Revisions of failing maxillary traditional hybrid dental implant treatments by Dr. Simon Oh with the exceptional “zygomatic and pterygoid implants” by Noris Medical

clinical case
Surgery by Dr. Simon Oh, DDS FICOI
This 67-year-old female presented with a chief complaint of having a painful denture, and wanting to be able to eat again. Her past medical history was noncontributory. Upon examination, her maxilla had severe atrophy, with a total lack of subnasal bone. A discussion took place regarding her options of quad zygomatic implants versus trans-nasal zygomatic configurations.
The patient denied cocaine history.

This patient was intubated and given local anesthesia. A crestal incision was made with a full-thickness flap. Nasal mucosa was reflected off the nasal fossa, the inferior turbinate bone was exposed. 4.2x22mm Noris Tuff implants were placed into the nasal turbinate bones bilaterally and extended into the mouth in lateral incisor positions. A thin layer of Augma was placed on the exposed implant in the nasal fossa, to hopefully re-establish a periosteal attachment of nasal mucosa. From here, 35mm zygomatic implants were placed in an inferior position, and 20mm Pteryfit implants were placed into the pyramidal process of the palatine bone. Composite torque exceeded 400NCm, so immediate loading took place.

Postoperatively the patient denies paresthesia and epiphora and is still in function today.




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