scholarly journals Three-Dimensional Radiographic Evaluation of the Malar Bone Engagement Available for Ideal Zygomatic Implant Placement

2020 ◽  
Vol 3 (3) ◽  
pp. 52 ◽  
Author(s):  
Gerardo Pellegrino ◽  
Francesco Grande ◽  
Agnese Ferri ◽  
Paolo Pisi ◽  
Maria Giovanna Gandolfi ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Ct Scans ◽  
Radiographic Evaluation ◽  
Anatomical Landmarks ◽  
Malar Bone ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Edentulous Patients ◽  
Zygomatic Implant ◽  
The Ideal

Zygomatic implant rehabilitation is a challenging procedure that requires an accurate prosthetic and implant plan. The aim of this study was to evaluate the malar bone available for three-dimensional zygomatic implant placement on the possible trajectories exhibiting optimal occlusal emergence. After a preliminary analysis on 30 computed tomography (CT) scans of dentate patients to identify the ideal implant emergencies, we used 80 CT scans of edentulous patients to create two sagittal planes representing the possible trajectories of the anterior and posterior zygomatic implants. These planes were rotated clockwise on the ideal emergence points and three different hypothetical implant trajectories per zygoma were drawn for each slice. Then, the engageable malar bone and intra- and extra-sinus paths were measured. It was possible to identify the ideal implant emergences via anatomical landmarks with a high predictability. Significant differences were evident between males and females, between implants featuring anterior and those featuring posterior emergences, and between the different trajectories. The use of internal trajectories provided better bone engagement but required a higher intra-sinus path. A significant association was found between higher intra-sinus paths and lower crestal bone heights.

scholarly journals Rehabilitation of Maxillary Defect Using Zygomatic Implant Retained Obturator

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mounika Ayinala ◽  
Gautam Shetty
Keyword(s):  
Hard Palate ◽  
Odontogenic Myxoma ◽  
Prosthetic Rehabilitation ◽  
Implant Placement ◽  
Heat Cure ◽  
Maxillary Defect ◽  
Zygomatic Implants ◽  
And Function ◽  
Zygomatic Implant

Tumors involving the hard palate, maxillary sinus, or nasal cavity require maxillectomy based on the extent of the lesion. Lack of these boundaries affects the speech, esthetics, and masticatory function. Prosthetic rehabilitation of these defects can be done utilizing zygomatic implants. This present case describes the use of a zygomatic implant to retain a maxillary obturator in a 22-year-old male patient following partial maxillectomy (Brown’s Class 2b) due to odontogenic myxoma. A surgical obturator was secured in position subsequent to the implant placement. Following the healing period, an interim obturator using heat cure acrylic was fabricated. Mechanical retention for the definitive obturator was obtained through the ball attachment suspended from the multiunit abutment of the zygomatic implant. The case was followed up closely for a year to evaluate the function of the prosthesis. The prosthetic rehabilitation not only promoted esthetics and function but also improved the patient’s quality of life.

scholarly journals Oral Rehabilitation with Zygomatic Implants in a Patient with Cleft Palate

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Guilherme José Pimentel Lopes de Oliveira ◽  
Mariana Schaffer Brackmann ◽  
Larissa Carvalho Trojan ◽  
Paulo Domingos Ribeiro Júnior ◽  
Luis Eduardo Marques Padovan
Keyword(s):  
Cleft Palate ◽  
Fibrous Tissue ◽  
Oral Rehabilitation ◽  
Atrophic Maxilla ◽  
Zygomatic Implants ◽  
Fixed Prosthesis ◽  
Edentulous Patients ◽  
The Right ◽  
Zygomatic Implant

Edentulous patients with an atrophic maxilla associated with lip-palate fissures have unpredictable results after undergoing grafting procedures. In situations where the atrophic maxilla does not adequately allow reconstruction, the use of zygomatic implants has been indicated, and probably these implants can be indicated for the rehabilitation of patients with lip-palate fissures. This case report describes the oral rehabilitation treatment of a patient with a lip-palate cleft treated with zygomatic implants and implant-supported fixed prosthesis with two years of follow-up. A 65-year-old female patient had a lip-palate cleft and previously underwent surgery to close the cleft. The patient had a severely atrophic maxilla and had difficulty adapting to a removable total prosthesis. Due to the small amount of bone remaining and extensive fibrous tissue in the palate region, a rehabilitation with conventional implants associated with zygomatic implants was chosen. Two zygomatic implants and a conventional implant were placed on the right side, and a zygomatic implant and conventional implant were placed on the left side; these implants were later activated by a protocol-type prosthesis. The zygomatic implants provided an adequate aesthetic and functional outcome of the prosthesis in a patient with cleft palate.

Three-dimensional-printed patient-specific Kirschner-wire guide for percutaneous fixation of undisplaced scaphoid fractures: a cadaveric study

2019 ◽  
Vol 44 (7) ◽  
pp. 692-696 ◽  
Author(s):  
Vincent Salabi ◽  
Guillaume Rigoulot ◽  
Alain Sautet ◽  
Adeline Cambon-Binder
Keyword(s):  
Kirschner Wire ◽  
Three Dimensional ◽  
Cadaveric Study ◽  
Ct Scans ◽  
Patient Specific ◽  
Angular Deviation ◽  
Percutaneous Fixation ◽  
Scaphoid Fractures ◽  
Cadaveric Model ◽  
The Ideal

Undisplaced scaphoid waist fractures can be managed by percutaneous fixation. The purpose of this study is to compare percutaneous fixation using a three-dimensional (3-D)-printed guide with the conventional method in a cadaveric study. Twelve wrists were divided into two groups: standard fluroscopic technique group, and a patient-specific 3-D-printed guide group. In the patient-specific group, using high resolution CT scans, we manufactured a mould-guide including a wire guide sleeve aligned with the planned ideal path, and 3-D printed it. On postoperative CT scans we measured the angular deviation of the screw axis from the ideal axis, and compared the two groups. The angular deviation was significantly lower in the patient-specific guide group. We concluded that a 3-D-printed guide for scaphoid percutaneous fixation allows a more accurate placement of the screw than a fluoroscopy guide in our cadaveric model.

Zygomatic Implants/Fixture: A Systematic Review

2013 ◽  
Vol 39 (2) ◽  
pp. 215-224 ◽  
Author(s):  
Ashu Sharma ◽  
G. R. Rahul
Keyword(s):  
Systematic Review ◽  
Bone Grafting ◽  
Sinus Augmentation ◽  
Le Fort ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Le Fort I ◽  
Implant Treatment ◽  
Zygomatic Implant ◽  
Anatomic Information

Patients with moderate to severe atrophy challenge the surgeon to discover alternative ways to use existing bone or resort to augmenting the patient with autogenous or alloplastic bone materials. Many procedures have been suggested for these atrophied maxillae before implant placement, which include Le Fort I maxillary downfracture, onlay bone grafts and maxillary sinus graft procedures. A zygomatic implant can be an effective device for rehabilitation of the severely resorbed maxilla. If zygomatic implants are used, onlay bone grafting or sinus augmentation would likely not be necessary. The purpose of this article is to review the developments that have taken place in zygomatic implant treatment over years, including anatomic information for installing the zygomatic implants, implant placement techniques, stabilization, and prosthodontic procedures.

scholarly journals Dynamic Navigation for Zygomatic Implants: A Case Report about a Protocol with Intraoral Anchored Reference Tool and an Up-To-Date Review of the Available Protocols

2020 ◽  
Vol 3 (4) ◽  
pp. 75
Author(s):  
Gerardo Pellegrino ◽  
Giuseppe Lizio ◽  
Francesco Basile ◽  
Luigi Vito Stefanelli ◽  
Claudio Marchetti ◽  
...  
Keyword(s):  
Navigation Systems ◽  
Radiological Anatomy ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Dynamic Navigation ◽  
Operative Planning ◽  
Placement Accuracy ◽  
Zygomatic Implant ◽  
Maxillary Atrophy ◽  
Reference Tool

Dynamic Navigation is a computer-aided technology that allows the surgeon to track the grip instruments while preparing the implant site in real time based on radiological anatomy and accurate pre-operative planning. The support of this technology to the zygoma implant placement aims to reduce the risks and the errors associated with this complex surgical and prosthetic treatment. Various navigation systems are available to clinicians currently, distinguished by handling, reliability, and the associated economic and biological benefits and disadvantages. The present paper reports on the different protocols of dynamic navigations following a standard workflow in correlation with zygomatic implant supported rehabilitations and describes a case of maxillary atrophy successfully resolved with this technology. An innovative and minimally invasive dynamic navigation system, with the use of an intraoral anchored trust marker plate and a patient reference tool, has been adopted to support the accurate insertion of four zygomatic implants, which rapidly resolved maxillary atrophy from a 75-year-old male system. This approach provided an optimal implant placement accuracy reducing surgical invasiveness.

Precision of Landmark Positioning on Digitized Models from Patients with Cleft Lip and Palate

2006 ◽  
Vol 43 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Jakob Brief ◽  
Jan H. Behle ◽  
Angelika Stellzig-Eisenhauer ◽  
Stefan Hassfeld
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Plaster Cast ◽  
Anatomical Landmarks ◽  
Positioning Error ◽  
The University ◽  
Plaster Models ◽  
The Ideal

Objective To quantify the precision of landmark positioning on digitized casts of patients with unilateral cleft lip and palate. Patients Forty plaster models of newborns up to 8 months of age were selected from the archive of the Department of Orthodontics of the University of Heidelberg. Material and Method The plaster-cast models were digitized with a Micromeasure 70 three-dimensional laser scanner (Micromeasure, Bischoffen, Germany). The laser scanner used in this study operates with a precision of 0.15 mm on the x- and y-axes and 0.06 mm on the z-axis. In the intraobserver study, a single observer placed anatomical landmarks in four rounds, with at least 4 weeks between each round. In the interobserver study, four different observers each placed the same landmarks once. For the two different studies, an ideal location for each landmark was calculated by averaging the landmark positions of the four rounds or observers. The distance between each of the four landmark positions and the ideal landmark was measured. Results A 95% confidence interval for the landmark positioning error was calculated. For the intraobserver investigation, this error was 0.34 to 1.30 mm, and for the interobserver investigation it was 0.7 to 2.00 mm. Conclusion Because both investigations displayed comparable error intervals, it was concluded that different observers could perform landmark positioning for the same studies.

scholarly journals Immediate implant-retained prosthetic obturation after maxillectomy based on zygomatic implant placement by 3D-guided surgery: a cadaver study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
N. Vosselman ◽  
H. H. Glas ◽  
S. A. H. J. de Visscher ◽  
J. Kraeima ◽  
B. J. Merema ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Immediate Loading ◽  
Virtual Surgical Planning ◽  
Implant Placement ◽  
Ablative Surgery ◽  
Zygomatic Implants ◽  
Immediate Implant ◽  
The Mean ◽  
Obturator Prosthesis ◽  
Zygomatic Implant

Abstract Background The aim of this study was to introduce a complete 3D workflow for immediate implant retained prosthetic rehabilitation following maxillectomy in cancer surgery. The workflow consists of a 3D virtual surgical planning for tumor resection, zygomatic implant placement, and for an implant-retained prosthetic-obturator to fit the planned outcome situation for immediate loading. Materials and methods In this study, 3D virtual surgical planning and resection of the maxilla, followed by guided placement of 10 zygomatic implants, using custom cutting and drill/placement-guides, was performed on 5 fresh frozen human cadavers. A preoperatively digitally designed and printed obturator prosthesis was placed and connected to the zygomatic implants. The accuracy of the implant positioning was obtained using 3D deviation analysis by merging the pre- and post-operative CT scan datasets. Results The preoperatively designed and manufactured obturator prostheses matched accurately the per-operative implant positions. All five obturators could be placed and fixated for immediate loading. The mean prosthetic point deviation on the cadavers was 1.03 ± 0.85 mm; the mean entry point deviation was 1.20 ± 0.62 mm; and the 3D angle deviation was 2.97 ± 1.44°. Conclusions It is possible to 3D plan and accurately execute the ablative surgery, placement of zygomatic implants, and immediate placement of an implant-retained obturator prosthesis with 3D virtual surgical planning.The next step is to apply the workflow in the operating room in patients planned for maxillectomy.

Accuracy Evaluation of Computed Tomography–Derived Stereolithographic Surgical Guides in Zygomatic Implant Placement in Human Cadavers

2010 ◽  
Vol 36 (5) ◽  
pp. 345-355 ◽  
Author(s):  
Bruno R. Chrcanovic ◽  
Davidson R. Oliveira ◽  
Antônio L. Custódio
Keyword(s):  
Computed Tomography ◽  
Computer Aided Design ◽  
Accuracy Evaluation ◽  
Angular Deviation ◽  
Implant Placement ◽  
Surgical Guides ◽  
Zygomatic Implants ◽  
Computer Aided ◽  
Human Cadavers ◽  
Zygomatic Implant

Abstract Presurgical planning is essential to achieve esthetic and functional implants. For implant planning and placement, the association of computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques furnishes some advantages regarding tridimensional determination of the patient's anatomy and fabrication of both anatomic models and surgical guides. The goal of this clinical study was to determine the angular deviations between planned and placed zygomatic implants using stereolithographic surgical guides in human cadavers. A total of 16 zygomatic implants were placed, 4 in each cadaver, with the use of stereolithographic (SLA) surgical guides generated by computed tomography (CT). A new CT scan was made after implant insertion. The angle between the long axis of the planned and actual implants was calculated. The mean angular deviation of the long axis between the planned and placed implants was 8.06 ± 6.40 (mean ± SD) for the anterior-posterior view, and 11.20 ± 9.75 (mean ± SD) for the caudal-cranial view. Use of the zygomatic implant, in the context of this protocol, should probably be reevaluated because some large deviations were noted. An implant insertion guiding system is needed because this last step is carried out manually. It is recommended that the sinus slot technique should be used together with the CT-based drilling guide to enhance final results. Further research to enhance the precision of zygomatic implant placement should be undertaken.

scholarly journals Universal Wire Grid for Implant Placement in Three Dimensions

2013 ◽  
Vol 4 (1) ◽  
pp. 74-76
Author(s):  
Narendra S Sharma ◽  
Pushpa V Hazarey ◽  
RH Kamble ◽  
Preethi N Sharma
Keyword(s):  
Insertion Site ◽  
Three Dimensional ◽  
Single Step ◽  
Three Dimensions ◽  
Radiographic Evaluation ◽  
Wire Grid ◽  
Implant Placement ◽  
Risk Of Injury ◽  
Rapid Healing ◽  
Clinical Advantage

ABSTRACT Implant used for skeletal anchorage offers clinical advantage of being smaller in size, ease of insertion and removal, the ability to load forces immediately and rapid healing. The risk of injury to dental roots during placement is one of the greatest concerns with implant especially when they are inserted between teeth. Placement of implant to close to the root can also result in insufficient bone remodeling around the screw and transmission of occlusal forces through the teeth to the screw which can lead to implant failure. Therefore it is important to select insertion site carefully using clinical and radiographic evaluation. Many techniques have been used to facilitate safe placement of implant. Some or the others may be inconsistent in different radiographic view. This article introduces a three-dimensional (3D) wire grid which is simple, reliable and accurate for placing implant in a single step which improves the insertion success rate. How to cite this article Sharma NS, Shrivastav SS, Hazarey PV, Kamble RH, Sharma PN. Universal Wire Grid for Implant Placement in Three Dimensions. World J Dent 2013;4(1): 74-76.

Stress Analysis of Prostheses Retained with Zygomatic Implants on Augmented and Non-Augmented Maxillary Sinus

2020 ◽  
Vol 10 (3) ◽  
pp. 336-340
Author(s):  
Hamiyet Güngör ◽  
Süleyman Kaman ◽  
Ozkan Ozgul ◽  
M. Ercüment Önder ◽  
Fethi Atil ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Treatment Options ◽  
Three Dimensional ◽  
Von Mises Stress ◽  
Posterior Maxilla ◽  
Atrophic Maxilla ◽  
Zygomatic Implants ◽  
Von Mises ◽  
Three Dimensional Finite Element ◽  
Zygomatic Implant

Zygomatic implants for toothless, atrophic posterior maxilla are effective treatment options and it is known that graft use has a positive effect on the zygomatic implant stability with this treatment option. The aim of this study was to evaluate the stress values and their distribution at zygomatic implant-supported prosthetic infrastructure in augmented and non-augmented models. In this study, the three-dimensional finite element method was used and 2 zygomatic implants (47.5 × 4.0 mm), 2 conventional implants (13 × 3.75 mm) and atrophic maxilla with augmented and non-augmented maxillary sinus with prosthetic infrastructure, were modelled. A vertical load of 150 N was applied onto the maxillary model at 4 different regions (#9, #12, #14 and #15). The von Mises stress, which is produced as a result of loading of zygomatic implants and prosthetic infrastructure has been evaluated in augmented and non-augmented models. The highest von Mises stress value for the prosthetic infrastructure was determined in the non-augmented model as a result of the loading to region #9 (MPa 222,886). Consequently, grafting procedures will increase bone support and reduce stresses in the prosthetic substructure, especially in posterior loads in the maxilla with low bone density.

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