Comprehensive Dental Rehabilitation with Tuff TT and Zygomatic Implants Following Severe Maxillofacial Trauma and Atrophy

clinical case
Performed by Dr. Alexander Nguyen, DDS, OMS
This patient had a severe motor vehicle collision in the past suffering what appears to be a Le Fort 3 fracture and had been edentulous in the maxilla for many years.

He never wore his denture due to being unhappy with it because of his atrophic maxilla.

He was also missing his posterior mandibular teeth for many years leading to atrophy in those areas as well. Starting off with the mandible, the ridge was split with a piezo and expanded with Densah burs. Using a pilot guide, Tuff TT implants were placed in the #19, 21, 29, 30 sites.

A veneer graft was then done with allograft.

Going to the maxilla, the anatomy was very scarred and atrophic from the previous trauma.

Tilted V point Tuff implants to the nasal crest allowed good BIC, massive torque, and avoided the quad zygo.

Pterygoids and bilateral zygomatic implants were placed with very high primary stability.

Buccal fat was advanced and an immediate chairside conversion was performed to put the patient in a screw-retained temporary.



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