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Int J Implant Dent. 2017 Dec;3(1):37. doi: 10.1186/s40729-017-0100-8. Epub 2017 Jul 29.

The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy.

Author information

1
Department of Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK. c.butterworth@liv.ac.uk.
2
Department of Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK.

Abstract

This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) for the primary management of maxillary malignancy with surgical closure of the resultant maxillary defect and the installation of osseointegrated support for a zygomatic implant-supported maxillary fixed dental prosthesis.The use of this technique facilitates extremely rapid oral and dental rehabilitation within a few weeks of resective surgery, providing rapid return to function and restoring appearance following low-level maxillary resection, even in cases where radiotherapy is required as an adjuvant treatment post-operatively. The ZIP flap technique has been adopted as a standard procedure in the unit for the management of low-level maxillary malignancy, and this report provides a detailed step-by-step approach to treatment and discusses modifications developed over the treatment of an initial cohort of patients.

KEYWORDS:

Early implant loading; Fixed dental prosthesis; Low-level maxillectomy; Micro-vascular reconstruction; Oral cancer rehabilitation; Radiotherapy; ZIP flap; Zygomatic implants; Zygomatic oncology implant

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