Would buccal pad of fat be comparable to platelet rich fibrin for Zygomatic implant coverage as a step for reconstruction of atrophic posterior maxilla, in terms of peri-implant soft tissue thickness and avoiding complicated postoperative sequalae?
Patients with severely atrophic edentulous upper arch (Cawood class IV, V, VI) that could not be restored by other type of treatment
Patients who had at least 8-12 mm vertical bone height in anterior maxilla to allow installation of 2 conventional implants.
Lacking posterior maxillary bone support due to significant sinus pneumatization
Good systemic health (ASA score I-II)
Patient not willing to give his/her informed consent.
Patients with systemic disease that did not permit the surgical procedure (including general anesthesia).
Patients with uncontrolled diabetes or under bisphosphonate therapy.
Heavy smoker. (> 20 cigarettes daily)
Parallel
Coverage with PRF for Zygomatic implant placed
Biological/VaccinePRF preparation and placement: Shortly before being positioned at the surgical site, the PRF was freshly prepared. Ten milliliters of blood were extracted from the antecubital vein and put into a test tube devoid of anticoagulant for the PRF preparation. The blood sample was centrifuged right away for 10-12 minutes at 3000 rpm. The PRF membrane was obtained by squeezing the fibrin clot between pieces of gauze after centrifugation
The peri-implant soft tissue thickness
The peri-implant soft tissue thickness using the average of three measurement points on the buccal side of the implant platform registered with a periodontal probe (HH12 periodontal probe, Deppeler SA)
Postoperative complications
Recording of frequency and Incidence of Zygomatic fracture/oroantral communication/implant failure
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