The establishment of a protocol for the total rehabilitation of atrophic maxillae employing four zygomatic fixtures in an immediate loading system--a 30-month clinical and radiographic follow-up.

BACKGROUND The existing approaches to the treatment of the atrophic maxilla are difficult and involve an element of risk. PURPOSE The aim of the present study was to establish a new surgical/prosthetic protocol for the treatment of extremely atrophic maxillae using four zygomatic implants (ZIs) in an immediate loading system. MATERIALS AND METHODS Twelve patients were treated with the surgical placement of 48 ZIs, and the totally edentulous maxillae were rehabilitated with protocol-type maxillary prostheses rigidly fixed to the ZIs in an immediate loading system. Follow-up was conducted at 6 months and again at 30 months. RESULTS Of the 48 ZIs inserted, one implant failed to achieve osseointegration. The prosthetic components fitted well and no sinus pathology was detected in any of the patients. CONCLUSION The surgical/prosthetic protocol showed that it was possible to insert four ZIs in an immediate loading system and achieve stability for up to 30 months.