ZAGA Case Report: Management of a surgical complication. CASE 20-01.

Overview

The following pictures correspond to a patient with an extremely atrophied maxilla, treated during the January 2020 edition of the ZAGA course in Barcelona. The objective is to illustrate the management of an intra-operatory complication. Zygomatic fracturing was experienced during the placement of the left upper premolar zygomatic implant. The implant diameter was 3.4 mm. After retrieving the implant, osteotomy depth was increased to allow for lateral stabilization of a wider and shorter implant that would not reach zygomatic anchorage.

A 4 mm diameter implant was customized to a length of approximately 27 mm. The new implant with a threaded design was placed. Achieved insertion torque was 50Ncm. Pterygoid implants were installed for better load distribution and implant stabilization during the healing period. All abutments were placed and secured with 25Ncm. An immediate prosthesis made of milled metallic core and acrylic teeth was delivered the following day at 1 pm. Prosthetic work was performed by Dr. Ignacio Mayo.


Planning


13-15


23-25 and Complication


Final situation


Dr. Aparicio is an expert in the complex technique of zygomatic implants, which consists of oral rehabilitation in the face of dental loss by means of prostheses fixed to the jawbone. It is the solution for patients who present lack of maxillary bone necessary for the fixation of an implant.

Graduated in Medicine and Surgery from the University of Navarra, he completed his training in implants, prostheses and dental aesthetics in the USA, Canada, Switzerland and Sweden. He is also honorary president and founder of the Spanish Society of Minimally Invasive Dentistry and director, in collaboration with the University of Barcelona and the University of Gothenburg, of the program at Zygomatic Implants.