- ZYGOMA IMPLANTS
- PATIENT SPECIFIC IMPLANT
- ADVANCED DENTAL IMPLANTOLOGY
PATIENT SPECIFIC IMPLANT
PATIENT SPECIFIC IMPLANT
Current times challenges imposed by COVID-19 put many patients to mucormycosis/black fungus infections to upper & lower jaw at time eyes also. This infection imposed critical illness endangerouring many patients life. It is true that many patients lost their battle to this fetal infection. Reason can be so many but mainly its aggressive spread across facial spaces & underlying lung infection, multi system damage leading to failure. In an attempt to save life patient’s life they had to undergo immediate surgery causing resection of upper jaws mainly followed by orbital exenterating & lower jaw resections too. Resection of the jaw imposes difficult question for the mode of reconstruction & final rehabilitation.
What can be the best & ideal solution to address this complex issue?
Solutions can be many as per the need. Traditional obturators are playing significant role to rehabilitate patients with immediate effect. I know that’s the big advantage. But it lacks in providing adequate support & efficient chewing process. So this is just the temporary option every patient should consider not the permanent one. Now when patient considers the permanent option he/she will look for proper esthetic outcomes+ chewing ability+ speech + long lasting option+ complication free option.
In my opinion any solution which is going to be stable, traction free, enough amount of soft tissue to drape around are the key factors for successful outcome. By saying that solutions where maxilla (upper jaw) Will require stable support in absence of adequate bone around which has been resected to get disease free status. Adequate support, uniform platform so that forces will be equally distributed (load sharing). Once the soft tissue is confirmed we cant proceed. This all is adding towards improved predictability of the solutions.
Advanced implantology solutions are the way to look ahead for these complex issues. Advanced dental implantology will provide solutions to rehabilitate compromised conditions of jaw. Any thing, which is beyond straightforward implant placement predictable outcome, will challenge clinician to rehabilitate jaw. In daily routine dental implantology one is not challenged because of the adequate availability of hard & soft tissue around. Prosthesis delivery becomes very easy for such cases. In cases of compromised jaw where it has been resected due to many reasons will impose serious challenge for dental rehabilitation.
Advanced dental implantology, Zygoma implants, Patient specific implants can be good options to be considered over here. Advanced dental implantology can be executed with fully digital guided protocols from implant placements to final prosthesis delivery.
When we consider zygoma implants as option it surely helps to rehabilitate resected upper jaws effectively. Zygoma implant will require stable bone in the region with adequate width & height of available bone. In my opinion zygoma implants getting placed bilaterally (both the sides) will provide better stability & outcome for the future. If planned to place on only side there needs two zygoma implant supplemented with one more implant in the midline region. Of course these procedures are technique sensitive & need proper angulation. Use of digitally guided technique play important role. Planning such accurate solution digitally is challenging. Many times when we are placing zygoma implants in guided manner there can be discrepancies due to various factors including inexperienced team delivering digital solutions in lack of planning for soft tissue is very challenging while delivering surgical guides. There can be various discrepancies in untrained hand while using such guides even though after proper surgical guides. It has observed that even after successfully placement of zygoma implants, behavior of the local bone especially in post mucormycosis resection cases is very unpredictable.
So zygoma implant as solutions needs to be executed with utmost experience in the specialty & proper understanding of the hard, soft tissue in the area. Use of Psi (Patient Specific Implant) is a very smart & better choice over zygoma implant. As Zygoma implant not necessarily will provide exact soft tissue emergence in oral cavity. More over only 10mm of implant is fixed inside actual zygoma rest area majorly not in touch or through any bony margin. This will not necessarily provide stability in long duration. To improve or give satisfactory solution use of removable prosthesis can be considered. Patient specific implants are manufactured with Bone Easy Portugal. This is world leader company in PSI (patient specific implant) & has delivered more than 2300 solution already. We as team have delivered approximately 100+ solution in last 5 years. We have recently conducted India’s First Ever Of Its Kind Scientific Session on PSI (patient Specific Implants) in Pune From 12, 13, 14th Aug 2022 where in senior clinicians from Pune, Mumbai, Bangalore, Hyderabad had participated. So we are proposing PSI (Patient Specific Implants) with the help of 3D printing technology for jaw defect rehabilitation for predictable & better outcomes.
Testimonial By
Dr. Vijaykumar Girhe
(Senior Maxillofacial Surgeon)
