Abstract
Dynamic Navigation is a computer-aided technology that allows the surgeon to track the grip instruments while preparing the implant site in real time based on radiological anatomy and accurate pre-operative planning. The support of this technology to the zygoma implant placement aims to reduce the risks and the errors associated with this complex surgical and prosthetic treatment. Various navigation systems are available to clinicians currently, distinguished by handling, reliability, and the associated economic and biological benefits and disadvantages. The present paper reports on the different protocols of dynamic navigations following a standard workflow in correlation with zygomatic implant supported rehabilitations and describes a case of maxillary atrophy successfully resolved with this technology. An innovative and minimally invasive dynamic navigation system, with the use of an intraoral anchored trust marker plate and a patient reference tool, has been adopted to support the accurate insertion of four zygomatic implants, which rapidly resolved maxillary atrophy from a 75-year-old male system. This approach provided an optimal implant placement accuracy reducing surgical invasiveness.
Highlights
Pre-implant bone reconstructions can often be avoided thanks to the introduction of short, narrow, and standard-length tilted implant [1,2,3]
Dynamic Navigation is a computer-aided technology that allows the surgeon to track the grip instruments while preparing the implant site in real time based on radiological anatomy and accurate pre-operative planning
The present paper reports on the different protocols of dynamic navigations following a standard workflow in correlation with zygomatic implant supported rehabilitations and describes a case of maxillary atrophy successfully resolved with this technology
Summary
Pre-implant bone reconstructions can often be avoided thanks to the introduction of short, narrow, and standard-length tilted implant [1,2,3]. In cases of severe atrophy of the jaw-bones, reconstructive techniques before implantology demonstrated several limits; grafting or tissue engineering procedures, with the use of growth factors and contenting devises, do not often obtain the hoped results due to the compromised vascularization and the anatomy of the residual alveolar ridge. Zygomatic implants (ZIs) are used for the rehabilitation of severe maxillary atrophies and defects with a >95% survival rate after nearly 13 years of follow-up [5,6,7] This approach, with shorter treatment times, the possibility of an immediate loading, and reduced surgical morbidity, is considered difficult and risky due to the complexity of the zygomatic bone in atrophic or resected patients, the limited direct visibility and the long pathway of implant site preparation [8]. A workflow of the DN protocols taking into account the technology currently available is illustrated with comments and discussions
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