Managing Zygomatic Implant Failure With Pterygomaxillary Implant and Sinus Floor Elevation: A Technical Note

This report describes a safe and staged protocol for managing the failure of a zygomatic implant complicated by severe sinusitis, using a pterygomaxillary implant and subsequent sinus floor elevation with intermediate implant placement. A 67-year-old male presented with a failed right zygomatic implant and refractory sinus infection 11 months after full-arch maxillary rehabilitation. After sectioning the zygomatic implant at the inferior border of the zygomatic arch, the authors inserted a pterygomaxillary implant and subsequent sinus floor elevation with intermediate implant placement to support a new restoration. The protocol successfully resolved the sinus infection and maintained prosthetic function throughout treatment. The final prosthesis, supported by the pterygomaxillary implant, the new intermediate implant, and the remaining stable implants, demonstrated good stability at the 1-year follow-up. Further long-term studies are needed to comprehensively evaluate the protocol's efficacy and stability.