Unilateral dental rehabilitation with zygomatic implants after tumor resection surgery: a case series

While the placement of zygomatic implants (ZI) has been described in cases of tumor resection in the posterior maxillary regions, few studies describe unilateral fixed prosthetic rehabilitations. Unilateral rehabilitation raises questions regarding immediate loading and the biomechanical distribution of masticatory forces. The combination with conventional implants (CI) allows, in some cases, the establishment of an implant tripod for better force distribution. In our department, we identified 6 patients who underwent ZI placement for unilateral fixed rehabilitation following tumor resection. Among the 6 cases, 4 patients received the placement of 2 ZI associated with a CI, while in 1 case, 1 ZI was placed in association with 3 CI. Finally, 1 case involved the placement of 2 ZI without the use of CI. The observation period ranged from 18 months to 4 years. Implants used included ZI (Nobel Zygoma, 35–50 mm) allowing immediate loading in all cases. Currently, the gold standard involves vascularized grafting combined with the placement of CI. However, this technique entails a lengthy and costly treatment plan in terms of morbidity. Similarly, performing grafts in reconstructed areas can be challenging due to the hostile vascular bed. ZI could offer significant advantages in these complex cases. Moreover, larger case series with longer follow-ups are needed to better evaluate this option.