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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
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Combined static and dynamic computer-guided surgery for prosthetically driven zygomatic implant placement
Chenlin Du1, Pei Peng2, Xiaodong Guo3
1School of Biomedical Engineering, Tsinghua University, Beijing, China.
Journal of Dentistry
|November 13, 2024
Summary
A new minimally invasive computer-assisted implant surgery (CAIS) workflow combining static and dynamic guidance was developed for zygomatic implant (ZI) placement. This accurate and reliable method enhances ZI surgery, potentially simplifying rehabilitation for patients with severe maxillary defects.
Area of Science:
- Dental Implantology
- Computer-Assisted Surgery
- Maxillofacial Reconstruction
Background:
- Zygomatic implant (ZI) placement is crucial for restoring function and aesthetics in patients with severe maxillary atrophy or defects.
- Traditional ZI placement can be technically demanding, requiring precise control over implant angulation and depth.
- Computer-assisted implant surgery (CAIS) offers potential for improved accuracy and reduced invasiveness.
Purpose of the Study:
- To propose and validate a novel, minimally invasive workflow for zygomatic implant (ZI) placement using a combined static and dynamic computer-assisted implant surgery (CAIS) approach.
- To assess the accuracy, safety, reliability, and robustness of this combined CAIS workflow for ZI placement.
Main Methods:
- A combined static and dynamic CAIS workflow was developed, utilizing static guidance for initial positioning and dynamic guidance for real-time control of angle, depth, and width.
- Fourteen patients requiring ZI-supported restoration underwent ZI placement using the proposed approach.
- Implant positioning accuracy was evaluated by measuring angular and global deviations between planned and placed ZI positions using cone-beam computed tomography (CBCT).
Main Results:
- Twenty-two zygomatic implants were successfully placed using the combined static and dynamic CAIS method.
- Mean angular deviation was 1.99±0.17°, coronal global deviation was 1.21±0.45 mm, and median apical global deviation was 1.67 mm.
- All implants demonstrated stability during a median follow-up of 14.5 months, with no significant differences noted between sides or zygomatic anatomy-guided approach (ZAGA) types.
Conclusions:
- The combined static and dynamic CAIS workflow is a safe, reliable, accurate, and robust method for zygomatic implant placement.
- This minimally invasive approach may reduce technique sensitivity, facilitating complex maxillary reconstructions.
- The validated accuracy supports the use of this technique for improved patient outcomes in challenging cases.
