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A case reoport of a patient with cleft palate treated 9 years ago with zygoma implants
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Situation (1)
• Before 2000: Iliac crest reconstruction and 6 implants with failure of all implants
• Referral to our Clinic 2001: patient desires fixed prosthesis
• Diagnosis
– Class III
– Cleft palate right side
– Buccosinusal fistula
– Situation after failed bonegrafts and implants
Situation (2)
• Treatment plan:
– Cleft palate right side
– 2 zygoma implants
– 2 pterygoid implant
– 1 implant left canine
Chronology
• Before 2000: iliac crest reconstruction and 6
implants with failure of all implants
• 2001: referral to our clinic
• 12/04/2001: Implant placement UJ
• 15/10/2001: Second stage
• 17/02/2011: > 9 year follow-up
Intake
23/01/2001: Intake
Treatment planning
06/03/2001: study casts
06/03/2001: study casts
06/03/2001: Implantplanning Simplant
06/03/2001: Implantplanning Simplant
06/03/2001: Implantplanning Simplant
06/03/2001: Implantplanning Simplant
06/03/2001: Implantplanning Simplant
06/03/2001: Implantplanning Simplant
2
1
3
4
5
6
6 implants planned
06/03/2001: Stereolithographic model with simulation of implant positions
06/03/2001: Stereolithographic model with simulation of implant positions
06/03/2001: Stereolithographic model with simulation of implant positions
12/04/2001: Implant placement
12/04/2001: Implant placement
SurgiGuide™ drill
guide attached
with
osteosynthesis
screwsDrill guide reinforcement of
Guiding cilinders
12/04/2001: Implant placement
12/04/2001: Implant placement
After removal of drill guide
12/04/2001: Implant placement
X
13/04/2001: RX postoperatief
1 2 3 4 5
6
Postoperative after loss of implant (6)
12/04/2001: second stage
12/04/2001: second stage
Prosthetic phase
Prosthetic phase
Prosthetic phase
Prosthetic phase
Follow-up 4 year
20/12/2005
20/12/2005: Follow-up 4 year
20/12/2005: Follow-up 4 year
Bucconasal communication is closed effectively by the prosthesis
20/12/2005: Follow-up 4 year
20/12/2005: Follow-up 4 year
Follow-up 8 year
17/02/2011
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
15 15 13 23 25
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
17/02/2011: Follow-up 8 year
Further measures
• Retreat the case prosthetically
– Add multiunit abutments
– CAD/CAM milled bar
– Overdenture
