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Published on: October 18, 2021
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The Accuracy of Zygomatic Implant Placement Assisted by Dynamic Computer-Aided Surgery: A Systematic Review and
Shengchi Fan1,2, Gustavo Sáenz-Ravello3, Leonardo Diaz4
1Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, 55131 Mainz, Germany.
Journal of Clinical Medicine
|August 26, 2023
Summary
This systematic review compared zygomatic implant (ZI) placement accuracy using dynamic computer-aided implant surgery (d-CAIS), static computer-aided implant surgery (s-CAIS), and free-hand methods. Modified s-CAIS and d-CAIS showed clinically acceptable deviations for ZI surgery.
Area of Science:
- Dental Implantology
- Computer-Aided Surgery
- Maxillofacial Reconstruction
Background:
- Severe atrophic edentulous maxilla presents challenges for dental implant placement.
- Zygomatic implants (ZIs) offer a solution for maxillary reconstruction in atrophic cases.
- Accurate ZI placement is crucial for successful outcomes.
Purpose of the Study:
- To systematically review and compare the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided implant surgery (d-CAIS), static computer-aided implant surgery (s-CAIS), and free-hand approaches.
- To evaluate ZI survival rates and surgical complications associated with each method.
Main Methods:
- Comprehensive literature search of PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases until May 2023.
- Inclusion of clinical trials and cadaver studies focusing on ZI placement accuracy.
- Meta-analyses and meta-regression to compare planned/placed deviations (entry, apex, angular) and analyze influencing factors like fiducial registration.
Main Results:
- Pooled mean deviations for d-CAIS: 1.81 mm (entry), 2.95 mm (apex), 3.49° (angular).
- Pooled mean deviations for s-CAIS: 1.19 mm (entry), 1.80 mm (apex), 2.15° (angular).
- Pooled mean deviations for free-hand: 2.04 mm (entry), 3.23 mm (apex), 4.92° (angular).
- Significant differences in deviations were found between all groups (p < 0.01).
- Modified s-CAIS and d-CAIS demonstrated clinically acceptable outcomes, while conventional s-CAIS showed maximal deviations.
Conclusions:
- Dynamic computer-aided implant surgery (d-CAIS) and modified static computer-aided implant surgery (s-CAIS) offer clinically acceptable accuracy for zygomatic implant placement.
- Conventional static computer-aided implant surgery (s-CAIS) exhibited the largest deviations.
- Surgeons must consider potential deviations and complications irrespective of the chosen surgical guidance approach.
