Immediate restoration of acute maxillary atrophy without augmentation ? angled implant insertion and the zygomatic concept The goal of this surgical procedure as performed by Dr. Wolfgang Bolz (Munich) is the insertion of zygomatic implants in the posterior upper jaw following extraction of the teeth that were not worth retaining. Thanks to immediate loading of the fixed bridge restoration, many months of treatment can be avoided. In the upper anterior jaw, angled implant insertion provides for additional support of the restoration using the local bone anatomy.
First, the maxillary sinus wall and the zygomatic process in the right and left upper jaw are exposed. An extended window in the lateral maxillary sinus wall is prepared and the Schneiderian membrane carefully mobilised and elevated. Preparation of the implant bed for the zygomatic implants begins from the alveolar ridge and continues via the sinus and into the zygomatic bone. The zygomatic implant is then inserted. In the next step, simultaneous augmentation is performed in the area of the zygomatic implant using bone substitute in order to establish a bone implant site in the long-term.
The augmentation material is then covered with a resorbable membrane. In the anterior area, additional implants are inserted at an angle. This allows optimum use of the existing residual bone for anchorage with primary stability. Primary wound closure is achieved using macro-surgical suture.