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Case report of retreatment after failed bone graft reconstruction in the upper jaw. Retreatment was performed with quad zygoma implants.
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Retreatment of failed bonegrafts for maxillary reconstruction
Treated with Quad zygoma and an overdenture
Author: Luc@Vrielinck.be
Situation• Patient desires: fixed prosthesis in Upper Jaw• Diagnosis:
– Situation after failed iliac crest reconstruction– Ill- fitting prosthesis
• Treatment plan:– Quad zygoma, – delayed loading, – bar supported overdenture
Chronology• 26/01/2010: Surgery placement Quad zygoma• 23/08/2010: second stage QZ• 11/10/2010: Prosthesis placed
Parameters
• #Failureheupkamgreffe• #quadzygoma• #overkappingsprothese
Intake
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
20/10/2007: Uitgangssituatie
Surgery
Lefort I advancement & Iliac crest interpositioning
08/10/2008: postoperative after bone reconstruction
08/10/2008: postoperative after bone reconstruction
08/10/2008: postoperative after bone reconstruction
05/11/2008: wounddehiscence finally resulting in total reconstruction failure
05/11/2008: wounddehiscence finally resulting in total reconstruction failure
Zygoma Treatment
Rescue therapy after failed bone grafts
19/03/2009: before zygoma treatment
19/03/2009: before zygoma treatment
Still some bone sequesters and
osteosynthesis material present
19/03/2009: before zygoma treatment
19/03/2009: before zygoma treatment
02/07/2009: Removal of bone sequesters and osteosynthesis material
03/10/2009: Situation after removal of sequesters and osteosynthesis material
Treatment
01/12/2009: Conebeamscan
21 22 23 24 25 26
11 12 13 14 15 16
16 15 14 13 12 11 21 22 23 24 25 26H 1.2 4.05 2.25 2.84 5.54 4.68 4.05 6.21 6.39 2.98 2.37 2.78
W 2.5 3.41 2.78 1.92 4.26 5.54 4.47 3.5 6.00 2.35 3.62 5.33
In all teeth location insufficient bone for standard implantsMinimum e.g. H: 8 mm, width 6 mm
19/01/2010: Planning for Quad zygoma
19/01/2010: Planning for Quad zygoma
19/01/2010: Planning for Quad zygoma
26/01/2010: Postoperative
26/01/2010: Postoperative
26/01/2010: Postoperative
26/04/2010 Wounddehiscence removal of a membrane (Synpor™)Resulting in a huge buccosinusal communiation….
23/08/2010: Just before second stage
23/08/2010: Just before second stage
23/08/2010: Just before second stage
The buccosinusal communication has well healed
23/08/2010: Second stage QZ
23/08/2010: Second stage QZ
23/08/2010: Second stage QZ
23/08/2010: Second stage QZ
02/09/2010: Placing multiunit abutments and impression taking
09/09/2010: Pasbalk
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Placing the bar and prosthesis
11/10/2010: Check of the occlusion
11/10/2010: Check of the occlusion
11/10/2010: Check of the occlusion
• In the right lower jaw one short implant (Bicon) will be placed as support for a removable partial prothesis
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