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Open Access 01-12-2023 | Research

Accuracy of computer-aided static and dynamic navigation systems in the placement of zygomatic dental implants

Authors: Juan Ramón González Rueda, Agustín Galparsoro Catalán, Víctor Manuel de Paz Hermoso, Elena Riad Deglow, Álvaro Zubizarreta-Macho, Jesús Pato Mourelo, Javier Montero Martín, Sofía Hernández Montero

Published in: BMC Oral Health | Issue 1/2023

Abstract

Background

Zygomatic implants are widely used in the rehabilitation of severely atrophic maxillae, but implant placement is not without risks, and it can potentially cause damage to related anatomical structures. The aim of this study was to perform a comparative analysis of the accuracy of static navigation systems in placing zygomatic dental implants in comparison to dynamic navigation systems.

Methods

Sixty zygomatic dental implants were randomly allocated to one of three study groups, categorized by which implant placement strategy was used: A: computer-aided static navigation system (n = 20) (GI); B: computer-aided dynamic navigation system (n = 20) (NI); or C: free-hand technique (n = 20) (FHI). For the computer-aided study groups, a preoperative cone-beam computed tomography (CBCT) scan of the existing situation was performed in order to plan the approach to be used during surgery. Four zygomatic dental implants were inserted in each of fifteen polyurethane stereolithographic models (n = 15), with a postoperative CBCT scan taken after the intervention. The pre- and postoperative CBCT scans were then uploaded to a software program used in dental implantology to analyze the angular deviations, apical end point, and coronal entry point. Student’s t-test was used to analyze the results.

Results

The results found statistically significant differences in apical end-point deviations between the FHI and NI (p = 0.0053) and FHI and GI (p = 0.0004) groups. There were also statistically significant differences between the angular deviations of the FHI and GI groups (p = 0.0043).

Conclusions

The manual free-hand technique may enable more accurate placement of zygomatic dental implants than computer-assisted surgical techniques due to the different learning curves required for each zygomatic dental implant placement techniques.

Aparicio C, Manresa C, Francisco K, Ouazzani W, Claros P, Potau JM, Aparicio A. The long-term use of zygomatic implants: a 10-year clinical and radiographic report. Clin Implant Dent Relat Res. 2014;16:447–59. https://doi.org/10.1111/cid.12007.CrossRefPubMed

Nyström E, Ahlqvist J, Legrell PE, Kahnberg KE. Bone graft remodelling and implant success rate in the treatment of the severely resorbed maxilla: a 5-year longitudinal study. Int J Oral Maxillofac Surg. 2002;31:158–64. https://doi.org/10.1054/ijom.2001.0197.CrossRefPubMed

Nyström E, Nilson H, Gunne J, Lundgren S. Reconstruction of the atrophic maxilla with interpositional bone grafting/Le Fort I osteotomy and endosteal implants: a 11–16 year follow-up. Int J Oral Maxillofac Surg. 2009;38:1–6. https://doi.org/10.1016/j.ijom.2008.10.009.CrossRefPubMed

Jensen J, Sindet-Pedersen S, Oliver AJ. Varying treatment strategies for reconstruction of maxillary atrophy with implants: results in 98 patients. J Oral Maxillofac Surg. 1994;52:210–6. https://doi.org/10.1016/0278-2391(94)90283-6. discussion 216-8.CrossRefPubMed

Kahnberg KE, Nilsson P, Rasmusson L. Le Fort I osteotomy with interpositional bone grafts and implants for rehabilitation of the severely resorbed maxilla: a 2-stage procedure. Int J Oral Maxillofac Implants. 1999;14:571–8.PubMed

Bedrossian E, Rangert B, Stumpel L, Indresano T. Immediate function with the zygomatic implant: a graftless solution for the patient with mild to advanced atrophy of the maxilla. Int J Oral Maxillofac Implants. 2006;21:937–42.PubMed

Davó R, Malevez C, Rojas J, Rodríguez J, Regolf J. Clinical outcome of 42 patients treated with 81 immediately loaded zygomatic implants: a 12- to 42-month retrospective study. Eur J Oral Implantol. 2008;9(Suppl 1):141–50.PubMed

Duarte LR, Filho HN, Francischone CE, Peredo LG, Brånemark PI. The establishment of a protocol for the total rehabilitation of atrophic maxillae employing four zygomatic fixtures in an immediate loading system–a 30-month clinical and radiographic follow-up. Clin Implant Dent Relat Res. 2007;9:186–96. https://doi.org/10.1111/j.1708-8208.2007.00046.x.CrossRefPubMed

Maló P, NobreMde A, Lopes I. A new approach to rehabilitate the severely atrophic maxilla using extramaxillary anchored implants in immediate function: a pilot study. J Prosthet Dent. 2008;100:354–66. https://doi.org/10.1016/S0022-3913(08)60237-1.CrossRefPubMed

10.

Aparicio C, Ouazzani W, Hatano N. The use of zygomatic implants for prosthetic rehabilitation of the severely resorbed maxilla. Periodontol. 2000;2008(47):162–71. https://doi.org/10.1111/j.1600-0757.2008.00259.x.CrossRef

11.

Malevez C, Abarca M, Durdu F, Daelemans P. Clinical outcome of 103 consecutive zygomatic implants: a 6–48 months follow-up study. Clin Oral Implants Res. 2004;15:18–22. https://doi.org/10.1046/j.1600-0501.2003.00985.x.CrossRefPubMed

12.

Davo R, Pons O, Rojas J, Carpio E. Immediate function of four zygomatic implants: a 1-year report of a prospective study. Eur J Oral Implantol. 2010;3:323–34.PubMed

13.

Esposito M, Barausse C, Balercia A, Pistilli R, Ippolito DR, Felice P. Conventional drills vs piezoelectric surgery preparation for placement of four immediately loaded zygomatic oncology implants in edentulous maxillae: results from 1-year split-mouth randomised controlled trial. Eur J Oral Implantol. 2017;10:147–58.PubMed

14.

Widmann G, Bale RJ. Accuracy in computer-aided implant surgery–a review. Int J Oral Maxillofac Implants. 2006;21:305–13.PubMed

15.

Chasioti E, Sayed M, Drew H. Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol. Case Rep Dent. 2015;2015:439706. https://doi.org/10.1155/2015/439706.CrossRefPubMedPubMedCentral

16.

Vrielinck L, Politis C, Schepers S, Pauwels M, Naert I. Image-based planning and clinical validation of zygoma and pterygoid implant placement in patients with severe bone atrophy using customized drill guides. Preliminary results from a prospective clinical follow-up study. Int J Oral Maxillofac Surg. 2003;32:7–14. https://doi.org/10.1054/ijom.2002.0337.CrossRefPubMed

17.

Chow J, Hui E, Lee PK, Li W. Zygomatic implants–protocol for immediate occlusal loading: a preliminary report. J Oral Maxillofac Surg. 2006;64:804–11. https://doi.org/10.1016/j.joms.2006.01.021.CrossRefPubMed

18.

Kaewsiri D, Panmekiate S, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of static vs. dynamic computer-assisted implant surgery in single tooth space: a randomized controlled trial. Clin Oral Implants Res. 2019;30:505–14. https://doi.org/10.1111/clr.13435.CrossRefPubMed

19.

Jorba-García A, Figueiredo R, González-Barnadas A, Camps-Font O, Valmaseda-Castellón E. Accuracy and the role of experience in dynamic computer guided dental implant surgery: an in-vitro study. Med Oral Patol Oral Cir Bucal. 2019;1(24):e76–83. https://doi.org/10.4317/medoral.22785.CrossRef

20.

MediavillaGuzmán A, RiadDeglow E, Zubizarreta-Macho Á, Agustín-Panadero R, Hernández MS. Accuracy of computer-aided dynamic navigation compared to computer-aided static navigation for dental implant placement: an in vitro study. J Clin Med. 2019;2(8):2123. https://doi.org/10.3390/jcm8122123.CrossRef

21.

Tahmaseb A, Wu V, Wismeijer D, Coucke W, Evans C. The accuracy of static computer-aided implant surgery: a systematic review and meta-analysis. Clin Oral Implants Res. 2018;29(Suppl 16):416–35. https://doi.org/10.1111/clr.13346.CrossRefPubMed

22.

Stefanelli LV, DeGroot BS, Lipton DI, Mandelaris GA. Accuracy of a dynamic dental implant navigation system in a private practice. Int J Oral Maxillofac Implants. 2019;34:205–13. https://doi.org/10.11607/jomi.6966.CrossRefPubMed

23.

Gutiérrez Muñoz D, ObradorAldover C, Zubizarreta-Macho Á, González Menéndez H, Lorrio Castro J, Peñarrocha-Oltra D, Montiel-Company JM, Hernández MS. Survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla: a systematic review and meta-analysis. Biology (Basel). 2021;10(7):601. https://doi.org/10.3390/biology10070601.CrossRefPubMed

24.

Wu Y, Tao B, Lan K, Shen Y, Huang W, Wang F. Reliability and accuracy of dynamic navigation for zygomatic implant placement. Clin Oral Implants Res. 2022;33(4):362–76. https://doi.org/10.1111/clr.13897.CrossRefPubMedPubMedCentral

25.

Bhalerao A, Marimuthu M, Wahab A, Ayoub A. Flapless placement of zygomatic implants using dynamic navigation: an innovative technical note. Br J Oral Maxillofac Surg. 2022;S0266–4356(22):00604. https://doi.org/10.1016/j.bjoms.2022.11.282.CrossRef

26.

Wang F, Fan S, Huang W, Shen Y, Li C, Wu Y. Dynamic navigation for prosthetically driven zygomatic implant placement in extensive maxillary defects: Results of a prospective case series. Clin Implant Dent Relat Res. 2022;24(4):435–43. https://doi.org/10.1111/cid.13101.CrossRefPubMed

27.

Shen Y, Dai Q, Tao B, Huang W, Wang F, Lan K, Sun Y, Ling X, Yan L, Wang Y, Wu Y. Real-time dynamic navigation system for the precise quad-zygomatic implant placement in a patient with a severely atrophic maxilla. J Vis Exp. 2021;(176). https://doi.org/10.3791/62489.

28.

Bhalerao A, Marimuthu M, Wahab A, Ayoub A. Dynamic navigation for zygomatic implant placement: a randomized clinical study comparing the flapless versus the conventional approach. J Dent. 2023;130:104436. https://doi.org/10.1016/j.jdent.2023.104436.CrossRefPubMed

29.

Zhou W, Fan S, Wang F, Huang W, Jamjoom FZ, Wu Y. A novel extraoral registration method for a dynamic navigation system guiding zygomatic implant placement in patients with maxillectomy defects. Int J Oral Maxillofac Surg. 2021;50(1):116–20. https://doi.org/10.1016/j.ijom.2020.03.018.CrossRefPubMed

30.

Grecchi F, Stefanelli LV, Grivetto F, Grecchi E, Siev R, Mazor Z, Del Fabbro M, Pranno N, Franchina A, Di Lucia V, De Angelis F, Goker F. A novel guided zygomatic and pterygoid implant surgery system: a human cadaver study on accuracy. Int J Environ Res Public Health. 2021;18(11):6142. https://doi.org/10.3390/ijerph18116142.CrossRefPubMedPubMedCentral

31.

González Rueda JR, García Ávila I, de Paz Hermoso VM, RiadDeglow E, Zubizarreta-Macho Á, PatoMourelo J, Montero Martín J, Hernández MS. Accuracy of a computer-aided dynamic navigation system in the placement of zygomatic dental implants: an in vitro study. J Clin Med. 2022;11(5):1436. https://doi.org/10.3390/jcm11051436.CrossRefPubMedPubMedCentral

32.

Aparicio C. A proposed classification for zygomatic implant patient based on the zygoma anatomy guided approach (ZAGA): a cross-sectional survey. Eur J Oral Implantol. 2011;4(3):269–75.PubMed

33.

Aparicio C. The zygoma anatomy guided approach (ZAGA). In: Aparicio C, editor. Zygomatic implants. The anatomy-guided approach. Berlin: Ed. Quintessence; 2012. p. 113–36.

34.

MediavillaGuzmán A, RiadDeglow E, Zubizarreta-Macho Á, Agustín-Panadero R, Hernández MS. Accuracy of computer-aided dynamic navigation compared to computer-aided static navigation for dental implant placement: an in vitro study. J Clin Med. 2019;8(12):2123. https://doi.org/10.3390/jcm8122123.CrossRef

35.

Hoffmann J, Westendorff C, Gomez-Roman G, Reinert S. Accuracy of navigation-guided socket drilling before implant installation compared to the conventional free-hand method in a synthetic edentulous lower jaw model. Clin Oral Implants Res. 2005;16:609–14. https://doi.org/10.1111/j.1600-0501.2005.01153.x.CrossRefPubMed

36.

Chen CK, Yuh DY, Huang RY, Fu E, Tsai CF, Chiang CY. Accuracy of implant placement with a navigation system, a laboratory guide, and freehand drilling. Int J Oral Maxillofac Implants. 2018;33:1213–8. https://doi.org/10.11607/jomi.6585.CrossRefPubMed

37.

Tao B, Shen Y, Sun Y, Huang W, Wang F, Wu Y. Comparative accuracy of cone-beam CT and conventional multislice computed tomography for real-time navigation in zygomatic implant surgery. Clin Implant Dent Relat Res. 2020;22(6):747–55. https://doi.org/10.1111/cid.12958.CrossRefPubMed

38.

Wu Y, Wang F, Huang W, Fan S. Real-time navigation in zygomatic implant placement: workflow. Oral Maxillofac Surg Clin North Am. 2019;31(3):357–67. https://doi.org/10.1016/j.coms.2019.03.001.CrossRefPubMed

39.

Spille J, Helmstetter E, Kübel P, Weitkamp JT, Wagner J, Wieker H, Naujokat H, Flörke C, Wiltfang J, Gülses A. Learning curve and comparison of dynamic implant placement accuracy using a navigation system in young professionals. Dent J (Basel). 2022;10(10):187. https://doi.org/10.3390/dj10100187.CrossRefPubMed

40.

Wang XY, Liu L, Guan MS, Liu Q, Zhao T, Li HB. The accuracy and learning curve of active and passive dynamic navigation-guided dental implant surgery: an in vitro study. J Dent. 2022;124:104240. https://doi.org/10.1016/j.jdent.2022.104240.CrossRefPubMed

41.

Marques-Guasch J, Rodriguez-Bauzá R, Satorres-Nieto M, Hom-Lay W, Hernández-Alfaro F, Gargallo-Albiol J. Accuracy of dynamic implant navigation surgery performed by a novice operator. Int J Comput Dent. 2022;25(4):377–85. https://doi.org/10.3290/j.ijcd.b2588207.CrossRefPubMed

42.

Sun TM, Lan TH, Pan CY, Lee HE. Dental implant navigation system guide the surgery future. Kaohsiung J Med Sci. 2018;34(1):56–64. https://doi.org/10.1016/j.kjms.2017.08.011.CrossRefPubMed

43.

Cassetta M, Altieri F, Giansanti M, Bellardini M, Brandetti G, Piccoli L. Is there a learning curve in static computer-assisted implant surgery? A prospective clinical study. Int J Oral Maxillofac Surg. 2020;49(10):1335–42. https://doi.org/10.1016/j.ijom.2020.03.007.CrossRefPubMed

44.

Lopes A, de Araújo NM, Santos D. The workflow of a new dynamic navigation system for the insertion of dental implants in the rehabilitation of edentulous jaws: report of two cases. J Clin Med. 2020;9(2):421. https://doi.org/10.3390/jcm9020421.CrossRefPubMedPubMedCentral

45.

Xiaojun C, Ming Y, Yanping L, Yiqun W, Chengtao W. Image guided oral implantology and its application in the placement of zygoma implants. Comput Methods Programs Biomed. 2009;93(2):162–73. https://doi.org/10.1016/j.cmpb.2008.09.002.CrossRefPubMed

46.

Lübbers HT, Matthews F, Zemann W, Grätz KW, Obwegeser JA, Bredell M. Registration for computer-navigated surgery in edentulous patients: a problem-based decision concept. J Craniomaxillofac Surg. 2011;39(6):453–8. https://doi.org/10.1016/j.jcms.2010.10.021.CrossRefPubMed

47.

Heinz TL, Felix M, Wolfgang Z, et al. Registration for computer-navigated surgery in edentulous patients: a problem-based decision concept. J Oral Maxillofac Surg. 2011;39:453–8.

48.

Fitzpatrick JM, West JB, Maurer CR Jr. Predicting error in rigid-body point-based registration. IEEE Trans Med Imaging. 1998;17(5):694–702.CrossRefPubMed

49.

Pellegrino G, Mangano C, Mangano R, Ferri A, Taraschi V, Marchetti C. Augmented reality for dental implantology: a pilot clinical report of two cases. BMC Oral Health. 2019;19:158. https://doi.org/10.1186/s12903-019-0853-y.CrossRefPubMedPubMedCentral

50.

Gargallo-Albiol J, Barootchi S, Salomó-Coll O, Wang HL. Advantages and disadvantages of implant navigation surgery. A systematic review. Ann Anat. 2019;225:1–10. https://doi.org/10.1016/j.aanat.2019.04.005.CrossRefPubMed

Title: Accuracy of computer-aided static and dynamic navigation systems in the placement of zygomatic dental implants
Authors: Juan Ramón González Rueda
Agustín Galparsoro Catalán
Víctor Manuel de Paz Hermoso
Elena Riad Deglow
Álvaro Zubizarreta-Macho
Jesús Pato Mourelo
Javier Montero Martín
Sofía Hernández Montero
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-02856-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Accuracy of computer-aided static and dynamic navigation systems in the placement of zygomatic dental implants

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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