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. 2023 May 4;11(5):123.
doi: 10.3390/dj11050123.

Accuracy of Zygomatic Implant Placement Using a Full Digital Planning and Custom-Made Bone-Supported Guide: A Retrospective Observational Cohort Study

Francesco Gallo  1 , Francesco Zingari  2 , Alessandro Bolzoni  3 , Selene Barone  4 , Amerigo Giudice  4
Affiliations

Accuracy of Zygomatic Implant Placement Using a Full Digital Planning and Custom-Made Bone-Supported Guide: A Retrospective Observational Cohort Study

Francesco Gallo et al. Dent J (Basel). .

Abstract

The aim of the study was to evaluate the accuracy of zygomatic implant placement using customized bone-supported laser-sintered titanium templates. Pre-surgical computed tomography (CT) scans allowed to develop the ideal virtual planning for each patient. Direct metal laser-sintering was used to create the surgical guides for the implant placement. Post-operative CT scans were taken 6 months after surgery to assess any differences between the planned and placed zygomatic implants. Qualitative and quantitative three-dimensional analyses were performed with the software Slicer3D, recording linear and angular displacements after the surface registration of the planned and placed models of each implant. A total of 59 zygomatic implants were analyzed. Apical displacement showed a mean movement of 0.57 ± 0.49 mm on the X-axis, 1.1 ± 0.6 mm on the Y-axis, and 1.15 ± 0.69 mm on the Z-axis for the anterior implant, with a linear displacement of 0.51 ± 0.51 mm on the X-axis, 1.48 ± 0.9 mm on the Y-axis, and 1.34 ± 0.9 mm on the Z-axis for the posterior implant. The basal displacement showed a mean movement of 0.33 ± 0.25 mm on the X-axis, 0.66 ± 0.47 mm on the Y-axis, and 0.58 ± 0.4 mm on the Z-axis for the anterior implant, with a linear displacement of 0.39 ± 0.43 mm on the X-axis, 0.42 ± 0.35 mm on the Y-axis, and 0.66 ± 0.4 mm on the Z-axis for the posterior implant. The angular displacements recorded significative differences between the anterior implants (yaw: 0.56 ± 0.46°; pitch: 0.52 ± 0.45°; roll: 0.57 ± 0.44°) and posterior implants (yaw: 1.3 ± 0.8°; pitch: 1.3 ± 0.78°; roll: 1.28 ± 1.1°) (p < 0.05). Fully guided surgery showed good accuracy for zygomatic implant placement and it should be considered in the decision-making process.

Keywords: accuracy; computer-assisted surgery; data; denture; guided zygomatic implant surgery; implant-supported; maxillary atrophy; zygomatic implants.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pre-operative digital planning using the EZplan Real Guide software (Noris Medical Ltd., Nesher, Israel).
Figure 2
Figure 2
(A) Full thickness flap and fixation of EZgoma® guide; (B) Implant site preparation with dedicated drills for the zygomatic fixture; (C) The zygomatic implant was screwed in place by a dedicated mounter.
Figure 3
Figure 3
Measurement of deviation between planned and placed implants.
Figure 4
Figure 4
Automated colormaps generated by the software. Different visualizations were recorded: anterior view; posterior view; implant base; implant apex.
See this image and copyright information in PMC

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