The new trend of the last years is the research of minimally invasive approach for the implant-supported rehabilitations. The new three-dimensional technologies, like static and dynamic navigation, as well as the use of tilted and zygomatic implants, allow the surgeons to reduce bone grafting procedures. Zygomatic implants can be considered a reliable method to treat severe maxillary bone atrophy or defects due to resection for cancer. The aim of this study is to compare, in a cohort patients group, the outcomes of computer-assisted zygomatic implant rehabilitation in atrophic and oncologic patients. Since 2013, 16 patients were treated: 8 patients with a severe maxillary atrophy and 8 patients with a defect of the upper jaw due to resection for cancer. All of the patients carried out a three-dimensional virtual planning to choose the implant length and the surgeon used a dynamic navigation system for trying to reproduce it clinically. The mean follow-up period was 28 months ( 8 - 48 months). The patient age ranged from 45-87 years (mean 66 months). 58 zygomatic implants were placed. A screw-retained prosthesis was delivered for both groups. An immediate-loading of the implants was possible in 14 cases. Two oncologic patients received a delayed loading. Clinical and radiographic outcomes were evaluated, complications were recorded and the correspondence between the planned implant length and the postoperative one was also evaluated. All the patients filled the quality of life questionnaire before the surgery, after the prosthetic rehabilitation and during the follow-up period. The implant survival rate was 96.54 %. No surgical complications occurred in the short term. A correspondence between the planned implant length and the real one was found in most of the cases. Two implant's failures occurred in the first year, one implant for each group. A long-term biological complication occurred in two oncologic-patients (transient mucositis); Prosthetic complication occurred more often in atrophic patients than in oncologic ones ( 4 cases versus 1 case ); all the complications were easily solved. The OHIP14 score increased with 65% in terms of satisfaction. The zygomatic-implant rehabilitation seems to be a reliable technique in the atrophic maxillae as well as oncologic patients. The three-dimensional computer-aided approach could allow the surgeon to plan the surgery increasing the predictability of it. The early prosthesis-loading certainly allows gaining better functional outcomes. More clinical trials with a longer follow-up period are required to confirm definitely the reliability of this method.
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