case 8 quad zygoma case with navigation
DESCRIPTION
Placement of 4 extramaxillary zygoma implants in the upper jaw. lower jaw was treated with short (Bicon) implantsTRANSCRIPT
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Quad zygoma case with Navigation
Dr Luc Vrielinck, MD DDSOral and Maxillofacial Surgery
Comments at: [email protected] Belgium
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Treatment plan• Total extraction upper jaw, healing• Upper jaw: Quad zygoma implant• Lower jaw: prosthetic reconstruction on short Bicon
implants• Navigation upper jaw for placement of zygoma implants• Drill guide lower jaw Aporis guide
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Materials and devices• Implants upper jaw: Zygoma Tiunite (NobelBiocare.com)• Lower jaw: prosthetic reconstruction on short Bicon
implants (4.5 x 8 mm; 3 mm well) bicon.com• Navigation upper jaw: Brainlab.com (experimental set-
up)• Drill guide lower jaw Aporis guide (aporis.be)• Bio-oss and Biogide
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06/02/2010: Intake
X X X X X X
XX
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06/02/2010: Intake
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06/02/2010: Intake
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06/02/2010: Intake
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06/02/2010: Intake
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06/02/2010: Intake
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05/08/2010: Healing after extractions
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05/08/2010: Healing after extractions
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05/08/2010: Healing after extractions
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05/08/2010: Planning Quad zygoma upper jaw (all extramaxillary)
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05/08/2010: Planning lower jaw (short implants needed on the left)
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05/08/2010: Planning lower jaw (short implants needed on the left)
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05/08/2010: Planning lower jaw (short implants needed on the left)
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05/08/2010: Planning lower jaw (short implants needed on the left)
The drill guide in
the lower jaw is
dental supported,
thanks to optical
scanning of the
plaster cast and
fusion with the
conebeam scan
images
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Aporis Drill guide design for the lower jaw
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15/09/2010: Implant placement sheet for upper and lower jaw
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15/09/2010: Implant placement
Placement of 3 fiducial screws preoperatively
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15/09/2010: Implant placement
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15/09/2010: Implant placement
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15/09/2010: Implant placement
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Working order Navigation• Antrotomy or sinus wall infracture• Registration (select best 4 points out of 6)
– Infraorbital formen left and right– Spina nasalis anterior– 3 fiducial screws
• Selection of entry point in the zygoma• Selection entry point in the maxilla• Drilling• Implant placement• External sinus lifting procedure
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15/09/2010: Implant placement
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Registration right fiducial screw
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Registration midline fiducial screw
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Registration left fiducial screw
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Entry point zygoma implant 1 left
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Entry point zygoma implant 2 left
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Entry point zygoma implant 3 right
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Entry point zygoma implant 4 right
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15/09/2010: Implant placement
Antrotomy anterior maxillary wall and distal infracture of bony wall
Zygoma intraoral Zygoma intraoral
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15/09/2010: Implant placement
Right side Left side
4 x extramaxillary
implants
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15/09/2010: Implant placement
External sinus lifting with Bio-Oss and Biogide
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15/09/2010: Implant placement
Bicon implants in the lower jaw
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15/09/2010: Postoperative radiography
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15/09/2010: Postoperative radiography
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15/09/2010: Postoperative radiography