The Application of Real Time Surgical Navigation for Zygomatic Implant Insertion in Severely Atrophic Maxilla Patients

Publication date: Available online 24 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Feng Wang, Michael M. Bornstein, Kuofeng Hung, Shengchi Fan, Xiaojun Chen, Wei Huang, Yiqun Wu
PurposeComputer-aided treatment technology has extended its applications to oral implantology. In this study, our initial clinical experience on the application of a commercially available navigation system (the VectorVision®) in zygomatic implant (ZI) insertion in severely atrophic maxilla was presented.Materials and MethodsIt was a retrospective longitudinal study. Eligible maxillary edentulous patients who were treated with ZI were enrolled. Treatment planning was performed on the computer based on previously obtained 3-dimensional imaging data. The surgical procedure was carried out under the guidance of a surgical navigation system. The outcome variable was safety and additional variables were ZI survival rate and radiological bone-to-implant contact (rBIC) area in the zygoma. Statistical analysis was performed with SPSS for Windows (Version 16.0, SPSS Inc., Chicago, IL, USA).ResultsA total of 15 patients (male: 8, female: 7; age: 30-69 y, average: 43±3.5 y) were eligible for the study and enrolled between May 2015 and September 2016. Of the included patients, 4 received one ZI on each side of the zygomatic bone and 2 to 4 standard implants in the edentulous anterior maxilla, and the other 11 received a ZI 'quad approach' without standard implant insertion. All ZIs were anchored in the site of the maxillary alveolar process and zygomatic bone, and no critical anatomical structure injuries occurred during insertion and post-operative radiographic examination. All ZIs that achieved osseointegration resulted in an overall survival rate of 100% after early healing. The overall rBIC area of ZIs in the study was between 4.1 mm and 24.7 mm with an average of 14.5± 4.6 mm.DiscussionFor the limited clinical cases treated in the study, our procedure for ZI placement was feasible and reliable with the guidance of the surgical navigation system. In addition, the potential risk of complications was minimized and ZIs were placed making the best possible use of the available bone volume.



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