Reconstruction of the entire maxillary in an irradiated patient, with an implant retained removable prosthesis, using implants in the zygomatic bone

Anestis Chrysostomidis, Dimitris Tatsis, Kontantinos Tsemberlides, George Papadopoulos, Vaia - Aikaterini Alexoudi, Athanassios Kyrgidis, Konstantinos Vahtsevanos
 
Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, Specialized Cancer Treatment and Recon- struction Center, General Hospital of Thessaloniki “George Papanikolaou”
Laboratory of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki


DOI: 10.54936/haoms252101108

SUMMARY: Maxillectomy is the surgical procedure for removing tumors that affect the hard palate, maxillary si- nus, or nasal cavity, with the extent of the tumor deter- mining the scope of the surgery. Speech, aesthetics, and masticatory function are disrupted when these bound- aries are not maintained, necessitating some form of reconstruction. One available option for the prosthetic restoration of such defects can be achieved with the use of an obturator supported by zygomatic implants.
Materials and Methods: This case report describes the placement of two implants in the zygomatic region to retain a palatal obturator in a 68-year-old patient who underwent a Brown Class 2d maxillectomy for the re- moval of a clear cell carcinoma of the palate. The sur- gical obturator was stabilized after implant placement. Following the healing period, a temporary obturator was made from thermoplastic acrylic material. Mechani- cal retention for the definitive obturator was achieved through a ball attachment suspended from a multi-unit abutment on the zygomatic implants.
Results: The patient was monitored for one year to as- sess the functionality of the prosthetic device, with mi- nor adjustments made to achieve maximum functional success. The prosthetic restoration improved not only function but also aesthetics, contributing to an enhanced quality of life for the patient.
Conclusion: Zygomatic implants offer increased reten- tion compared to traditional obturators. A multidisci- plinary approach, involving the surgeon and a specialized prosthodontist with a precise treatment plan, proves ef- fective in the reconstruction and restoration of patients at various stages of treatment.
 
KEY WORDS: maxillectomy, obturator, zygomatic im- plants, dental implants, maxilla, head & neck cancer




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