This clinical report describes the successful implant-supported prosthetic rehabilitation of a patient who underwent subtotal bilateral maxillectomy for an oral squamous cell carcinoma with a consequent wide defect interesting the whole hard palate and most of the soft palate, causing a large opening that directly connects the oral cavity to the nasal fosse bilaterally. The innovative aspect of this case is represented by the realization of a obturator prosthesis supported by just three zygoma implants. The maxillary bone had been largely excised by radical surgery. Despite the resection had a complete oncological success and the patient was free of disease after 24 months follow up, the patient experienced severe speech and deglutition deficit due to the iatrogenic large oro-antral communication. Three zygoma implants have been positioned, two trough the right maxillary bone and, owing the wide lack of bone, just one on the left side. No mucogengival surgery was necessary around the zygoma implants. The obturator prosthesis was stabilized by the three implants and the patient’s oral function as well as quality of life widely improved. The results show that zygoma implants could represent a viable surgical option to obtain a satisfactory oral function rehabilitation even in case of extensive maxillary defect.

ZYGOMA IMPLANT-SUPPORTED PROSTHETIC REHABILITATION OF A PATIENT AFTER SUBTOTAL BILATERAL MAXILLECTOMY

D'AGOSTINO, Antonio;PROCACCI, Pasquale;FERRARI, Francesca;TREVISIOL, Lorenzo;NOCINI, Pier Francesco
2013

Abstract

This clinical report describes the successful implant-supported prosthetic rehabilitation of a patient who underwent subtotal bilateral maxillectomy for an oral squamous cell carcinoma with a consequent wide defect interesting the whole hard palate and most of the soft palate, causing a large opening that directly connects the oral cavity to the nasal fosse bilaterally. The innovative aspect of this case is represented by the realization of a obturator prosthesis supported by just three zygoma implants. The maxillary bone had been largely excised by radical surgery. Despite the resection had a complete oncological success and the patient was free of disease after 24 months follow up, the patient experienced severe speech and deglutition deficit due to the iatrogenic large oro-antral communication. Three zygoma implants have been positioned, two trough the right maxillary bone and, owing the wide lack of bone, just one on the left side. No mucogengival surgery was necessary around the zygoma implants. The obturator prosthesis was stabilized by the three implants and the patient’s oral function as well as quality of life widely improved. The results show that zygoma implants could represent a viable surgical option to obtain a satisfactory oral function rehabilitation even in case of extensive maxillary defect.
Zygoma implants; maxillectomy; squamous cell carcinoma; implant-supported prosthetic rehabilitation
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/478568
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