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.