Protocolo para la colocación de implantes cigomáticos bajo anestesia local: serie de casos

Introduction Zygomatic implants are a technique that allows rehabilitating patients with great maxillary atrophy. The objective of the work was to develop a reproducible surgical and prosthetic protocol in the performance of bilateral zygomatic implants accompanied by conventional implants under local anesthesia and oral medication and to evaluate the distance between the zygomatic implants and the infraorbitary nerve. Materials and methods Nine female patients weighing more than 70 kg were operated on under local anesthesia and oral sedation. 19 zygomatic implants and 23 conventional implants were placed. In no case was Quad Zygoma performed. The loading of the provisional prosthesis was 8 days after surgery and the zygomatic implants were placed in the ZAGA 4 classification. An initial panoramic radiograph and a control radiograph were performed at 6 months. Results 10 zygomatic implants were placed in the first quadrant and 9 in the second. In the first quadrant, 40% (4/10) of the implants were in position 1.4. In position 1.5, 40% (4/10) of the implants were placed. 66.1% (6/9) of the zygomatic implants in the second quadrant were placed in position 2.5 and 33.3% (3/9) in position 2.6. The mean distance from the most mesial zygomatic implant to the infraorbital nerve of the first quadrant was 14.5 mm. The mean distance from the most mesial zygomatic implant to the second quadrant infraorbital nerve was 15.5 mm. 10.55 carpules of 4% articaine were placed on average. Zolpidem hemitartarate, dexamethasone, and tramadol hydrochloride were used as oral medication in all patients. Dipyrone was used only in surgeries of more than two hours. Conclusion The more mesial the emergence of the zygomatic implant is, the closer it will be to the infraorbital nerve. Local anesthesia plus oral medication can be used as long as two and a half hours of surgery are not exceeded. The surgical and prosthetic protocol is reproducible.