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评估颧骨种植体在眶底并发症中的应用：一项临床与解剖学研究。

Evaluating Zygomatic Implants in Orbital Floor Complications: A Clinical and Anatomical Study.

作者信息

Zielinski Rafal, Okulski Jakub, Simka Wojciech, Sowinski Jerzy, Łoś Jan, Kozakiewicz Marcin

机构信息

Stomatologia na Ksiezym Mlynie, Lodz, 16D Tymienieckiego, 90-365 Lodz, Poland.

Department of Maxillofacial Surgery, Medical University of Lodz, 113st Zeromskiego, 90-001 Lodz, Poland.

出版信息

J Maxillofac Oral Surg. 2025 Aug;24(4):989-1003. doi: 10.1007/s12663-024-02403-1. Epub 2025 Jan 9.

DOI:10.1007/s12663-024-02403-1
PMID:40756911
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12316615/
Abstract

BACKGROUND

One of the most critical complications that can occur after placing zygomatic implants is the accidental penetration of the patient's eye socket by a drill or implant. This article aims to find some relationships between the anatomical features of the lower orbital wall, different configuration of zygomatic implants, and other factors when planning the placement of zygomatic implants.

METHODS

A total of 81 patients underwent zygomatic implant procedures, receiving different combinations of implants. These included four zygomatic implants along with one or two conventional implants (Group I), four zygomatic implants alone (Group II), two zygomatic implants paired with four conventional implants (Group III), or three zygomatic implants alongside one or two conventional implants (Group IV). The aim of the study was to describe the complications and clinical outcomes of treatment in 81 patients who received zygomatic implants.

RESULTS

The following parameters were statistically significant between all four groups of patients: height and distance of two zygomatic implants in the zygomatic bone; surgery type and duration; the distance between zygomatic implants in the zygomatic bone; and zygomatic orbital floor (ZOF) classification at the left side showed significant differences; intramaxillary insertion of zygomatic implants reduced the rupture of Schneiderian's membrane; the average of zygomatic implants' length in all groups was 42.8 mm.

CONCLUSIONS

Not damaging the ZOF is profoundly important for preventing orbital damage during osteotomy for zygomatic implants and should be measured before every surgery.

摘要

背景

植入颧骨种植体后可能发生的最严重并发症之一是钻头或种植体意外穿透患者的眼眶。本文旨在找出在规划颧骨种植体植入时，眶下壁的解剖特征、颧骨种植体的不同构型以及其他因素之间的一些关系。

方法

共有81例患者接受了颧骨种植体手术，接受了不同组合的种植体。这些包括四颗颧骨种植体加一颗或两颗传统种植体（第一组）、仅四颗颧骨种植体（第二组）、两颗颧骨种植体与四颗传统种植体配对（第三组）或三颗颧骨种植体加一颗或两颗传统种植体（第四组）。该研究的目的是描述81例接受颧骨种植体治疗患者的并发症和临床结果。

结果

在所有四组患者之间，以下参数具有统计学意义：颧骨中两颗颧骨种植体的高度和距离；手术类型和持续时间；颧骨中颧骨种植体之间的距离；左侧颧骨眶底（ZOF）分类显示出显著差异；颧骨种植体的上颌内插入减少了施奈德氏膜的破裂；所有组中颧骨种植体的平均长度为42.8毫米。

结论

在颧骨种植体截骨术期间，不损伤ZOF对于防止眼眶损伤至关重要，并且在每次手术前都应进行测量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/4c3a24129cab/12663_2024_2403_Fig12_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/b94b4ca20a6d/12663_2024_2403_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/83904268b94e/12663_2024_2403_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/a3f7b968b19d/12663_2024_2403_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/939d7215e1db/12663_2024_2403_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/0a64bfed6205/12663_2024_2403_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/c77c2776913e/12663_2024_2403_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/06e28e598505/12663_2024_2403_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/1883a6369af7/12663_2024_2403_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7baa/12316615/4c3a24129cab/12663_2024_2403_Fig12_HTML.jpg

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本文引用的文献

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Accuracy of Zygomatic Implant Placement Using a Full Digital Planning and Custom-Made Bone-Supported Guide: A Retrospective Observational Cohort Study.使用全数字规划和定制骨支持导板进行颧骨种植体植入的准确性：一项回顾性观察队列研究。
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ORIS Criteria of Success for the Zygoma-Related Rehabilitation: The (Revisited) Zygoma Success Code.颧骨相关修复的 ORIS 成功标准：（再探讨）颧骨成功编码。
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Oral Dis. 2021 Jan;27(1):27-41. doi: 10.1111/odi.13305. Epub 2020 Mar 5.
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Guidance means accuracy: A randomized clinical trial on freehand versus guided dental implantation.导板意味着精准：一项关于徒手与引导式牙种植的随机临床试验。
Clin Oral Implants Res. 2020 May;31(5):417-430. doi: 10.1111/clr.13578. Epub 2020 Jan 31.
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Extraocular muscle damage from dental implant penetration to the orbit.牙种植体穿入眼眶导致的眼外肌损伤。
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