Bedrossian, E. Armand

Purpose: This review article evaluated biomechanical studies, finite element analyses, and clinical papers on the prosthetic and surgical principles for the survival of implants when reconstructing the edentulous mandible, including the use of a three-implant-supported fixed prosthesis. Materials and Methods: A comprehensive search of studies published from 1983 to December 2017 listed in the PubMed/MEDLINE databases was performed. Relevant studies were selected according to predetermined inclusion and exclusion criteria. Results: The initial database search yielded 942 titles. After filtering, 157 abstracts were selected, with 68 articles considered relevant and included. Consensus among authors was identified in regard to the number and the distribution of implants, limiting or eliminating distal cantilevers, and the principles of biomechanical loading of a cross-arch splinted prosthesis. Conclusion: The result of this review suggests that reconstruction of the edentulous mandible with a fixed prosthesis using three, four, or six implants is a viable treatment option. However, when using three implants, wider-diameter implants are recommended for favorable force control. Schlagwörter: ad modum Brånemark, biomechanics, graftless solution, implant, mandible

Purpose: To review potential complications that may occur using the zygoma implant published in the literature as well as complications encountered by the primary author. Solutions for prevention as well as the management of such complications are also discussed in detail. Materials and Methods: The authors have reviewed and outlined reports discussing the etiology as well as the management of potential complications associated with the use of the zygoma implant and have offered recommendations for the management of these complications. Results: Predictable clinical solutions are offered for the identification of the cause as well as the management of complications, including orbital involvement, intracranial involvement, paresthesia of V2, subperiosteal infections, overextended apical extension, vestibular dehiscence, failed zygoma implant, fractured implant, and management of sinus infections. Conclusion: A comprehensive knowledge of the specific steps for the proper execution of this complex procedure will allow for a predictable outcome as presented by the systematic reviews of the zygoma implant, which have reported a cumulative survival rate of 96.7% to 97.8%. Understanding the cause, the prevention, as well as the management of potential complications is imperative for the contemporary surgeon using the zygoma implant. Schlagwörter: ad modum Brånemark, biomechanics, complications, extra-sinus, implant, maxillary reconstruction, zygoma, zygomatic