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Unilateral Zygomatic Complex Fracture - A Comparison Between Nonsurgical Treatment and Surgical Treatment

Ling XF, Yew CC, Mohd Nazri SB, Tew MM

J Craniofac Surg, 2021 Oct 01;32(7):e627-e630.
PMID: 33654041 DOI: 10.1097/SCS.0000000000007603

BACKGROUND: Medical advances have enabled zygomatic complex (ZMC) fractures to be treated by various approaches. This study aims to analyze the demographics and treatment outcomes of unilateral ZMC fractures, treated nonsurgically or surgically.
METHODS: This 5-year nonrandomized prospective study had included 65 cases of unilateral ZMC fractures from October 2014 until December 2019. Patients were treated and divided into nonsurgical and surgically treated group. Treatment outcomes in terms of step deformities, malar depression, diplopia, infraorbital hypoaesthesia, and mouth opening were evaluated up to six months post-trauma/intervention.
RESULTS: Road traffic accident (96.9%) was the main cause, with predominant male involvement (80%) and median age of 28 years. Significant improvements (P < 0.05) were observed for step deformities and malar depression among the surgically treated group at postoperative day 1 and week 1. Throughout the six months review, infraorbital hypoesthesia and diplopia showed no significant differences between both groups, (P > 0.05). Besides, all patients showed significant mouth opening improvement (P

Matched MeSH terms: Zygoma/surgery
Fulltext Fixed rehabilitation of patient with aggressive periodontitis using zygoma implants

Rajan G, Baig MR, Nesan J, Subramanian J

Indian J Dent Res, 2010 Jan-Mar;21(1):125-8.
PMID: 20427922 DOI: 10.4103/0970-9290.62801

Treatment of patients with aggressive periodontitis has always been a challenge to the clinician. Both young and old are known to be affected by this progressive destructive condition of the supporting dental structures. Although dental implants have been offered as a viable treatment alternative for such patients, additional procedures (like bone grafting) and delayed protocols have limited their usage. This case report describes the treatment of a young patient with aggressive periodontitis using a graftless implant solution. Zygoma implants in conjunction with conventional implants were used with immediate loading.

Matched MeSH terms: Zygoma/surgery*
Addition of zygomatic arch resection in decompressive craniectomy

Martin AG, Abdullah JY, Jaafar A, Ghani AR, Rajion ZA, Abdullah JM

J Clin Neurosci, 2015 Apr;22(4):735-9.
PMID: 25564264 DOI: 10.1016/j.jocn.2014.09.021

Decompressive craniectomy (DC) is a surgical option in managing uncontrolled raised intracranial pressure refractory to medical therapy. The authors evaluate the addition of zygomatic arch (ZA) resection with standard DC and analyze the resulting increase in brain volume using three-dimensional volumetric CT scans. Measurements of brain expansion dimension morphometrics from CT images were also analyzed. Eighteen patients were selected and underwent DC with ZA resection. The pre- and post-operative CT images were analyzed for volume and dimensional changes. CT images of 29 patients previously operated on at the same center were retrieved from the picture archiving and communication system (PACS) and were similarly studied. The findings obtained from the two groups were compared and analyzed. Analysis from three-dimensional CT volumetric techniques revealed an significant increase of 27.97ml (95% confidence interval [CI]: 39.98-180.36; p=0.048) when compared with standard DC. Brain expansion analysis of maximum hemicraniectomy diameter revealed a mean difference of 0.82cm (95% CI: 0.25-1.38; p=0.006). Analysis of the ratio of maximum hemicraniectomy diameter to maximum anteroposterior diameter gave a mean difference of 0.04 (95% CI: 0.05-0.07; p=0.026). The addition of ZA resection to standard DC may prove valuable in terms of absolute brain volume gain. This technique is comparable to other maneuvers used to provide maximum brain expansion in the immediate post-operative period.

Matched MeSH terms: Zygoma/surgery*
Finite element analysis of different surgical approaches in various occlusal loading locations for zygomatic implant placement for the treatment of atrophic maxillae

Ishak MI, Abdul Kadir MR, Sulaiman E, Abu Kasim NH

Int J Oral Maxillofac Surg, 2012 Sep;41(9):1077-89.
PMID: 22575179 DOI: 10.1016/j.ijom.2012.04.010

The aim of this study was to compare two different types of surgical approaches, intrasinus and extramaxillary, for the placement of zygomatic implants to treat atrophic maxillae. A computational finite element simulation was used to analyze the strength of implant anchorage for both approaches in various occlusal loading locations. Three-dimensional models of the craniofacial structures surrounding a region of interest, soft tissue and framework were developed using computed tomography image datasets. The implants were modelled using computer-aided design software. The bone was assumed to be linear isotropic with a stiffness of 13.4 GPa, and the implants were assumed to be made of titanium with a stiffness of 110 GPa. Masseter forces of 300 N were applied at the zygomatic arch, and occlusal loads of 150 N were applied vertically onto the framework surface at different locations. The intrasinus approach demonstrated more satisfactory results and could be a viable treatment option. The extramaxillary approach could also be recommended as a reasonable treatment option, provided some improvements are made to address the cantilever effects seen with that approach.

Matched MeSH terms: Zygoma/surgery*
Treatment of a maxillary dento-alveolar defect using an immediately loaded definitive zygoma implant-retained prosthesis with 11-month follow-up: a clinical report

Baig MR, Rajan G

J Oral Implantol, 2010;36(1):31-5.
PMID: 20218868 DOI: 10.1563/AAID-JOI-D-09-00062

This article describes the dental implant-based rehabilitation of a partially edentulous patient with a unilateral maxillary dento-alveolar defect. A screw-retained prosthesis with a modified design was fabricated on zygomatic and regular dental implants. One section of the implant prosthesis has cemented crowns and the other section is conventional screw-retained. The design of the prosthesis overcame the hard and soft tissue deficit and provided the desired esthetics.

Matched MeSH terms: Zygoma/surgery*
Zygomatic implant-retained fixed complete denture for an elderly patient

Baig MR, Rajan G, Yunus N

Gerodontology, 2012 Jun;29(2):e1140-5.
PMID: 21615782 DOI: 10.1111/j.1741-2358.2010.00433.x

Dental rehabilitation of a completely edentulous geriatric patient has always been a challenge to the clinician, especially in treating those with higher expectations and demands. Treatment duration and the amount of residual alveolar bone available are often important considerations when planning for dental implant-based fixed treatment for these patients. With the introduction of zygomatic implants, a graftless alternative solution has emerged for deficient maxillary bone with provision for immediate loading. This article describes the treatment of a completely edentulous elderly patient using zygomatic implants in conjunction with conventional implants. The implants were immediately loaded using a definitive acrylic resin fixed denture reinforced with a cast metal framework, to provide function and aesthetics.

Matched MeSH terms: Zygoma/surgery*