Complications in the use of zygomatic implants for the rehabilitation of the atrophic maxilla: a literature review

Abstract

The rehabilitation of atrophic jaws has always been a challenge for the surgeon and the use of zygomatic implants has become a popular alternative treatment to alveolar reconstruction. The present study consists of a literature review seeking trans and postoperative surgical complications that are most commonly related to zygomatic implant surgery. A search was performed in PubMed database for articles published between 2010 and 2015, and 92 articles on the subject were found. Studies were selected based on the inclusion and exclusion criteria. Twelve of the 92 articles were selected for review, with a total of 5.425 zygomatic implants. Articles that only considered prosthetic complications were not selected. The reported post-operative complications were 162 cases of sinusitis (2.98%), 129 soft tissue infection (2.37%), 16 (0.29%), 21 orosinusais fistulae (0.38%) 2 subcutaneous emphysema (0.036%), 1 penetration of the orbital cavity (0.018%), 9 cases of persistent pain (0.16%), 5 exposures of the implant (0.092%) and failure of osseointegration 16 (0.29%). Articles of clinical cases with a small sample group reported the absence of clinical complications. The follow-up ranged from 1 to 7 years. The most frequent complication is maxillary sinusitis, and the zygomatic fixation technique may incur in numerous complications when the surgeon is inexperienced and/or do not have good anatomical knowledge of the region. There is a lack of studies with controled postoperative followup that discuss trans and postoperative complications.