Robot-Assisted Zygomatic Implant Placement for Hemimaxillectomy Defect Reconstruction: A Case Series

The application of zygomatic implants (ZIs) in functional maxillary reconstruction for patients with hemimaxillectomy defects is limited by the complex anatomy of the zygomatic bone, restricted surgical fields, and long implant trajectories. Robotic technology has the potential to enhance surgical accuracy and overcome limitations. This study presents a clinical digital workflow for robotic ZI placement and immediate restoration in patients with hemimaxillectomy defects. The process included data collection with cone-beam computed tomography (CBCT), intraoral scanning and 3D reconstruction, virtual surgical planning, prefabricated prostheses, robotic-assisted surgery, and postoperative installation of prefabricated prostheses. Eight ZIs were successfully placed in three four patients with maxillary defects using robotic surgery. No biological or mechanical complications were observed during the 2- to 15-month follow-up period. The mean entry deviation of ZIs was 1.97 ± 1.15 mm, the mean exit deviation was 1.79 ± 1.04 mm, and the mean angular deviation was 1.92 ± 0.76°. The Oral Health Impact Profile-14 questionnaire showed significant improvement in scores postoperatively. This study demonstrates the feasibility and effectiveness of robotic ZI placement in reconstructing maxillary defects, offering a clinical treatment option.