Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, School of Medicine Second Dental Clinic, Ninth People's Hospital, National Clinical Research Center for Oral Disease, College of Stomatology, Shanghai Jiao Tong University, 200011, Shanghai, China.
Int J Implant Dent. 2023 May 17;9(1):11. doi: 10.1186/s40729-023-00478-y.
To assess the outcome [zygomatic implant (ZI) survival] and complications of the original surgical technique (OST) and an Anatomy-Guided approach (AGA) in the placement of ZI in patients with severely atrophic maxillae.
Two independent reviewers conducted an electronic literature search from January 2000 to August 2022. The inclusion criteria were articles reporting at least five patients with severely atrophic edentulous maxilla undergoing placement OST and/or AGA, with a minimum of 6 months of follow-up. Number of patients, defect characteristics, number of ZI, implant details, surgical technique, survival rate, loading protocol, prosthetic rehabilitation, complications, and follow-up period were compared.
Twenty-four studies comprised 2194 ZI in 918 patients with 41 failures. The ZI survival rate was 90.3-100% in OST and 90.4-100% in AGA. Probability of complications with ZI with OST was as follows: sinusitis, 9.53%; soft tissue infection, 7.50%; paresthesia, 10.78%; oroantral fistulas, 4.58%; and direct surgical complication, 6.91%. With AGA, the presenting complications were as follows: sinusitis, 4.39%; soft tissue infection, 4.35%; paresthesia, 0.55%; oroantral fistulas, 1.71%; and direct surgical complication, 1.60%. The prevalence of immediate loading protocol was 22.3% in OST and 89.6% in the AGA. Due to the heterogeneity of studies, statistical comparison was only possible after the descriptive analysis.
Based on the current systematic review, placing ZI in severely atrophic edentulous maxillae rehabilitation with the OST and AGA is associated with a high implant survival rate and surgical complications within a minimum of 6 months follow-up. Complications, including sinusitis and soft tissue infection around the implant, are the most common. The utilization of immediate loading protocol is more observed in AGA than in OST.
评估在严重萎缩的上颌骨中使用颧骨种植体（ZI）的原始手术技术（OST）和解剖导向方法（AGA）的结果[ZI 存活率]和并发症。
两位独立的审查员从 2000 年 1 月至 2022 年 8 月进行了电子文献检索。纳入标准是报告至少 5 名严重萎缩无牙上颌骨患者接受 OST 和/或 AGA 治疗，并进行至少 6 个月随访的文章。比较患者人数、缺损特征、ZI 数量、种植体细节、手术技术、存活率、加载方案、修复体、并发症和随访时间。
24 项研究包括 918 名患者的 2194 个 ZI，其中有 41 个失败。OST 中的 ZI 存活率为 90.3-100%，AGA 中的 ZI 存活率为 90.4-100%。OST 中 ZI 并发症的概率如下：鼻窦炎 9.53%；软组织感染 7.50%；感觉异常 10.78%；口鼻瘘 4.58%；直接手术并发症 6.91%。AGA 中出现的并发症如下：鼻窦炎 4.39%；软组织感染 4.35%；感觉异常 0.55%；口鼻瘘 1.71%；直接手术并发症 1.60%。OST 中即刻负载方案的患病率为 22.3%，AGA 中为 89.6%。由于研究的异质性，仅在描述性分析后才能进行统计学比较。
根据目前的系统评价，在严重萎缩的无牙上颌骨修复中使用 OST 和 AGA 放置 ZI 与高种植体存活率和手术并发症相关，在至少 6 个月的随访中。最常见的并发症是围绕种植体的鼻窦炎和软组织感染。即刻负载方案在 AGA 中的应用比 OST 更常见。
