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Immediate Loading in the Atrophic Maxilla: The Zygoma Concept

Clinical case by Dr Edmond Bedrossian, DDS, FACD, FACOMS


Dr Edmond Bedrossian, DDS, FACD, FACOMS Private Practice, San Francisco, Ca, USA


63 year old Female. Past medical history is non contributory. Presents with ill fitting dentures secondary to advanced resorption of her maxillary alveolus, Fig 1.

Treatment planning

Evaluation of her maxilla was consistent with presence of Zone 1 bone only, Fig 2. The patient was scheduled for the placement of 2 premaxillary implants and 2 Zygomatic implants, Fig 3 and 4.


Achieving initial stability in softer bone and immediately load the implants.


Achieving initial stability in softer bone is possible by undesizing the osteotomy. In order to immediate load the implants; two objective methods were used to objectively determine initial stability. The first measurement is the insertion torque which records the resistance to shear forces documented as Ncm. The second measurement, the “lateral stability” or resistance to lateral bending moments is documented in the mesio-distal as well as the buccal-lingual directions using the ISQ value Fig 6.

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