Zygomatic implants as a solution for severe maxillary atrophy: a retrospective analysis of the original Brånemark scheme vs the quad zygoma scheme

Abstract

This retrospective cohort study was performed to evaluate the original Brånemark scheme vs the quad zygoma scheme for treating severe maxillary atrophy. Zygomatic implant surgeries performed between 1998 and 2021 at Ziekenhuis Oost Limburg, Belgium were analysed. Patients with =2 years of follow-up were included. Data on implant survival, prosthesis survival, and surgical techniques were assessed using Kaplan-Meier survival curves and multivariable Cox proportional hazards models adjusted for age, sex, and smoking; statistical significance was set at P = 0.05. Overall, 203 patients with 675 zygomatic and 223 standard implants were evaluated. The quad zygoma scheme demonstrated a significantly higher implant survival rate than the classic Brånemark scheme (P = 0.009), particularly in the anterior maxilla, although no significant difference in prosthesis survival was observed between the two. The sinus slot technique showed superior implant and prosthesis survival compared to the intrasinus approach (P = 0.002, P = 0.015). These findings suggest that the quad scheme offers advantages in implant survival, especially in the anterior maxilla, while prosthetic outcomes remain comparable between the two schemes. Additionally, the sinus slot technique may help reduce sinus-related complications. Five-year implant survival was 91.5% for the classic scheme and 94.9% for the quad scheme; 10-year survival was 83.7% and 92.6%, respectively. Personalized surgical strategies are crucial for optimizing outcomes in zygomatic implant treatments, and further long-term research is necessary to confirm these results.