Zygomatic Implant Rehabilitation in Patients With Cleft Lip and Palate: A Narrative Review of Clinical Outcomes and Indication Criteria Validation.

Abstract

Zygomatic implant (ZI) is considered a predictable alternative for patients with atrophic maxilla. However, regarding the case of patients with cleft lip and palate (CLP), the evidence of ZI rehabilitation remains unclear. This study aimed to evaluate the indications and clinical outcomes of rehabilitation using ZI in CLP patients. The focus question was: "What are the indications and clinical outcomes of ZI rehabilitation in patients with CLP?" Electronic and manual literature searches were performed from January 2000 to May 2024 in five databases. Clinical studies and case reports were selected. The primary outcome was the ZI survival rates. The secondary outcomes were indications, loading protocols, and complications. The extracted data were subjected to descriptive analysis. In total, 16 studies were included, 24 patients with CLP received 48 ZIs, with an average of 4.2 years of follow-up. The survival rate of ZIs was 97.9% and was mainly indicated for those with Cawood and Howell classification V and VI, with insufficient bone in the maxilla with bilateral CLP. The immediate loading was performed in 33.3% of the cases, and the prosthesis was designed according to case complexity and necessity. ZI rehabilitation appears to be a reliable and predictable solution for the patient with CLP. The immediate loading solution can be beneficial to CLP patients as it helps avoid additional treatments. However, with the inconsistently limited data, the indications cannot be only based on the existing CLP classification.