Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Private practice, Cairo, Egypt.
BMC Oral Health. 2024 Oct 24;24(1):1273. doi: 10.1186/s12903-024-05010-1.
Zygomatic implant surgery can be difficult due to the limited intraoperative visibility of the surgical field and the complex anatomy of the zygomatic bone, which could lead to serious complications. This study aims to assess the accuracy of zygomatic implants placement using computer-guided surgical templates.
A total of 13 zygomatic implants were placed in four participants. Double-sleeve drill guides were used with the help of computer-guided surgical templates designed with a lateral window. The accuracy was evaluated by measuring the linear deviations regarding the implants' platforms and apices' positions in addition to the angular deviations. Moreover, deviations of both implants from three fixed planes of space were measured.
The mean linear deviation at platforms was 2.44 mm ± 1.57 and at the apices 2.32 mm ± 1 while the mean angular deviation was 3.6˚ ± 1.92. Differences at the entry points were 0.43 ± 1.79 mm, 0.39 ± 1.12 mm, and - 0.54 ± 2.00 mm from the mid-sagittal, horizontal, and coronal planes respectively. Differences at the exit points were - 0.75 ± 1.25 mm, -0.06 ± 1.09 mm, and 0.63 ± 1.24 mm from the same planes respectively. Within all planes, there was no statistically significant difference.
Given the limitations of this study, the use of the computer-guided surgical templates augmented by the double sleeve drill guides allowed favorable control over the tip of the long surgical drill away from vital structures during the zygomatic implant osteotomy. It also allowed control over alveolar crest osteotomy and its placement in a favorable prosthetic position. Overall, this protocol should be considered for further research and improvement to allow more predictable surgical outcomes while preventing the occurrence of complications. Before conducting this study, the protocol was reviewed and approved by the Research Ethical Committee of Faculty of Dentistry, Ain Shams University in meeting no. (105), on 15th of July 2020 with the application no.: (FDASU-RecD072029).
颧骨种植手术由于手术视野有限且颧骨解剖结构复杂，可能导致严重并发症，因此具有一定难度。本研究旨在评估计算机引导手术模板在颧骨种植体放置中的准确性。
共对四名参与者的 13 个颧骨种植体进行了研究。使用双套管钻导板，借助计算机设计的带有侧窗的引导模板进行手术。通过测量种植体平台和根尖位置的线性偏差以及角度偏差来评估准确性。此外，还测量了两个种植体与三个固定空间平面的偏差。
平台处的平均线性偏差为 2.44±1.57mm，根尖处为 2.32±1mm，平均角度偏差为 3.6°±1.92°。入口处的差异分别为 0.43±1.79mm、0.39±1.12mm 和-0.54±2.00mm，从中矢状面、水平面和冠状面测量。出口处的差异分别为-0.75±1.25mm、-0.06±1.09mm 和 0.63±1.24mm，从同一平面测量。所有平面之间均无统计学差异。
考虑到本研究的局限性，使用计算机引导手术模板和双套管钻导板可以在颧骨种植体截骨术中控制长手术钻头远离重要结构的尖端，使其处于有利的位置。它还可以控制牙槽嵴截骨术及其在有利的修复位置的放置。总的来说，该方案应进一步研究和改进，以在预防并发症的同时获得更可预测的手术效果。在进行本研究之前，该方案已经过 Ain Shams 大学牙科学院研究伦理委员会的审查和批准，会议编号为 (105)，于 2020 年 7 月 15 日，申请编号为：(FDASU-RecD072029)。
