{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:58:56Z","timestamp":1788962336541,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Implant Dent Rel Res"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The objective of the study was to provide long\u2010term clinical outcomes and complications in the severely atrophic edentulous maxillae treated by means of the quad zygoma protocol (QZP) using the Anatomy\u2010Guided Approach (AGA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of all consecutive patients with severely atrophic edentulous maxilla and insufficient bone height and width in the anterior and posterior regions bilaterally, who underwent rehabilitation with the QZP between May 2006 and December 2021. All patients were followed for at least 1\u2009year. All zygomatic implants (ZIs) were placed by the same surgeon. The primary endpoint of the study was the implant survival rate. Secondary endpoints were implant success rate, prosthesis success rate, complications, and Oral Health\u2010Related Quality of Life using the OHIP\u201014 questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 56 patients (men 16, women 40) with 224 ZIs (Nobel Biocare, <jats:italic>n<\/jats:italic>\u2009=\u2009204; Straumann, <jats:italic>n<\/jats:italic>\u2009=\u200916; Southern Implant, <jats:italic>n<\/jats:italic>\u2009=\u20094) placement were included with a mean follow\u2010up period 8.8\u2009\u00b1\u20093.9\u2009years (range, 1.2\u201317.0). The survival (success) rate was 97.7%. Five ZIs in four patients failed. The mean time between implant placement and failure was 8.6\u2009years (range, 0.5\u201313.3). All patients received immediate loading with acrylic prosthesis. The successful rates for the definitive prosthesis were 98.2%. Forty\u2010two patients received posterior cantilever for rehabilitation of fixed definitive prosthesis. Local orofacial inflammation (35.7%) and Sinusitis (12.5%) were the most common complications, occurring at a mean follow\u2010up of 10.0 (range, 4.2\u201314.9) and 10.3 (range, 4.3\u201316.2) years, respectively. In 48 patients, the mean score of the OHIP\u201014 questionnaire was 1.7\u2009\u00b1\u20092.6 with the follow\u2010up period of 9.0\u2009\u00b1\u20094.1\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rehabilitation of severely atrophic edentulous maxilla using the QZP has shown a predictable and high survival rate in the long term. The implementation of an immediate loading protocol offers potential benefits in stabilizing ZIs with cross\u2010arch stabilization. Moreover, the use of a posterior cantilever in reconstruction can effectively establish functional occlusion through well\u2010distributed ZIs, eliminating the need for additional implant placement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cid.13296","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T23:04:39Z","timestamp":1702422279000},"page":"343-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Long\u2010term survival and complications of Quad Zygoma Protocol with <scp>Anatomy\u2010Guided Approach<\/scp> in severely atrophic maxilla: A retrospective follow\u2010up analysis of up to 17\u2009years"],"prefix":"10.1111","volume":"26","author":[{"given":"Rub\u00e9n","family":"Dav\u00f3","sequence":"first","affiliation":[{"name":"Department of Implantology and Maxillofacial Surgery, Vithas Dav\u00f3 Instituto Dental Hospital Medimar Internacional  Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0231-7151","authenticated-orcid":false,"given":"Shengchi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Plastic Operations University Medical Center Mainz  Mainz Germany"},{"name":"Second Dental Clinic, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology Shanghai Research Institute of Stomatology  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-686X","authenticated-orcid":false,"given":"Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Second Dental Clinic, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology Shanghai Research Institute of Stomatology  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8352-6256","authenticated-orcid":false,"given":"Yiqun","family":"Wu","sequence":"additional","affiliation":[{"name":"Second Dental Clinic, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology Shanghai Research Institute of Stomatology  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/02844310310023918"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729\u2010023\u201000489\u20109"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.11607\/jomi.3691"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cxom.2021.04.003"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8208.2007.00046.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2010.01.009"},{"issue":"4","key":"e_1_2_12_8_1","first-page":"323","article-title":"Immediate function of four zygomatic implants: a 1\u2010year report of a prospective study","volume":"3","author":"Davo R","year":"2010","journal-title":"Eur J Oral Implantol"},{"issue":"3","key":"e_1_2_12_9_1","first-page":"263","article-title":"Prostheses supported by four immediately loaded zygomatic implants: a 3\u2010year prospective study","volume":"6","author":"Dav\u00f3 R","year":"2013","journal-title":"Eur J Oral Implantol"},{"issue":"2","key":"e_1_2_12_10_1","first-page":"169","article-title":"5\u2010year outcome of cross\u2010arch prostheses supported by four immediately loaded zygomatic implants: a prospective case series","volume":"8","author":"Dav\u00f3 R","year":"2015","journal-title":"Eur J Oral Implantol"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729\u2010023\u201000478\u2010y"},{"issue":"2","key":"e_1_2_12_12_1","first-page":"145","article-title":"Immediately loaded zygomatic implants vs conventional dental implants in augmented atrophic maxillae: 1\u2010year post\u2010loading results from a multicentre randomised controlled trial","volume":"11","author":"Dav\u00f3 R","year":"2018","journal-title":"Eur J Oral Implantol"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3913(07)60007-9"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-4356(02)00289-9"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9103254"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.11607\/jomi.8417"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0901-5027(88)80047-X"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2018.12.006"},{"issue":"1","key":"e_1_2_12_20_1","first-page":"39","article-title":"Immediately loaded zygomatic implants: a 5\u2010year prospective study","volume":"6","author":"Dav\u00f3 R","year":"2013","journal-title":"Eur J Oral Implantol"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.1997.tb00941.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"s19","DOI":"10.11607\/jomi.16suppl.g1","article-title":"Bone augmentation of the edentulous maxilla for implant placement: a systematic review","volume":"31","author":"Aghaloo TL","year":"2016","journal-title":"Int J Oral Maxillofac Implants"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13307"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020480"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/biology10070601"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12524"},{"issue":"3","key":"e_1_2_12_27_1","first-page":"441","article-title":"Zygomatic bone: anatomic bases for osseointegrated implant anchorage","volume":"20","author":"Rigolizzo MB","year":"2005","journal-title":"Int J Oral Maxillofac Implants"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12731"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2015.07.015"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2016.06.007"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2021.103942"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2023.104436"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13897"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12475"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12165418"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729\u2010023\u201000483\u20101"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0501.2003.140110.x"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12147"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2007.03.007"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2018.04.008"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.11607\/jomi.te59"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.14027"},{"issue":"3","key":"e_1_2_12_43_1","first-page":"267","article-title":"Evaluation of clinical soft tissue parameters for extramaxillary zygomatic implants and conventional implants in all\u2010on\u20104 hybrid rehabilitations: short\u2010term outcome and proposal of clinical recommendations for intervention in recall appointments","volume":"24","author":"Ara\u00fajo NM","year":"2015","journal-title":"Implant Dent"},{"issue":"2","key":"e_1_2_12_44_1","first-page":"147","article-title":"Conventional drills vs piezoelectric surgery preparation for placement of four immediately loaded zygomatic oncology implants in edentulous maxillae: results from 1\u2010year split\u2010mouth randomised controlled trial","volume":"10","author":"Esposito M","year":"2017","journal-title":"Eur J Oral Implantol"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001536"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.13046"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/cid.12909"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729\u2010023\u201000479\u2010x"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jobcr.2023.01.008"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016357.2021.2018494"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.11607\/jomi.9791"}],"container-title":["Clinical Implant Dentistry and Related Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cid.13296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T12:56:45Z","timestamp":1751374605000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cid.13296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,12]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/cid.13296"],"URL":"https:\/\/doi.org\/10.1111\/cid.13296","archive":["Portico"],"relation":{},"ISSN":["1523-0899","1708-8208"],"issn-type":[{"value":"1523-0899","type":"print"},{"value":"1708-8208","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,12]]},"assertion":[{"value":"2023-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}