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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
Estudio multicéntrico de cinco años sobre implantes estrechos de una sola pieza para incisivos laterales maxilares
Zaid Hamdoon1, Ahmad Aziz2, Waad Kheder2
1Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
Purpose:
This prospective multicenter study evaluated the 5-year clinical performance of one-piece, long, smooth-necked narrow-diameter implants (NDIs) in rehabilitating patients with congenital maxillary lateral incisor agenesis and limited alveolar bone.
Materials And Methods:
Patients aged ≥ 18 years with unilateral or bilateral agenesis and mesiodistal spaces of 3.5-5.5 mm were recruited. Flapless implant placement of Ø2.7 mm, smooth-necked implants was performed, followed by immediate loading with lithium disilicate crowns. Radiographic assessments of marginal bone levels, peri-implant soft tissue parameters, and esthetic outcomes were conducted at baseline, 1 month, 1 year, and 5 years. Implant survival, success, and mechanical/biological complications were systematically recorded. Statistical analyses employed Kaplan-Meier survival curves and ANOVA with significance set at p < 0.05.
Results:
Forty-six patients completed the 5-year follow-up. Implant survival and success rates were 97.8% and 93.5%, respectively. Mean marginal bone loss was 0.43 ± 0.06 mm at 1 year and 0.84 ± 0.11 mm at 5 years. Probing depths and bleeding indices remained within normal limits (2.96 ± 0.1 mm at 5 years). Papilla preservation was achieved in 89% of cases, and pink esthetic scores indicated stable soft tissue integration. Mechanical complications were minimal, with two cementation failures and one minor ceramic chipping; no implant or abutment fractures occurred.
Conclusions:
One-piece NDIs represent a reliable, esthetic, and cost-effective treatment option for maxillary lateral incisor agenesis in patients with limited alveolar dimensions. High survival, minimal bone loss, stable soft tissue, and low complication rates support their use as a minimally invasive, patient-centered solution.

