositioning the mandible would enhance the facial profile more. Twin Block was chosen over Activator because to increased patient...
Bassett et al. were the first to employ magnetic fields to promote fracture healing in a non-invasive and safe manner. Camilleri and McDonald investigated the effect of a static magnetic field using a Neodymium Iron-Boron magnet placed over a skull suture on a rat model and discovered that the mitotic activity of the cells was affected. Bruce et al. demonstrated that stimulation wi...
Fig. 6. a Panoramic X-ray image 1 year after the surgery. b Intraoral photo 1 year after the surgery
Fig. 6. a Panoramic X-ray image 1 year after the surgery. b Intraoral photo 1 year after the surgery
Fig. 5. Histopathologic photo of the resected mandible (H-E staining)
Fig. 5. Histopathologic photo of the resected mandible (H-E staining)
gmentally resected. b Intraoperative photo. A vascularized fibula bone graft. c Resected mandible. d Panoramic X-ray image after the surgery
Fig. 4. a Intraoperative photo. The affected left mandible was segmentally resected. b Intraoperative photo. A vascularized fibula bone graft. c Resected mandible. d Panoramic X-ray image after the surgery
Fig. 3. CT images of the left mandible. a Axial view at the left first molar. b Coronal view at the left first molar
Fig. 3. CT images of the left mandible. a Axial view at the left first molar. b Coronal view at the left first molar
Fig. 2. Panoramic X-ray image at the first visit
Fig. 2. Panoramic X-ray image at the first visit
Fig. 1. Intraoral photo at the first visit
Fig. 1. Intraoral photo at the first visit
Teramoto, Y., Kurita, H., Kamata, T. et al. A case of peri-implantitis and osteoradionecrosis arising around dental implants placed before radiation therapy.
Int J Implant Dent 2, 11 (2016). https://doi.org/10.1186/s40729-016-0039-1
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Received: 01 August 2015
Accepted: 21 March 2016
Published: 05 April 2016
DOI: https://doi.org/10.1186/s40729-016-0039-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Yuji Teramoto, Hiroshi Kurita, Takahiro Kamata, Hitoshi Aizawa, Nobuhiko Yoshimura, Humihiro Nishimaki, Kazunobu Takamizawa declare that they have no competing interests.
All authors read and approved the final manuscript.
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
Yuji Teramoto, Hiroshi Kurita, Takahiro Kamata, Hitoshi Aizawa, Nobuhiko Yoshimura, Humihiro Nishimaki & Kazunobu Takamizawa
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O'Dell K, Sinha U. Osteoradionecrosis. Oral Maxillofac Surg Clin North Am. 2011;23(3):455–64.
Madrid C, Abarca M, Bouferrache K. Osteoradionecrosis: an update. Oral Oncol. 2010;46(6):471–4.
Jacobson AS, Buchbinder D, Hu K, Urken ML. Paradigm shifts in the management of osteoradionecrosis of the mandible. Oral Oncol. 2010;46(11):795–801.
Ozen J, Dirican B, Oysul K, Beyzadeoglu M, Ucok O, B...
Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Dental implants have become increasingly popular, and a considerable number of people have undergone dental restorations using dental implants. Therefore, there will be an increasing probability of patients with dental implants receiving irradiation around their implants. Further studies are required to analyze whether dental implants located in the radiation field cause adverse effects in the lon...
Secondarily, infection associated with dental implant may become a possible cause of ORN. In radiotherapy including the oral cavity, gingivitis is frequently observed adjacent to fixed metal dental restorations because they cause significant dose enhancement around them [12]. It is easy to speculate that the same occurs around dental implant prostheses (peri-implant mucositis). The presence of muc...
In this paper, we reported a case of ORN arising around dental implants placed before radiotherapy. This is the third such case report to be published. Granström et al. reported three cases of ORN developing around dental implants previously placed for skin-penetrating prosthesis [8]. Slama et al. reported a case of mandibular ORN in post-implant radiation [9]. In these cases, the presence of den...
A 66-year-old man was referred to our hospital for further treatment of ORN of the mandible. He had undergone dental implant treatments on both sides of the mandible (#35, #36, #45, and #47) 7 years previously. All of the implants were osseointegrated and charged. The patient had been followed up regularly by his dentist, and the clinical course had remained uneventful. He experienced left oropha...
Osteoradionecrosis (ORN) of the mandible is a severe complication that follows ionizing radiation therapy in patients undergoing treatment for head and neck cancer. The radiation dose, tumor location, dental trauma, premorbid state of dentition, and concomitant chemoradiotherapy are thought to be contributing factors for ORN [1–3]. Most patients with head and neck cancer are aged 50 years or mo...
A little is known about the effect of radiotherapy on the dental implants that have previously been osseointegrated and charged. Here, we reported a case of osteoradionecrosis which arose around dental implants placed before radiation therapy.
Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase
Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase
Fig. 15. Facial appearance 18 months following treatment
Fig. 15. Facial appearance 18 months following treatment
Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Fig. 8. Abutment level impression utilising light-cured acrylic tray material
Fig. 8. Abutment level impression utilising light-cured acrylic tray material
Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Fig. 5. Left-sided maxillary resection (Brown class 2b)
Fig. 5. Left-sided maxillary resection (Brown class 2b)
Fig. 4. Panoramic dental radiograph showing dental status at presentation
Fig. 4. Panoramic dental radiograph showing dental status at presentation
Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Fig. 2. Staging MRI scan showing destructive lesion left maxilla
Fig. 2. Staging MRI scan showing destructive lesion left maxilla
Fig. 1. Clinical view of left-sided maxillary tumour at presentation
Fig. 1. Clinical view of left-sided maxillary tumour at presentation
Domain
Score
Activity
100 (“I am as active as I have ever been”)
Anxiety
100 (“...
Butterworth, C.J., Rogers, S.N. The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy.
Int J Implant Dent 3, 37 (2017). https://doi.org/10.1186/s40729-017-0100-8
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Received: 14 May 2017
Accepted: 23 July 2017
Published: 29 July 2017
DOI: https...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Consent has been obtained from the patient for the use and publication of all images.
Chris Butterworth and Simon Rogers declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK
C. J. Butterworth & S. N. Rogers
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CB devised the treatment concept and undertook all implant surgeries and prostho...
Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63.
Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Implants. 2013;28(5):e221...
The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function and restored f...
Whilst technically, it would be possible to construct and fit the prosthesis on the same day or even a week later, the need for microvascular flap monitoring in the immediate post-operative period, together with the significant recovery period required by the patient following surgery has lead the authors to delay the fitting of the prosthesis at the 4 to 6-week period post-operatively. In terms o...
In contrast, the use of a soft tissue flap such as the RFFF or antero-lateral thigh flap can often be safely employed in elderly patients with peripheral vascular disease without unduly lengthening the operation too significantly with two-team operating. In addition, the predictability of these flaps with their excellent pedicle lengths is ideal for closure of the resulting oro-nasal surgical defe...
In low-level maxillectomy (Brown class II), the need for bony reconstruction is questionable depending on the horizontal component. With the preservation of the orbital floor, zygomatic prominence and some bony support for the nose, facial appearance, in the experience of the authors and, as demonstrated by this case, is not significantly worsened despite low-level removal of the maxilla. The key ...
In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in the unit. Once the flap was perforated, a 2-mm thick p...
The implant positions were then accurately registered by utilising light-cured resin tray material (Individo® Lux, Voco Gmbh, Germany) and abutment level impression copings. The resin material was applied in sections around the impression copings and cured incrementally to ensure a rigid splinting of the impression copings (Fig. 8). Abutment protection caps were then placed over all four abutment...
A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruction of the lateral m...
The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment include effec...
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.
The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) fo...
Figure 7. Post-operative occlusal photograph of the maxilla
Figure 6. Post-operative lateral view of the right maxillary arch
Figure 5. Post-operative lateral view of the left maxillary arch
Figure 4. Post-operative frontal view with teeth in occlusion
Date
Site number
Implant diameter (mm)
Implant length (mm)
Immediate load
Bone graft augmentation
3/26/14
12
4.3
10
Yes
Allograft
3/26/14
14
4.3
10
Yes
None
11/10/14
10
3.5
13
Yes
Allograft
3/5/15
7
3.5
13
Yes
Allograft
4/19/16
11
4.3
11.5
Yes
None
2/22/17
3
4.3
10
Yes
Allograft
2/22/17
4
5.0
10
Yes
Allograft
...
Figure 1. Characteristic blue sclerae
Table 1 Osteogenesis imperfecta classifications
Type
Inheritance
Gene
Locus
Clinical features
OMIM
I
AD
COL1A1 or COL1A2
17q21.33 or 7q21.3
Variable bone fragility, moderate bone deformity, blue sclerae, possible dentinogenesis imperfecta
166,200
II
AD
COL1A1 or COL1A2
17q21.33 or 7q21.3
Perinatally lethal
166,210
III
AD
COL1A1 or COL1A2
17q21....
References
Sillence DO, Senn A, Danks DM. Genetic heterogeneity in osteogenesis imperfecta. J Med Genet. 1979;16:101–16.
Orioli IM, Castilla EE, Barbosa-Neto JG. The birth prevalence rates for the skeletal dysplasias. J Med Genet. 1986;23:328–32.
Stevenson DA, Carey JC, Byrne JL, Srisukhumbowornchai S, Feldkamp ML. Analysis of skeletal dysplasias in the Utah population. Am J Med Genet...
Discussion
The vast majority of published articles regarding OI type I revolve around fractures of the long bones and treatment strategies. An extensive literature search for manuscripts detailing the implant therapy for patients diagnosed with OI produced a marginal amount of literature (Table 3). Our case posits that oral restoration is attainable without implant failure for OI type I patien...
Surgical technique
The patient underwent implant therapy in stages under general anesthesia with immediate load protocol. Intravenous access was obtained, and the patient was anesthetized under general anesthesia by our anesthesiologist. Carpules of 2% lidocaine with 1:100,000 epinephrine, 4% articaine hydrochloride with 1:100,000 epinephrine (Septocaine), and 0.5% bupivacaine hydrochloride w...
Case presentation
Evaluation
A 53-year-old male diagnosed with OI type I was referred to our clinic for extraction of the remaining maxillary teeth and evaluation for full arch immediate load hybrid prosthesis. His clinical history included osteogenesis type 1, bipolar disorder, alopecia, and hypothyroidism. The patient presented with normal stature, measuring 170.18 cm and weighing 81.65 kg...
Introduction
Osteogenesis imperfecta (OI), colloquially known as “brittle bone disease,” is a broad term for a group of congenital disorders affecting the connective tissue resulting in a susceptibility to fractures. In 1979, Sillence et al. conducted an epidemiological and genetic study of OI patients [1]. These patients were grouped according to four distinct syndromes: (1) dominantly inh...
Implant therapy for a patient with osteogenesis imperfecta type I: review of literature with a case report
Abstract
Bone fragility and skeletal irregularities are the characteristic features of osteogenesis imperfecta (OI). Many patients with OI have weakened maxillary and mandibular bone, leading to poor oral hygiene and subsequent loss of teeth. Improvements in implant therapy have allowed f...
Figure 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Figure 15. Facial appearance 18 months following treatment
Figure 15. Facial appearance 18 months following treatment
Figure 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Figure 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Figure 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Figure 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Figure 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Figure 8. Abutment level impression utilising light-cured acrylic tray material
Figure 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Figure 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Figure 5. Left-sided maxillary resection (Brown class 2b)
Figure 4. Panoramic dental radiograph showing dental status at presentation
Figure 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Figure 2. Staging MRI scan showing destructive lesion left maxilla
Figure 1. Clinical view of left-sided maxillary tumour at presentation
Table 1 Patient-reported quality of life outcomes following ZIP flap procedure
From: The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy
Domain
Score
Activity
100 (“I am as active as I have ever been”)
Anxiety
100 (“I am not anxious about ...
References
Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63.
Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Impl...
Conclusions
The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function...
Immediate/early loading of zygomatic [8] and dental implants [9] have been well demonstrated already within the literature with very high implant survival rates. In the oncology setting, Boyes-Varley et al. [4] lost no zygomatic/oncology implants in their series of 20 patients restored with implant-retained obturators, 6 of whom received radiotherapy post-operatively. The case reported...
The use of soft tissue flaps to close a typical hemi-maxillectomy defect is an effective way of dealing with the oro-nasal communication, but in isolation, this technique works against dental rehabilitation as the bulk of the flap provides a very poor moveable foundation for a subsequent removable prosthesis. The move towards the use of composite reconstruction (especially the fibula flap) h...
Discussion
In order to reduce intra-operative time, the soft tissue free flap is harvested at the same time as the implant placement and prosthodontic procedures. On raising a skin island, it is appropriate to make it a little over-sized for the required defect to ensure that tension and possible dehiscence at the surgical margins during healing is reduced.
In low-level maxillectomy (Brown...
Procedural modifications to the ZIP flap technique
In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in th...
The radial forearm free flap (RFFF) was then disconnected from the arm and inset into the maxillary defect after creating a tunnel down into the left neck for the pedicle. The flap was carefully perforated over the zygomatic implant abutment protection caps using a short incision just through the skin layer followed by blunt dissection to allow the abutment and cap to perforate the flap ensuring a...
The ZIP flap technique
The patient underwent tracheostomy, a limited left-sided selective neck dissection for node sampling and vessels preparation. The maxillary tumour was excised in a standard manner via an intra-oral approach with preservation of the left orbital floor (Fig. 5). The resection extended to the maxillary alveolar midline in the incisor region with extension posteriorly just into...
Case presentation
A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruc...
Background
The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment...
The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy
Abstract
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prost...