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.

scholarly journals Accuracy of digital planning in zygomatic implants

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
B. Xing Gao ◽  
O. Iglesias-Velázquez ◽  
F. G.F. Tresguerres ◽  
A. Rodríguez González Cortes ◽  
I. F. Tresguerres ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Angular Deviation ◽  
Surgical Experience ◽  
Proper Position ◽  
Zygomatic Implants ◽  
Digital Planning ◽  
Key Factor ◽  
Implant Length ◽  
Zygomatic Implant ◽  
Maxillary Atrophy

Abstract Background Zygomatic implants have been described as a therapeutic alternative for patients with severe maxillary atrophy in order to avoid bone augmentation procedures. Taking that into account, in these treatments, the key factor is the position of the implant, the virtual surgical planning (VSP) is widespread among most clinicians before surgery on the patient. However, there are no studies which evaluate the clinical relevance of these VSP. The aim of this study is to determine whether digital planning on zygomatic implants has any influence on the implant dimensions and position, even when performing conventional surgery afterwards. Results Fourteen zygomatic implants were placed in four patients. Pre-operative and post-operative helicoidal computed tomography were performed to each patient to allow the comparison between the digital planning and the final position of implants. Tridimensional deviation (TD), mesio-distal deviation (MDD), bucco-palatine deviation (BPD), and apico-coronal deviation (ACD) were evaluated as well as angular deviation (AD). Significative differences in apical TD were observed with a mean of 6.114 ± 4.28 mm (p < 0.05). Regarding implant position, only implants placed in the area of the first right molar reported significant differences (p < 0.05) for ACD. Also, implant length larger than 45 mm showed BPD significative differences (p < 0.05). Conclusions Zygomatic implant surgery is a complex surgical procedure, and although VSP is a useful tool which helps the clinician determine the number and the length of zygomatic implants as well as its proper position, surgical experience is still mandatory.

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.

Implant Placement Accuracy Using Dynamic Navigation

2017 ◽  
Vol 32 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Michael Block ◽  
Robert Emery ◽  
Kathryn Lank ◽  
James Ryan
Keyword(s):  
Implant Placement ◽  
Dynamic Navigation ◽  
Placement Accuracy

scholarly journals Dynamic Navigation in Dental Implantology: The Influence of Surgical Experience on Implant Placement Accuracy and Operating Time. An in Vitro Study

2020 ◽  
Vol 17 (6) ◽  
pp. 2153
Author(s):  
Gerardo Pellegrino ◽  
Pierantonio Bellini ◽  
Pier Francesco Cavallini ◽  
Agnese Ferri ◽  
Andrea Zacchino ◽  
...  
Keyword(s):  
Operating Time ◽  
In Vitro Study ◽  
Vitro Study ◽  
Surgical Experience ◽  
Reliable Technique ◽  
Implant Positioning ◽  
Implant Placement ◽  
Dynamic Navigation ◽  
Placement Accuracy

Aim: the aim of this in vitro study was to test whether the implant placement accuracy and the operating time can be influenced by the operator’s experience. Materials and methods: sixteen models underwent a (Cone Beam Computer Tomography) CBCT and implant positioning was digitally planned on this. The models were randomly assigned to four operators with different levels of surgical experience. One hundred and twelve implant sites were drilled using a dynamic navigation system and operating times were measured. Based on postoperative CBCTs, dental implants were virtually inserted and superimposed over the planned ones. Two-dimensional and 3D deviations between planned and virtually inserted implants were measured at the entry point and at the apical point. Angular and vertical errors were also calculated. Results: considering coronal and apical 3D deviations, no statistically significant differences were found between the four operators (p = 0.27; p = 0.06). Some vectorial components of the deviation at the apical point and the angular errors of some operators differed from each other. Conclusions: within the limitations of this study, dynamic navigation can be considered a reliable technique both for experienced and novice clinicians.

scholarly journals Implant placement accuracy using a dynamic navigation system- a prospective clinical trial

2018 ◽  
Vol 29 ◽  
pp. 59-59
Author(s):  
Gerardo Pellegrino ◽  
Valerio Taraschi ◽  
Agnese Ferri ◽  
Andrea Zacchino ◽  
Claudio Marchetti
Keyword(s):  
Clinical Trial ◽  
Navigation System ◽  
Prospective Clinical Trial ◽  
System A ◽  
Implant Placement ◽  
Dynamic Navigation ◽  
Placement Accuracy

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 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 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.

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