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Updated: May 14, 2026
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
Accuracy of a novel minimally invasive registration method for dynamic navigation-assisted zygomatic implant surgery:
1Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China; Shanghai Research Institute of Stomatology, Shanghai, China.
Abstract:
This prospective single-arm study enrolled 10 patients with 33 zygomatic implants (ZIs) to prospectively evaluate the accuracy of a novel minimally invasive registration method for dynamic navigation-assisted ZI placement. A patient-specific minimally invasive registration plate was designed, featuring a base plate fixed with four pins and bilateral wings to position registration points adjacent to the zygomatic bone. Intraoperative registration was performed using this plate during dynamic navigation-guided ZI surgery. Postoperative cone-beam computed tomography was utilized to quantify trueness (deviation from planned position) and precision (inter-implant variability) of ZI placement. Statistical significance was set at P < 0.05. Mean deviations of ZIs at the platform, apex, and angle were 1.98 ± 0.84 mm, 1.55 ± 0.52 mm, and 2.3 ± 0.93°, respectively. The maximum deviation at apex was 2.68 mm. The precision measurements (inter-implant distances) were 0.97 ± 0.68 mm, 0.6 ± 0.43 mm, and 1.06 ± 0.78°, respectively. No significant differences in trueness were observed between left/right or mesial/distal implant subgroups (P > 0.05). No intraoperative or postoperative complications occurred, with a 100% implant survival rate over a mean follow-up of 3.21 ± 3.07 months. As the first clinical evaluation of this minimally invasive registration plate for ZI placement, the study confirms its feasibility and precision. The technique may enhance the safety, predictability, and accuracy of zygomatic implant procedures, warranting further validation in larger cohorts.
