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Related Experiment Video

Updated: Jan 18, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
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Fully guided, flapless zygomatic implants for oncological rehabilitation-a technical note.

M J Yap1, T Singh1, M Williams1

  • 1Oral and Maxillofacial Department, Waikato Hospital, Te Whatu Ora, 183 Pembroke Street, Hamilton 3204, New Zealand.

International Journal of Oral and Maxillofacial Surgery
|May 24, 2025
PubMed
Summary

A novel flapless technique for zygomatic implant placement using 3D-printed guides offers a minimally invasive solution for midface reconstruction. This approach reduces trauma to irradiated tissues, aiding patients with head and neck cancer.

Keywords:
Computer-aided designDental implantsDental prosthesisHead and neck neoplasmsMaxillaOsteoradionecrosisZygoma

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Biomedical Engineering
  • Oncology Reconstruction

Background:

  • Midface defects post-head and neck cancer surgery pose significant reconstructive challenges.
  • Free-tissue transfer is common but has contraindications and risks.
  • Zygomatic implant-supported prostheses are an alternative, but traditional placement risks osteoradionecrosis in irradiated bone.

Purpose of the Study:

  • To describe a novel, fully guided, flapless technique for zygomatic implant placement.
  • To evaluate the application of this technique in a patient with a large maxillary defect.
  • To highlight the benefits of minimizing surgical trauma in irradiated tissues.

Main Methods:

  • Virtual surgical planning and 3D-printed, tissue-borne drill guides were utilized.
  • The guides were designed for high accuracy, stability, and minimal angular deviation.
  • A flapless surgical approach was employed to place two zygomatic implants.

Main Results:

  • Accurate zygomatic implant placement was achieved using the described flapless technique.
  • The technique minimized trauma to the irradiated tissues of the maxilla.
  • The patient had a Brown Class IId maxillary defect following hemi-maxillectomy.

Conclusions:

  • Flapless, guided zygomatic implant placement is a viable and innovative alternative for midface reconstruction.
  • This technique minimizes risks associated with traditional flap elevation in irradiated bone.
  • Multidisciplinary collaboration is crucial for successful outcomes in complex oncologic reconstructions.