Immediate Function with the Zygomatic Implant: A Graftless Solution for the Patient with Mild to Advanced Atrophy of the Maxilla

Purpose: In many edentulous maxillae, posterior alveolar atrophy calls for bone grafting. Patient treatment acceptance is increased by eliminating grafting using tilted implants, especially the zygomatic implant in combination with immediate function. The purpose of this study was to evaluate a protocol for immediate function (within 2 hours) of 2 zygomatic and 4 standard implants (Nobel Biocare) supporting a fixed prosthesis in the completely edentulous maxilla. Materials and Methods: This clinical study included 14 patients with 83 immediately loaded implants (28 bilateral zygomatic and 55 premaxillary implants) supporting a complete maxillary denture converted to a fixed provisional prosthesis immediately following the surgical procedure. After 6 months of use, a new fixed metal-supported prosthesis was fabricated. Results: Fourteen patients treated with immediate loading of zygomatic implants were followed for at least 12 months. All patients reported minimization of postoperative pain and security during speech, animation, and mastication. No failures occurred during the follow-up period. Discussion: The patients in the study could have been candidates for sinus grafting. With the present concept these patients benefited from a less invasive procedure (1 surgical procedure and no grafting) and immediate rehabilitation (prosthesis attached directly after surgery). Conclusion: The high survival rate, increase in patients' immediate functional ability, and reduction of morbidity following the surgical procedure render this procedure a viable treatment option for the completely edentulous maxilla. (Case Series)