A modified Delphi consensus for rehabilitations anchored to zygomatic implants

Background: Studies on different surgical approaches have been published with excellent success rates for zygomatic implants. The same publications offer different results regarding the complications associated with the use of such implants. A consensus protocol on zygomatic implant interventions has yet to be documented.
Purpose: To seek to establish a consensus at each step of treatment consisting of oral rehabilitation using zygomatic implant–anchored restorations, and to share the outcome of the process to serve as a basis for practitioners and researchers.
Materials and methods: A wide variety of protocols were identified based on the results of a literature review conducted previously. All participants received the results of the systematic literature search. A modified Delphi process was used to establish a consensus protocol. Six sections were defined: Diagnosis and indications, Planning, Medication, Surgery, Prosthesis, and Follow-up. The first round of 17 open-ended questions was shared with 63 participants, all of whom were experts in zygomatic implant rehabilitation and part of the ZAGA Centers network. A total of 77 follow-up questions were then generated after analysis of the responses to the first 17 questions.
Results: Of the 63 experts enrolled, 48 responded to both rounds of questions. Consensus was determined based on the percentage of agreement: < 70% was considered “no consensus” and ≥ 70% was considered “consensus”. A high level of consensus was reached. The sections with the lowest percentage of agreement were Medication and Surgery, where a consensus was reached for 67% of the questions. Of the questions included in the Follow-up section in both rounds, a consensus was reached for 80%. Overall, agreement was obtained on 71% of the topics.
Conclusions: Use of the modified Delphi process led to the creation of the first consensus protocol for oral restorations anchored to zygomatic implants.