Chrcanovic Bruno Ramos, Pedrosa Alexsander Ribeiro, Neto Custódio Antônio Luís
Oral Maxillofac Surg. 2013 Mar;17(1):1-9. doi: 10.1007/s10006-012-0316-y. Epub 2012 Jan 25.
The purpose of the present study is to identify and describe the different surgical techniques for placement of zygomatic implants reported in the literature and discuss the differences between them.
An electronic search was undertaken in July 2011. The titles and abstracts from these results (n = 130) were read for identifying studies, which reported different surgical techniques for placement of zygomatic implants, which resulted in 41 articles.
Five different surgical approaches were identified: (1) the classical approach, (2) the sinus slot technique, (3) the exteriorized approach, (4) the minimally invasive approach by the use of custom-made drill guides, and (5) the computer-aided surgical navigation system approach. When the maxilla is severely resorbed, the concavity formed by the ridge crest is small, and the original classical technique should be used. When maxillary resorption generates a large concavity, it would be better to exteriorize the zygomatic implant. The externalized technique has fewer surgical steps than the classical and sinus slot methods, is less invasive, and reduces surgical time. It is recommended that utilization of the sinus slot technique together with the CT-based drilling guide would enhance the final results. Although the technique that uses the computer-aided surgical navigation system approach may produce an improved precision in the clinical procedure, its use is expensive, prolongs the operation time, and is limited to centers that have the necessary equipment for the surgery.
Preference for one technique over the other should take into consideration the concavity formed by the ridge crest, maxillary sinus, and region of implant insertion in the zygomatic bone.
本研究旨在识别和描述文献中报道的颧种植体植入的不同手术技术，并讨论它们之间的差异。
于2011年7月进行电子检索。阅读这些结果（n = 130）的标题和摘要以识别研究，这些研究报道了颧种植体植入的不同手术技术，最终得到41篇文章。
确定了五种不同的手术方法：（1）经典方法；（2）鼻窦槽技术；（3）外置法；（4）使用定制钻孔导向器的微创方法；（5）计算机辅助手术导航系统方法。当上颌严重吸收时，牙槽嵴形成的凹陷较小，应采用原始的经典技术。当上颌吸收产生较大凹陷时，将颧种植体外置会更好。外置技术比经典方法和鼻窦槽方法的手术步骤更少，侵入性更小，且缩短了手术时间。建议将鼻窦槽技术与基于CT的钻孔导向器结合使用可提高最终效果。尽管使用计算机辅助手术导航系统方法的技术可能会在临床操作中提高精度，但其使用成本高，延长了手术时间，并且仅限于具备该手术所需设备的中心。
在选择一种技术优于另一种技术时，应考虑牙槽嵴、上颌窦形成的凹陷以及颧骨中种植体植入区域。
