New SIN Zygomatic Implant - Zygomatic Plus
With the emergence of new digital tools, an evolution in surgical technique has been noted. The implant is now positioned with its head, in many cases, at the top of the alveolar ridge crest. On some occasions, when looking at the working model or clinically in the mouth, it becomes impossible to differentiate a well-positioned zygomatic implant from a well-installed conventional implant.
Given this, planned and assertive perforations have drastically reduced the risk of errors and deviations in perforations that could potentially harm noble anatomical structures.
Sinus problems have been reduced with the possibility of exteriorizing the zygomatic implant, with the correct positioning of the implant head, always supported by residual bone.
The evolution of the surgical process has been clear and beneficial to the patient; for this reason, the development of new geometries for zygomatic implants has become necessary over the years.
DEVELOPMENT
The initial design with spirals and a wider head, ideally conceived for the Branemark Technique, continues to be frequently used. Recently, some changes have been adopted for improvements, meeting clinical needs within the contemporary concept of correct indications for the proper use of the technique.
CLINICAL INDICATIONS
The Zygomatic implant is recommended for complex and challenging situations that arise in the practice of implant dentistry. It is indicated for cases of severe maxillary atrophy, in which the head of the zygomatic implant is often only supported in a groove in the alveolar ridge, leaving the body and head of the implant without bone coverage.
At this point, we arrive at the challenge of the current technique: long-term peri-implant tissue stability.
CARE
It is not uncommon to find well-installed and rehabilitated zygomatic implants, but with tissue dehiscence and exposure of some cervical threads. Such dehiscence found in zygomatic implants causes concern for the patient, hindering hygiene and potentially leading to inflammation or even local infections. Thus, the search for an implant design optimized for clinical situations is fundamental in the solution and surgical process of cases.
With this in mind, the contemporary design of a zygomatic implant needs to take into account osseointegration and primary stability, primarily in the apical region of the implant. In addition, it must have a tissue-friendly design in the cervical region. This means that it must have the smallest possible volume in the cervical region and obtain a macrostructure that is non-irritating to soft tissues. On the surface, a treatment in this case is something that will further optimize stability and tissue adhesion.
HANANO SURFACE
The inclusion of a bioactive surface elevates the product to another level, increasing its predictability and clinical success. The HAnano Surface is formed by hydroxyapatite nanocrystals, whose size and shape are similar to human bone. At a thickness of 20 nanometers, sintered on titanium, which promotes the alteration of surface energy. Furthermore, it increases hydrophilicity and provides a substrate that stimulates greater protein adsorption, adhesion, proliferation, and differentiation of osteoblasts.
Preliminary studies have demonstrated optimal fibroblast adhesion, which would be highly desirable in the cervical region. Taking these factors into account, the new Zygomatic from S.I.N. Implant System aims to be a solution aligned with the modern and updated indications for this type of implant, as well as enabling greater stability, easier osseointegration, and promoting good peri-implant health.
CONCLUSION
Although the external hexagon is the most studied type of prosthetic platform regarding zygomatic implants, the use of internal connections has sparked the interest of many surgeons. The fact that it eliminates the need for assemblers, and allows for customization of angulations with mini-abutments, are advantages perceived by professionals. Thus, having two prosthetic platform options in the portfolio makes sense to meet the global market.