Digital Planning for Navigation-assisted Zygomatic Implant Rehabilitation: A Case Report

Area of Science:

• Dentistry
• Oral and Maxillofacial Surgery
• Implantology

Background:

• Severe maxillary atrophy presents a challenge for dental implant rehabilitation.
• Zygomatic implants (ZIs) offer a graftless solution for such cases.
• Global Consensus for Clinical Guidelines (GCCG) emphasize guided planning and surgical expertise for ZIs.

Purpose of the Study:

• To describe the digital planning and navigation-assisted surgical workflow for a hybrid rehabilitation using zygomatic implants.
• To illustrate the integration of digital planning with dynamic computer-assisted implant surgery (D-CAIS) in a patient with severe maxillary atrophy.

Main Methods:

• Cone-beam computed tomography (CBCT) and intraoral scanning were used for data acquisition.
• A prosthetically driven virtual wax-up was performed for full-arch rehabilitation planning.
• Dynamic computer-assisted implant surgery (D-CAIS) with fiducial marker-based registration guided the placement of conventional and zygomatic implants.

Main Results:

• Successful digital planning and navigation-assisted placement of four anterior conventional implants and two posterior zygomatic implants.
• Demonstrated feasibility of a hybrid approach combining conventional and zygomatic implants in a severely atrophic maxilla.

Conclusions:

• The integration of prosthetically driven digital planning with navigation-assisted surgery provides a predictable approach for hybrid zygomatic implant rehabilitation.
• This workflow addresses the anatomical complexities of zygomatic implant placement in severely atrophic maxillae.