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

Zygomatic implants (ZIs) have become a predictable graftless treatment option for rehabilitation of the severely atrophic edentulous maxilla. Recent Global Consensus for Clinical Guidelines (GCCG) recommendations have emphasized prosthetically guided treatment planning and advanced surgical expertise due to the anatomical complexity associated with ZI placement. This case report describes the digital planning workflow of a navigation-assisted hybrid rehabilitation approach in a 58-year-old male patient presenting with severe posterior maxillary atrophy and sufficient anterior residual bone for conventional implant placement. Following cone-beam computed tomography and intraoral scanning, a prosthetically driven virtual wax-up was performed for full-arch rehabilitation. Four anterior conventional implants and two posterior zygomatic implants were digitally planned according to anatomical and restorative considerations. Dynamic computer-assisted implant surgery (D-CAIS) with fiducial marker-based registration was subsequently integrated into the workflow to facilitate navigation-assisted implant placement. The present case illustrates illustrating the integration of prosthetically driven digital planning with navigation-assisted implant surgery in hybrid zygomatic implant rehabilitation.