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Updated: Jul 6, 2025

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Variability associated with maxillary infrazygomatic crest and palatal bone width, height, and angulation in subjects
Objectives:
To assess the infrazygomatic crest (IZC) and palatal bone width, height, and angulation in patients with different vertical facial growth types as potential miniscrew insertion sites.
Materials And Methods:
In this retrospective cone-beam computed tomography study, 162 subjects (81 males and 81 females, mean age 16.05 ± 0.65 years) were included. They were divided into three groups (hypodivergent, normodivergent, and hyperdivergent) based on the Frankfort mandibular plane angle. Ten buccal bone measurements were made at two different coronal sections: maxillary first molar mesiobuccal and distobuccal roots (bilaterally). Six palatal bone measurements were made on a sagittal section at the maxillary central incisors (bilaterally). A total of 32 measurements per subject were considered in the study.
Results:
No significant difference was observed for the IZC (width and angle) at the maxillary first molar mesiobuccal root. A comparison of normodivergent and hyperdivergent groups for buccal width at the distobuccal root of the first molar showed significant differences. Palatal bone thickness at the level of 2 mm distal to the apex of the central incisor was significantly higher for the hyperdivergent group (10.43 mm) compared with the normodivergent (7.58 mm) and hypodivergent groups (7.83 mm).
Conclusions:
Hyperdivergent subjects tend to present a longer and deeper IZC and increased palatal bone thickness compared with other groups. The recommended insertion angle for the IZC mini-implant at 3 mm from the alveolar crest should be between 75.5° and 77°.
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