Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Sao Paulo, Sao Paulo, Brazil.
Int J Implant Dent. 2021 Jul 22;7(1):65. doi: 10.1186/s40729-021-00350-x.
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.
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).
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.
颧骨种植体已被描述为严重上颌萎缩患者的治疗选择，以避免骨增强手术。考虑到这一点，在这些治疗中，植入物的位置是关键因素，虚拟手术规划（VSP）在大多数临床医生在患者手术前广泛使用。然而，目前尚无研究评估这些 VSP 的临床相关性。本研究旨在确定数字规划颧骨种植体是否会对植入物的尺寸和位置产生任何影响，即使随后进行常规手术。
在四名患者中放置了 14 个颧骨植入物。对每位患者进行术前和术后螺旋 CT 检查，以允许在数字规划和植入物最终位置之间进行比较。评估了三维偏差（TD）、近远中偏差（MDD）、颊腭向偏差（BPD）和根尖冠向偏差（ACD）以及角偏差（AD）。根尖 TD 的平均差异为 6.114 ± 4.28mm（p<0.05），差异具有统计学意义。关于植入物的位置，只有放置在第一右侧磨牙区域的植入物在 ACD 方面报告了显著差异（p<0.05）。此外，长度大于 45mm 的植入物的 BPD 差异具有统计学意义（p<0.05）。
颧骨种植体手术是一种复杂的手术，尽管 VSP 是一种有用的工具，可以帮助临床医生确定颧骨种植体的数量和长度以及其正确位置，但手术经验仍然是必不可少的。
