International Journal of Prosthodontics and Restorative Dentistry

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VOLUME 12 , ISSUE 4 ( October-December, 2022 ) > List of Articles


Accelerating Midfacial Prosthetic Rehabilitation Using Zygomatic Implants and Intraoperative Facial Impression: A Case Report

Tengku Fazrina Tengku Mohd Ariff, Christopher J Butterworth

Keywords : Case report, Nasal prosthesis, Rhinectomy, Zygomatic implant

Citation Information : Ariff TF, Butterworth CJ. Accelerating Midfacial Prosthetic Rehabilitation Using Zygomatic Implants and Intraoperative Facial Impression: A Case Report. Int J Prosthodont Restor Dent 2022; 12 (4):209-213.

DOI: 10.5005/jp-journals-10019-1378

License: CC BY-NC 4.0

Published Online: 03-05-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Prosthetic rehabilitation of rhinectomy defects with a custom-made silicone prosthesis can provide excellent results for patients. However, prosthesis stability, retention, and time to full rehabilitation remain a concern for many patients. The aim of this clinical report is to describe the early prosthetic rehabilitation of a rhinectomy defect with a zygomatic implant-supported nasal prosthesis. Bilateral horizontal zygomatic implant placement, performed at the time of tumor resection in this Brown class VI nasomaxillary resection, provided predictable remote anchorage for a subsequent prosthesis, with the initial implant-retained prosthesis being provided just 2 weeks following surgery. High implant stability was achieved, which allowed early loading of the implants and facilitated early rehabilitation for the patient through the engagement of high-quality bone in the zygomatic body. The technique has offered an accelerated restoration of facial cosmesis following rhinectomy, allowing early recovery for the patient even prior to postoperative (post-OP) radiotherapy.

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  1. Beumer J, Marunick MT, Esposito SJ. Maxillofacial rehabilitation: prosthodontic and surgical management of cancer-related, acquired, and congenital defects of the head and neck, Third Edition. 2011;255314.
  2. Kashmoola S, Ariff TFTM. Prosthetic management of unfavourable nasal defect: a case report. Compend of Oral Sci 2021;8:9096. DOI: 10.24191/cos.v8i0.17486
  3. Jazayeri HE, Kang S, Masri RM, et al. Advancements in craniofacial prosthesis fabrication: a narrative review of holistic treatment. J Adv Prosthodont 2018;10(6):430–439. DOI: 10.4047/jap.2018.10.6.430
  4. Korfage A, Raghoebar GM, Noorda WD, et al. Recommendations for implant-retained nasal prostheses after ablative tumor surgery: minimal surgical aftercare, high implant survival, and satisfied patients. Head Neck 2016;38(Suppl 1):E619–E624. DOI: 10.1002/hed.24053
  5. Scott N, Kittur MA, Evans PL, et al. The use of zygomatic implants for the retention of nasal prosthesis following rhinectomy: the Morriston experience. Int J Oral Maxillofac Surg 2016;45(8):1044–1048. DOI: 10.1016/j.ijom.2016.01.020
  6. Ethunandan M, Downie I, Flood T. Implant-retained nasal prosthesis for reconstruction of large rhinectomy defects: the Salisbury experience. Int J Oral Maxillofac Surg 2010;39(4):343–349. DOI: 10.1016/j.ijom.2010.01.003
  7. Le JM, Chen PH, Seidenfaden JC, et al. Zygomatic implants for restoration of complex nasal defects – a case report and outcome. J Diagn Treat Oral Maxillofac Pathol 2020;4(9):152–661. DOI: 10.23999/j.dtomp.2020.9.2
  8. Bowden JR, Flood TR, Downie IP. Zygomaticus implants for retention of nasal prostheses after rhinectomy. Br J Oral Maxillofac Surg 2006;44(1):54–56. DOI: 10.1016/j.bjoms.2005.04.006
  9. Hackett S, El-Wazani B, Butterworth C. Zygomatic implant-based rehabilitation for patients with maxillary and mid-facial oncology defects: a review. Oral Dis 2021;27(1):27–41. DOI: 10.1111/odi.13305
  10. Brown JS, Rogers SN, McNally DN, et al. A modified classification for the maxillectomy defect. Head Neck 2000;22(1):17–26. DOI: 10.1002/(sici)1097-0347(200001)22:1<17::aid-hed4>;2-2
  11. Caputi S, Varvara G. Dimensional accuracy of resultant casts made by a monophase, one-step and two-step, and a novel two-step putty/light-body impression technique: an in vitro study. J Prosthet Dent 2008;99(4):274–281. DOI: 10.1016/S0022-3913(08)60061-X
  12. Nandini VV, Venkatesh KV, Nair KC. Alginate impressions: a practical perspective. J Conserv Dent 2008;11(1):37–41. DOI: 10.4103/0972-0707.43416
  13. Engelhardt S, Papacosta P, Rathe F, et al. Annual failure rates and marginal bone-level changes of immediate compared to conventional loading of dental implants. a systematic review of the literature and meta-analysis. Clin Oral Implants Res 2015;26(6):671–687. DOI: 10.1111/clr.12363
  14. Boyes-Varley JG, Howes DG, Davidge-Pitts KD, et al. A protocol for maxillary reconstruction following oncology resection using zygomatic implants. Int J Prosthodont 2007;20(5):521–531.
  15. Becker C, Becker AM, Pfeiffer J. Health-related quality of life in patients with nasal prosthesis. J Craniomaxillofac Surg 2016;44(1):75–79. DOI: 10.1016/j.jcms.2015.10.028
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