Zygomatic implants perforated through a composite scapulo-dorsal free flap for maxillary reconstruction allowing dental rehabilitation: A surgical technique with a step-by-step video.

Background: Dental rehabilitation is considered challenging to achieve whenever composite scapulo-dorsal free flaps are used to reconstruct medium-to-large maxillary defects due to the fact that bone quality and quantity may be low, which may preclude placement of conventional dental implants. In such cases, current options for dental rehabilitation include printed patient-specific subperiosteal implants or zygomatic implants.

Methods: The authors report three cases of maxillary tumour resections that led to medium-to-large defects reconstructed using composite scapulo-dorsal free flaps. Secondary zygomatic implants were perforated through the composite scapulo-dorsal flap more than 12 months after primary reconstruction. Initial loading with removable dental prostheses took place at the time of zygomatic implant placement, followed by secondary non-removable prosthesis placement.

Results: Adequate dental rehabilitation was achieved in all three cases, with an implant survival rate of 100% and no apparent complications after a follow-up period of more than 24 months.

Conclusion: The technique described in the present paper shows promising results in achieving adequate dental rehabilitation in cases with composite scapulo-dorsal free flaps for reconstruction of medium-to-large maxillary defects and could be used as part of the dental rehabilitation strategy, especially in cases where dental prostheses have failed or removable prostheses cannot be used.

Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.