Zygomatic implant-caused infection in sinus which surgery does not resolve: thoughts?

Sadly always can be a side effect of Zygomatic implants due to the position and sinus transferrence . Removal may be the best solution and may be easier with the Neobiotech removal system although I have not tried it with a zygomatic . Peter

Refer this case to a maxillofacial and oral surgeon. We dont know about the condition of the sinus before all on 6 placement. Its important before any maxillary sinus augmentation that the osteomeatal complex with ostium need to be reviewed for any signs of pathology, and patency...All infected implants need to be removed asap...this may lead to a pan sinusitis with covernous sinus thrombosis...concider Caldwell Luc to remove sinus membrane with infection...AB cover....do closure of OAF only after 2 weeks or so...

This is a 911 case. Many possible complications and death threatening. Should be done in the OR. Care should be taken that is not affecting the base of the Orbit. In my humble opinion Zygomatic Implants have no place in dentistry. There are so many other treatments that are more effective and less chances of severe complication. Raul R Mena DMD Oral-Cranio-Maxillofacial Implantology.

Hi I have experience as an OMS on zigomatic implants, first of all if there is still any Kind of suppuration please do a cultive so you can prescribe the exact anthibiotic, do not try to remove the zigomatic implant, really there is alot of risk, specially a fracture, first try the exact prescripción to resolve the problem, try to take out of oclussion the implant site, some oral corticoids, and antihistamines for at least one week also will help, and you will see than in one month you will be giving us good news.

The reason of the infection is not occlusion. Hope that you are right with the AB treatment, but in my opinion it is only a temporary treatment. Raul

I have seen a couple of cases with the same problem, one of them was placed by me, one case was done by a well know spanish doctor who has written a book on Zi implants and reports 100% success rate, another one was from another spanish Dr. With a very a high success rate reported in articles published in high impact dental magazines, some other cases were from less known dental and oms. From my observation and experience I can tell that those cases are very hard to treat, dangerous and cause many problems to patients, because they cause chronic sinus infections, and persistent oro-antral fistulae, these conditions are resistant to medication and can only be solved by extracting the implant, doing thorough cleaning of the sinus cavity curetting away all the granulation tissue, abundant irrigation with saline and iodine solution must be done until no signs of infection and suppuration are observed, at that time oro-antral communication must be closed surgically with a triple layered flap: first layer consisting of the fistulae epithelium, second layer a pediculate Bichat fatty pad flap and a third layer of a rotated palatal or buccal flap. From my clinical data I can tell you that those kind of problems associated with Zigoma implants are not uncommon and are harder to treat than the typical infection of a sinus graft, usually solved removing the graft. Zygoma implants as introduced By Branemarck are a good solution to treat very extreme cases, the problem is the trivialization of this treatment option encouraged by articles and reports that are far from being true, in which Zi are presented as a fast trouble free solution.

Alternative prior to Zygomatic : Co-Axis Implant posterior and one anterior to the maxillary antrum plus 2 anteriors ie all-on-6 . Saves hazzles and works . Co-axis Implants ( Southern Implants )

HI David nice resume ,you have said it all straight up . See you in London for your lecture to our Association , enjoy Ibiza. Peter

Yikes the implant needs to go I agree with Dr Morales Schwartz. This is an extremely difficult surgical access with significant complications. Get this case into the right experienced hands ASAP!

This is all very helpful. Thank you.

There seems to be a buzz about zygomatic implants and when I see these cases I can't imagine them being successful long term. When they fail they will fail ugly. They seem to violate everything I know about successful implantology. Because of the invasive surgery and the potential for very significant complications I will leave this technique for those more skilled than I. Greg Steiner Steiner Biotechnology

Did Branemark pay DMD or Oral surgeons to do zygomatic implants? Did they offer or provide other support to promulgate this procedure?

HBO therapy will be a very good option in the meantime the decission to take the implant out is done. This is a clear indication to treat and prevent complications related to this condition.