Use of buccal fat pads to prevent vestibular gingival recession of zygomatic implants.

Zygomatic implants can be used for dental rehabilitation in atrophic maxillae. This allows for maxillary grafts to be avoided while also permitting immediate functional use. Initially, the implants had a palatal emergence. The surgical technique has undergone continuous development and the implants are now sometimes extra-maxillary in order to better match with the prosthetic space. The main risk is vestibular exposure of the implant as a gingival recession caused by mucositis or peri-implantitis. When the first patients exhibited this problem, the authors sought a solution in order to prevent this complication from occurring. The authors here describe a technique for covering the implants with the buccal fat pad. The dissection and the suture of the fat pad around the implants provide a thick gingiva and mucosa on the vestibular side. The authors have used this technique for the past four years. Twenty-five patients had coverage of the implants. Nineteen had Hybrid Zygoma and six had Quad Zygoma All-on-Four implants. Not a single patient had a gingival recession upon follow-up examination. This technique allows a considerable amount of thick gingiva around the implants to be retained. It also prevents long-term exposure of the implants on the vestibular side.