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Updated: Aug 6, 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
Technologically guided zygomatic implants to improve accuracy. Systematic review and meta-analysis
Juan Pablo López1, David Díaz-Báez2, Dana Montoya3
1Professor, Oral and Maxillofacial Surgeon, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, DC, Colombia; Universidad El Bosque, Unidad de Investigación en Epidemiología Clínica Oral UNIECLO, Bogotá, DC, Colombia.
Virtual surgical planning with surgical guides and dynamic navigation improves zygomatic implant accuracy compared to freehand methods. Further clinical studies are needed to confirm these findings due to limited evidence.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Surgical Navigation
Background:
- Zygomatic implant placement is a complex procedure.
- Conventional freehand techniques may have limitations in accuracy.
- Virtual surgical planning offers potential for enhanced precision.
Purpose of the Study:
- To evaluate the surgical accuracy of zygomatic implant placement.
- Comparison between virtual surgical planning (surgical guides and dynamic navigation) and conventional freehand techniques.
Main Methods:
- Systematic literature search across major databases (PubMed, Scopus, Ovid, Embase).
- Inclusion of clinical and in vitro studies comparing guided/navigated vs. freehand zygomatic implant placement.
- Random-effects meta-analysis of primary outcomes: linear and angular deviations.
Main Results:
- Twenty-five studies were included.
- Dynamic navigation showed mean deviations of 2.28 mm (entry) and 3.23 mm (apex) in clinical trials.
- Surgical guides demonstrated the lowest angular deviation (0.88°) in case series, with in vitro studies supporting improved accuracy over freehand methods.
Conclusions:
- Virtual surgical planning with surgical guides and dynamic navigation appears to enhance zygomatic implant placement accuracy.
- Current clinical evidence is limited and heterogeneous.
- Well-designed prospective studies are necessary to validate these findings.
