Immediately Loaded Zygomatic Implant Retained Maxillary Obturator used in the Management of a Patient following Total Maxillectomy

ABSTRACT

Aim

This study aimed to report on the use of specialized zygomatic oncology osseointegrated implants to assist in the management of a patient struggling to cope with a large maxillary obturator prosthesis following a low-level total maxillectomy.

Background

Maxillary obturator prostheses are commonly used in the rehabilitation of patients following maxillary resection. Whilst these prostheses can be retained adequately with remaining maxillary teeth and/or implants, as the horizontal component of the resection increases, the retention, and support of the obturator are increasingly difficult to manage.

Case description

A 72-year-old female patient was referred with problems tolerating a large removable maxillary obturator prosthesis, following total maxillectomy three years previously. Despite successful disease control without the need for adjuvant therapy, the patient functioned poorly with the obturator prosthesis which was poorly retained and supported by the large defect. In addition, the movement of the obturator resulted in soreness and ulceration, and she relied on the heavy use of denture fixative to assist in the wearing of the obturator prosthesis. Following a radiographic investigation, four zygomatic oncology osseointegrated implants were placed into the residual zygomatic bodies and within a week were used to provide much-improved support and retention for the large obturator prosthesis, resulting in successful amelioration of the patient's pre-existing difficulties.

Conclusion

The use of specialized remotely-anchored osseointegrated zygomatic implants can provide a means of effective support and retention for large prosthetic obturators even where the horizontal component of the maxillary resection is large. The density of the zygomatic bone provides excellent initial stability for these implants which can be used immediately to support

Clinical significance

The use of zygomatic oncology implants provides an improved means of retaining and supporting maxillary obturator prostheses where these are required following partial or total maxillary resection.

How to cite this article

Butterworth CJ. Immediately Loaded Zygomatic Implant Retained Maxillary Obturator used in the Management of a Patient following Total Maxillectomy. Int J Head Neck Surg 2018;9(2):94-100.