Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691, Madrid, Spain.
Department of Maxillofacial Surgery, Quirón Health Hospital, 28002, Madrid, Spain.
BMC Oral Health. 2023 Mar 15;23(1):150. doi: 10.1186/s12903-023-02856-9.
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.
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.
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).
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.
颧骨种植体广泛应用于严重萎缩上颌骨的修复，但种植体的植入并非没有风险，它可能会对相关解剖结构造成损伤。本研究旨在对颧骨牙种植体放置中静态导航系统与动态导航系统的准确性进行比较分析。
将 60 枚颧骨牙种植体随机分配到三个研究组之一，根据使用的种植体放置策略进行分类：A：计算机辅助静态导航系统（n=20）（GI）；B：计算机辅助动态导航系统（n=20）（NI）；或 C：徒手技术（n=20）（FHI）。对于计算机辅助研究组，进行术前锥形束 CT（CBCT）扫描以规划手术中使用的方法。在 15 个聚碳酸酯立体光刻模型（n=15）中每个模型中插入 4 枚颧骨牙种植体，干预后进行术后 CBCT 扫描。然后将术前和术后的 CBCT 扫描上传到用于牙科种植体分析的软件程序中，以分析角度偏差、根尖终点和冠状入口点。使用学生 t 检验分析结果。
FHI 和 NI（p=0.0053）以及 FHI 和 GI（p=0.0004）组之间根尖终点偏差存在统计学显著差异。FHI 和 GI 组之间的角度偏差也存在统计学显著差异（p=0.0043）。
由于每种颧骨牙种植体放置技术所需的不同学习曲线，手动徒手技术可能比计算机辅助手术技术更能准确地放置颧骨牙种植体。
