Zygomatic Implants in Oncology Patients
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Zygomatic and modified zygomatic implants emerge as a key adjunct in the management of patients presenting with maxillary and mid-facial benign and malignant diseases requiring radical resection to effect cure. Their popularity has gained momentum, especially over the past 10 years and the evidence for their successful use continues to evolve and be presented by clinicians in high-volume cancer centres. The zygomatic implant was conceived initially by Professor Branemark to support treatment of the maxillectomy patient by means of remote anchorage that was available in the highly cortical zygomatic bone with a design incorporating angle correction and extension into the oral cavity in order to provide much-needed support and retention for a prosthesis. This concept was taken up slowly around the world, but now is becoming an area of significant interest among multi-disciplinary teams who grapple with these challenging cases. This chapter covers the application and evolution of the zygomatic implant and its associated techniques, both alone and in conjunction with microvascular free tissue transfer in the prosthetic and prosthodontic management of the oncology patient. It discusses the evidence behind the treatments presented, the relevance of modified implant designs and illustrates the cutting-edge new techniques such as the Zygomatic Implant Perforated (ZIP) Flap technique that combines soft tissue reconstruction of the maxillary defect and full fixed dental reconstruction within weeks of surgery, irrespective of the need for adjuvant radiotherapy.
KeywordsZygomatic implant Maxillectomy ZIP flap Maxillofacial prosthesis
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