Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique
Identifieur interne : 000555 ( Main/Exploration ); précédent : 000554; suivant : 000556Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique
Auteurs : Lorenzo Trevisiol [Italie] ; Pasquale Procacci [Italie] ; Antonio D Gostino [Italie] ; Francesca Ferrari [Italie] ; Daniele De Santis [Italie] ; Pier Francesco Nocini [Italie]Source :
- International Journal of Implant Dentistry [ 2198-4034 ] ; 2016.
Abstract
Several authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis.
The patient presented with a subtotal bilateral maxillectomy and total rhinectomy defect because of a squamous cell carcinoma of the nose. No reconstructive surgery was performed because of the high risk of recurrence; moreover, the patient refused any secondary procedure. After surgery, the patient presented a wide palatal defect associated to the absence of the nasal pyramid. Zygoma-retained prostheses are well documented, and they offer good anchorage in rehabilitating wide defects after oncological surgery and a good chance for patients to improve their quality of life. We hereby describe two prosthetic devices rehabilitating two iatrogenic defects by means of a single intraoral implant-supported bar extending throughout the oronasal communication, thus offering nasal epithesis anchorage.
At 1-year follow-up after functional prosthetic loading, no implant failure has been reported. Clinical and radiological follow-up showed no sign of nasal infection or peri-implantitis. The patient reported a sensitive improvement of his quality of life.
Simultaneous oral and nasal rehabilitation of complex oronasal defects with zygoma-implant-supported dental prosthesis and nasal epithesis represents a reliable surgical technique. According to this clinical report, the above-mentioned technique seems to be a valuable treatment option as it is safe, reliable and easy to handle for both surgeon and patient.
Url:
DOI: 10.1186/s40729-016-0043-5
PubMed: 27747699
PubMed Central: 5005694
Affiliations:
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id="Aff1">Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona</wicri:regionArea><wicri:noRegion>37134 Verona</wicri:noRegion></affiliation></author><author><name sortKey="Procacci, Pasquale" sort="Procacci, Pasquale" uniqKey="Procacci P" first="Pasquale" last="Procacci">Pasquale Procacci</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona</wicri:regionArea><wicri:noRegion>37134 Verona</wicri:noRegion></affiliation></author><author><name sortKey="D Gostino, Antonio" sort="D Gostino, Antonio" uniqKey="D Gostino A" first="Antonio" last="D Gostino">Antonio D Gostino</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona</wicri:regionArea><wicri:noRegion>37134 Verona</wicri:noRegion></affiliation></author><author><name sortKey="Ferrari, Francesca" sort="Ferrari, Francesca" uniqKey="Ferrari F" first="Francesca" last="Ferrari">Francesca Ferrari</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona</wicri:regionArea><wicri:noRegion>37134 Verona</wicri:noRegion></affiliation></author><author><name sortKey="De Santis, Daniele" sort="De Santis, Daniele" uniqKey="De Santis D" first="Daniele" last="De Santis">Daniele De Santis</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona</wicri:regionArea><wicri:noRegion>37134 Verona</wicri:noRegion></affiliation></author><author><name sortKey="Nocini, Pier Francesco" sort="Nocini, Pier Francesco" uniqKey="Nocini P" first="Pier Francesco" last="Nocini">Pier Francesco Nocini</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134 Verona</wicri:regionArea><wicri:noRegion>37134 Verona</wicri:noRegion></affiliation></author></analytic><series><title level="j">International Journal of Implant Dentistry</title><idno type="eISSN">2198-4034</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>Several authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis.</p></sec><sec><title>Patients and methods</title><p>The patient presented with a subtotal bilateral maxillectomy and total rhinectomy defect because of a squamous cell carcinoma of the nose. No reconstructive surgery was performed because of the high risk of recurrence; moreover, the patient refused any secondary procedure. After surgery, the patient presented a wide palatal defect associated to the absence of the nasal pyramid. Zygoma-retained prostheses are well documented, and they offer good anchorage in rehabilitating wide defects after oncological surgery and a good chance for patients to improve their quality of life. We hereby describe two prosthetic devices rehabilitating two iatrogenic defects by means of a single intraoral implant-supported bar extending throughout the oronasal communication, thus offering nasal epithesis anchorage.</p></sec><sec><title>Results</title><p>At 1-year follow-up after functional prosthetic loading, no implant failure has been reported. Clinical and radiological follow-up showed no sign of nasal infection or peri-implantitis. The patient reported a sensitive improvement of his quality of life.</p></sec><sec><title>Conclusions</title><p>Simultaneous oral and nasal rehabilitation of complex oronasal defects with zygoma-implant-supported dental prosthesis and nasal epithesis represents a reliable surgical technique. According to this clinical report, the above-mentioned technique seems to be a valuable treatment option as it is safe, reliable and easy to handle for both surgeon and patient.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Parel, Sm" uniqKey="Parel S">SM Parel</name></author><author><name sortKey="Branemark, Pi" uniqKey="Branemark P">PI Branemark</name></author><author><name sortKey="Ohrnell, Lo" uniqKey="Ohrnell L">LO Ohrnell</name></author><author><name sortKey="Svensson, B" uniqKey="Svensson B">B Svensson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bowden, Jr" uniqKey="Bowden J">JR Bowden</name></author><author><name sortKey="Flood, Tr" uniqKey="Flood T">TR Flood</name></author><author><name sortKey="Downie, Ip" uniqKey="Downie I">IP Downie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="D Gostino, A" uniqKey="D Gostino A">A 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Bal</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Trevisiol, Lorenzo" sort="Trevisiol, Lorenzo" uniqKey="Trevisiol L" first="Lorenzo" last="Trevisiol">Lorenzo Trevisiol</name></noRegion><name sortKey="D Gostino, Antonio" sort="D Gostino, Antonio" uniqKey="D Gostino A" first="Antonio" last="D Gostino">Antonio D Gostino</name><name sortKey="De Santis, Daniele" sort="De Santis, Daniele" uniqKey="De Santis D" first="Daniele" last="De Santis">Daniele De Santis</name><name sortKey="Ferrari, Francesca" sort="Ferrari, Francesca" uniqKey="Ferrari F" first="Francesca" last="Ferrari">Francesca Ferrari</name><name sortKey="Nocini, Pier Francesco" sort="Nocini, Pier Francesco" uniqKey="Nocini P" first="Pier Francesco" last="Nocini">Pier Francesco Nocini</name><name sortKey="Procacci, Pasquale" sort="Procacci, Pasquale" uniqKey="Procacci P" first="Pasquale" 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