zygomatic endosseous implants, maxillary immediate loaded restoration, skeletal implant anchorage, Trefoil


This is a Case Report of a 72 y/ old patient that was wearing two removable prostheses, a maxillary complete denture and a mandibular complete denture retained by two implants and locator attachments. The patients’ medical condition is complicated, the patient is blind, has suffered from kidney failure and has a donated kidney. She also suffers from diabetes. The patient’s desires were to convert both prostheses to fixed restorations. The lack of maxillary osseous tissue required the use of skeletal anchorage outside the immediate oral cavity to retain a maxillary prostheses. The current placement of mandibular implants would not allow the use of the a strict stent driven protocol and placement of prefabricated prosthesis (Trefoil, Nobel Biocare) so they were removed to allow for the placement of 3 endosseous implants in a specific orientation. The patients’ medical history also necessitated the doing both procedures simultaneously while under a general anesthetic.