Utilization of the Z-Point with trans-nasal implants as an alternative to the Quad Zygomatic configuration

clinical case
Performed by Dr. Simon Oh DDS, FICOI
This patient presented with a chief complaint of loose teeth. Upon examination, there were generalized mobility grades 2 and 3. Radiographically, generalized bone loss was noted, along with pneumatized sinuses with poor medial sinus anatomy. A discussion took place regarding the need for Extramaxillary implants and a treatment plan was agreed upon.

Day of surgery, the patient was nasally intubated, the skin was prepped, and a local anesthetic was administered. Full mouth extraction and alveoloplasty were performed. The mucosa was reflected along the lateral nasal walls and up to the zygomatic-frontal notch. Nasal mucosa was reflected off the lateral nasal wall internally, and the inferior concha (Z-Point) was exposed and identified. Placement of a 3.75x25mm implant was placed in both inferior conchas (Z-Point), engaging both the maxillary alveoli and the Z-Points. Torque >80NCm was observed in both Z-Point fixtures. From here, bilateral zygomatic implants were placed in an inferior fashion, as well as bilateral pterygoids. A Noris Tuff implant was then placed into the Nasopalatine canal. Augma was placed around the Z-point fixtures, as well as the zygomatic implants. Primary closure via 3-0 chromic gut was achieved, and an immediately loaded prosthesis was picked up and fabricated.

more Clinical cases

Receive the latest news

Subscribe to our newsletters and blogs

We’ll keep you updated with current product news, special offers, events and more: