An Advance In Implant Dentistry In Vietnam: ZYGOMATIC IMPLANT PLACEMENT

After 6 months since the zygomatic implant surgery done for a restoration of her missing teeth, on 1 June, Mrs. Luong Ngoc Linh (57 years old, HCMC) is back to Nhan Tam Dental Clinic for follow-up examination and very ecstatic to let us know that her implant teeth have thoroughly recovered and they feel just as comfortable as real teeth.

Dr. Vo Van Nhan and his surgical team

The journey to bring back my confident in communicating.This is the first zygomatic implant in Vietnam by PhD, DDS. Vo Van Nhan (picture). This success had marked an new advance in the implant dentistry in Vietnam and brought hope to patients who suffer from teeth loss and serious maxillary bone resorption.

Mrs. Ngoc Linh expressed: “My upper teeth had been lost for more than 20 years, only a few left in the anterior, but recently, these teeth were loosened and need to be removed. Although I made denture in many dental clinics but it could not use due to the denture was loose and mobidity that causing pain and difficulty in eating. There was a time that it hurts so much, I can only eat porridge. Moreover, this condition also affect my social communication and business. These troubles have occurred for the last 20 years without a solution.”

"Only a day after surgery, I was able to eat soft food with my fixed temporary teeth. After 6 months, I finally have my new permanent teeth which feel just like real teeth. According to Dr. Nhan, my teeth were made with new technology from all ceramic porcelain which were designed and auto-manufactured on the computer so that it have high accuracy and is screw-retained to zygomatic implants.  My teeth not only make me feel comelier, younger but withal allow me to eat my favorite food, in supplemental, I do not have to suffer from any pain or bad breath. I feel so much alive and more confident in daily conversation.” Ms. Linh blissfully shares with us.Thank to one of her relatives, Mrs. Linh was examined and consulted by Dr. Vo Van Nhan about a new treatment technique: ”Zygomatic implant placement” in order to recover her dental function.

Dr. Nhan:” Through examination and investigation the 3D structure of her zygomatic bone on CT scan images, I spotted that the maxillary was suffered serious bone loss, especially at the posterior area, maxillary sinus was low, bone resorption in both vertical and horizontal only few milimeter and weak bone quality (spongy bone). This condition is very popular in Vietnam since the patients had lost their teeth and had to wear dentures for a long time.

In PhD, DDS. Vo Van Nhan’s opinion, nowadays, there are 2 treatments method for patients who lost all their teeth on the maxilla and suffered serious bone resorption.

The zygomatic implant is a technique introduced by Professor Branemark in 1998. Base on this technique, Dr. Nhan had inserted 2 implants which are 50mm long into the zygomatic bone, they are 5 times longer than the standard implants (10mm), and the implants were inserted through several important anatomic areas, from alveolar bone to maxillary sinus bone and ended at the zygomatic bone to form 4 anchors at the cortical bone. This explains why the implant is very stable and will be a decisive factor to the success of this technique. At the same time, 4 conventional implants were inserted in the anterior area and then fixed temporary teeth were placed immediately right after the surgery. The surgery was completed in 4 hours under general anesthesia.In the case of Mrs. Linh, if she followed the traditional treatment technique (sinus lift and standard implant placement), the success rate would be low due to the too thin remaining bone in the sinus and weak quality bone that could not nourish the grafted bone leading to implant failure. In order to bring the best result to Mrs. Linh, a new technique was utilized, it is zygomatic implant. This is a very complicated technique which uses long implants; the implants are inserted through some important anatomical structures such as maxillary sinus membrane, an infraorbital nerve, orbital floor... Thus, an experienced dentist who know thoroughly the anatomy is required to avoid any damage to these important structures. However, if the Zygomatic implant placement is in well-management, it will have a high success rate and a long-term result. According to Dr. Carlos Aparicio – an expert on zygomatic implant–the success rate of this technique is high, about 98-100%, and is an effective treatment for patients suffer from serious bone loss, especially in the posterior region.

Until now, Dr. Nhan had had 2 successful operations for Ms. H.N.Hà (48 years old, Quang Ngai Province) and Mr. N.N.Minh (52 years old, Vietnamese Australian) who share the same condition with Ms. Linh.

The benefits of Zygomatic implant

The zygomatic implant is a final solution for the special case of serious maxillary bone loss, failure in standard implant placement after sinus lift, jawbone resecting after cancer treatment or maxillofacial abnormalities.

This method also has the advantage of reducing the number of operation; therefore, shorter length of hospitalization and duration of treatment. In addition, it also allows the patient to have fixed temporary teeth placed immediately; while old methods would require patient to wait 4 to 6 weeks or even longer to have temporary removable dentures.  

A new step in implant dentistry in Vietnam

The research of zygomatic implant was reported by PhD, DDS. Nhan at local scientific conference. Recently, he has received an invitation to speak at the International Conference of Oral Maxillofacial Surgery in Melbourne, Australia in the upcoming October. This is one of the biggest conference in the field of Maxillofacial Surgery of the world, hosted once every 2 years and will gather a lot of famous surgeons.

CT scan image of 2 zygomatic implants and 4 standard dental implants in the anterior maxilla.

Final teeth after treatment

Back in 2013, PhD, DDS. Vo Van Nhan was also a first dentist in Vietnam to perform successfully the inferior alveolar nerve repositioning and implant insertion to restore chewing function for Mr. Nguyen Van Luom (HCMC) - whose jawbone was broken due to gunshot led to teeth loss for over 40 years. After the surgery, the patient was completely recovered and was able to chew normally, even with hard and chewy food.Prof.,  Ph.D.- Le Van Son, Dean of Department of Oral and Maxillofacial Reconstructive Surgery of National Hospital of Odonto – Stomatology, Hanoi said: “I’m sincerely blissful for Dr. Nhan who has thoroughly succeeded in performing zygomatic bone implant and I believe this technique will bring hope to patients who are suffering from serious maxilla bone loss or maxilla bone removal due to several reasons. In order to restore the function of mastication and aesthetics for these patient, the zygomatic bone implants play an important role in supporting the jawbones and porcelain bridges on standard implants. However, this technique requires adequate equipment, experienced and adept dentist. This would be considered a big advance in implant dentistry in Vietnam”.

Only within 2 years, PhD, DDS. Vo Van Nhan has performed successfully not 1 but 2 of the most difficult techniques in the implant dentistry which are the Zygomatic implant to restore maxillary teeth and the Inferior alveolar nerve repositioning for implant insertion to restore mandibular teeth. Up to now, PhD, DDS. Vo Van Nhan is the first dentist in Vietnam to successfully perform these 2 techniques. By mastering these 2 techniques, PhD, DDS. Vo Van Nhan has marked an important step in implant dentistry in Vietnam, contributed to amending the efficacy of treatment and rehabilitation of masticating function and aesthetics for patients who have complicated and disadvantage clinical condition that the traditional implant techniques are unable to be executed.

Nhan Tam Dental Clinic