Quad zygoma after failed maxillary reconstruction
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Retreatment of failed bonegrafts for maxillary reconstruction
Treated with Quad zygoma and an overdenture
Author: [email protected]
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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
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Chronology• 26/01/2010: Surgery placement Quad zygoma• 23/08/2010: second stage QZ• 11/10/2010: Prosthesis placed
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Parameters
• #Failureheupkamgreffe• #quadzygoma• #overkappingsprothese
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Intake
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20/10/2007: Uitgangssituatie
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20/10/2007: Uitgangssituatie
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20/10/2007: Uitgangssituatie
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20/10/2007: Uitgangssituatie
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20/10/2007: Uitgangssituatie
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20/10/2007: Uitgangssituatie
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Surgery
Lefort I advancement & Iliac crest interpositioning
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08/10/2008: postoperative after bone reconstruction
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08/10/2008: postoperative after bone reconstruction
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08/10/2008: postoperative after bone reconstruction
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05/11/2008: wounddehiscence finally resulting in total reconstruction failure
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05/11/2008: wounddehiscence finally resulting in total reconstruction failure
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Zygoma Treatment
Rescue therapy after failed bone grafts
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19/03/2009: before zygoma treatment
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19/03/2009: before zygoma treatment
Still some bone sequesters and
osteosynthesis material present
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19/03/2009: before zygoma treatment
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19/03/2009: before zygoma treatment
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02/07/2009: Removal of bone sequesters and osteosynthesis material
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03/10/2009: Situation after removal of sequesters and osteosynthesis material
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Treatment
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01/12/2009: Conebeamscan
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21 22 23 24 25 26
11 12 13 14 15 16
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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
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19/01/2010: Planning for Quad zygoma
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19/01/2010: Planning for Quad zygoma
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19/01/2010: Planning for Quad zygoma
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26/01/2010: Postoperative
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26/01/2010: Postoperative
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26/01/2010: Postoperative
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26/04/2010 Wounddehiscence removal of a membrane (Synpor™)Resulting in a huge buccosinusal communiation….
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23/08/2010: Just before second stage
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23/08/2010: Just before second stage
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23/08/2010: Just before second stage
The buccosinusal communication has well healed
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23/08/2010: Second stage QZ
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23/08/2010: Second stage QZ
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23/08/2010: Second stage QZ
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23/08/2010: Second stage QZ
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02/09/2010: Placing multiunit abutments and impression taking
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09/09/2010: Pasbalk
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11/10/2010: Placing the bar and prosthesis
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11/10/2010: Placing the bar and prosthesis
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11/10/2010: Placing the bar and prosthesis
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11/10/2010: Placing the bar and prosthesis
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11/10/2010: Placing the bar and prosthesis
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11/10/2010: Placing the bar and prosthesis
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11/10/2010: Check of the occlusion
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11/10/2010: Check of the occlusion
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11/10/2010: Check of the occlusion
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• In the right lower jaw one short implant (Bicon) will be placed as support for a removable partial prothesis