Zygomatic Implants Research Articles

Bone reconstruction of extensive maxillomandibular defects in adults.

Reconstruction of significant maxillomandibular defects is a challenge that has been much discussed over the last few decades. Fundamental principles were developed decades ago (bone bed viability, graft immobilization). Clinical decision-making criteria are highly relevant, including local/systemic factors and incision designs, the choice of material, grafting technique, and donor site morbidity. Stabilizing particulated grafts for defined defects-that is, via meshes or shells-might allow significant horizontal and vertical augmentation; the alternatives are onlay and inlay techniques. More significant defects might require extra orally harvested autologous bone blocks. The anterior iliac crest is often used for nonvascularized augmentation, whereas more extensive defects often require microvascular reconstruction. In those cases, the free fibula flap has become the standard of care. The development of alternatives is still ongoing (i.e., alloplastic reconstruction, zygomatic implants, obturators, distraction osteogenesis). Especially for these complex procedures, three-dimensional planning tools enable facilitated planning and a surgical workflow.

Zygomatic Implants: A Narrative Review

Zygomatic Implants: A Narrative Review

The Accuracy of Zygomatic Implant Placement Assisted by Dynamic Computer-Aided Surgery: A Systematic Review and Meta-Analysis.

The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided surgery (s-CAIS), and a free-hand approach in patients with severe atrophic edentulous maxilla and/or deficient maxilla. Electronic and manual literature searches until May 2023 were performed in the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases. Clinical trials and cadaver studies were selected. The primary outcome was planned/placed deviation. Secondary outcomes were to evaluate the survival of ZI and surgical complications. Random-effects meta-analyses were conducted and meta-regression was utilized to compare fiducial registration amounts for d-CAIS and the different designs of s-CAIS. A total of 14 studies with 511 ZIs were included (Nobel Biocare: 274, Southern Implant: 42, SIN Implant: 16, non-mentioned: 179). The pooled mean ZI deviations from the d-CAIS group were 1.81 mm (95% CI: 1.34-2.29) at the entry point and 2.95 mm (95% CI: 1.66-4.24) at the apex point, and angular deviations were 3.49 degrees (95% CI: 2.04-4.93). The pooled mean ZI deviations from the s-CAIS group were 1.19 mm (95% CI: 0.83-1.54) at the entry point and 1.80 mm (95% CI: 1.10-2.50) at the apex point, and angular deviations were 2.15 degrees (95% CI: 1.43-2.88). The pooled mean ZI deviations from the free-hand group were 2.04 mm (95% CI: 1.69-2.39) at the entry point and 3.23 mm (95% CI: 2.34-4.12) at the apex point, and angular deviations were 4.92 degrees (95% CI: 3.86-5.98). There was strong evidence of differences in the average entry, apex, and angular deviation between the navigation, surgical guide, and free-hand groups (p < 0.01). A significant inverse correlation was observed between the number of fiducial screws and the planned/placed deviation regarding entry, apex, and angular measurements. Using d-CAIS and modified s-CAIS for ZI surgery has shown clinically acceptable outcomes regarding average entry, apex, and angular deviations. The maximal deviation values were predominantly observed in the conventional s-CAIS. Surgeons should be mindful of potential deviations and complications regardless of the decision making in different guide approaches.

The Buccal Fat Pad Technique an Option to Prevent Complications in Zygomatic Implants Surgery: 5 -13 Years Follow Up

Background: The extrasinus approach is a technique, with an implant placement of zygomatic implants with approach outside of the maxillary sinus. The technique reduces the risk of sinusitis and favors prosthetic rehabilitation, but there is a risk of soft tissue recession, exposure of the implant threads and contamination of the implant surface. Purpose: The objective of this retrospective clinical study is to prove and present the benefits of the use of the Buccal Fat pad flap technique and its feasibility in preventing soft tissue complications in rehabilitations with zygomatic implants. Materials and Methods: Patients from authors clinics in Brazil (IDM - Clinic – Rio de Janeiro) and Chile (Universidad de Los Andes – Santiago and Universidad de La Frontera – Temuco) with severe maxillary atrophy rehabilitated by maxillary full fixed prosthesis with zygomatic implants. Were installed two implants one in each side associated to conventional implants and in more critical conditions of bone atrophy, four zygomatic implants, two in each side were used. In cases with risk of an oroantral communication and were used extrasinusal approach (ZAGA concept), the buccal fat pad flap technique was used. The peri-implant soft tissue recession (PISTR) was evaluated by clinical examination and recession was scored on an ordinal scale: I = no recession; II = slight recession (implant head visible); III = recession with up to seven exposed threads. Results: In the period from May 2005 to January 2013, a total of 147 zygomatic implants were installed in 52 patients (Men = 22 and Women = 30) with mean age of 56,9 years old, were submitted to surgery of zygomatic implants. In all cases, the buccal fat pad flap technique was used to prevent complications such as: mucosal resection or frenestration and exposure of the implants or oroantral communication, depending on the positioning of these implants. The patients were followed over the years and in 5 cases (3,4%) there was tissue retraction and exposure of the threads of an implant. Conclusion: It can be concluded that the use of the buccal fat pad flap proved to be a simple and effective technique in the prevention of complications of soft tissue recession associated with the surgery of zygomatic implants installed with the extrasinusal technique.

Longitudinal reactions of maxillary sinus in patients treated with multiple zygomatic implants: A modified radiographic evaluation with clinical follow-up.

To investigate the effects of zygomatic implant placement on the maxillary sinus using radiographic and clinical indicators. Patients with an atrophic maxilla who underwent zygomatic implant placement were included. The thickness and morphology of the Schneiderian membrane (SM), infundibular obstruction, and posterior bone wall of the maxillary sinus were analyzed. The generalized estimating equation and chi-square tests were performed to compare the measurements. Fifty patients with 100 maxillary sinuses were included. In total, 148 zygomatic implants and 105 regular implants were placed in the maxilla. Overall, the mean pre- and postoperative SM thickness was 2.79 ± 3.26 mm and 3.97 ± 5.45 mm, respectively (p = 0.063). In sinuses with two zygomatic implants, the SM thickness increased significantly from 2.12 ± 2.14 mm preoperatively to 4.07 ± 6.14 mm postoperatively (p = 0.026). The number of sinuses with type IV morphology (fully radiopaque) increased from zero preoperatively to six (13%) postoperatively. Sinuses with a single zygomatic implant showed no difference in the pre- and postoperative SM thickness. Postoperatively, six sinuses had infundibulum obstructions. Postoperative osteitis of the bilateral sinuses was found in two patients. We have proposed a new imaging evaluation method and system for evaluating the maxillary sinus response. Preoperative infundibulum obstruction combined with mucosal thickening and double zygomatic implant placement are more likely to induce postoperative maxillary sinus mucositis and osteitis.

Quantitative assessment of image artifacts from zygoma implants on CBCT scans using different exposure parameters.

This study was aimed at quantifying artifacts from zygoma implants in cone-beam computed tomography (CBCT) images using different exposure parameters. Two cadaver heads, one with two zygoma implants on each side and the other for control, were scanned using 18 different exposure parameters. Quantitative analysis was performed to evaluate the hypodense and hyperdense artifact percentages calculated as the percentage of the area. Hyperdense artifacts and hypodense artifacts were detected, followed by the calculation of the hyperdense and hypodense artifact percentages in the image. In the qualitative analysis of the artifacts, the scores used were as follows: absence (0), moderate presence (1), or high presence (2) for hypodense halos, thin hypodense lines, and hyperdense lines. Artifact analysis was performed qualitatively and quantitatively using the post-hoc Tukey and Two-way ANOVA tests. As a result, in the qualitative analyses, zygoma implants showed a significant difference compared to the control group with regard to hyperdense and hypodense artifacts (p < 0.05). There was a significant difference between the means according to the FOV size arithmetic averages (p < 0.05). In terms of voxel size, the difference was found to be significant, where 400 microns showed the highest hypodense artifact while 200 microns showed the lowest hypodense artifact. In conclusion, hypodense and hyperdense artifacts were significantly higher in cadavers with zygoma implants than in controls. As FOV and voxel size increase, more hypodense artifacts are produced by zygoma implants so smaller FOV and voxel sizes should be used to prevent poor image quality of adjacent teeth.

Influence of Prosthodontic Rehabilitation Using Zygomatic Implants in Covid 19 Related Mucormycosis (Rhino-Orbital-Cerebral) Maxillectomy Patients Upon Post-Operative Stress, Anxiety and Functional Impairment: A Prospective Cohort Study.

To determine the influence of prosthodontic rehabilitation using zygomatic implants in partial maxillectomy upon post-operative stress, anxiety and functional impairment, due to covid 19 associated rhino-orbital-cerebral mucormycosis (ROCM). Twenty maxillectomy patients fulfilling study criterion, received zygomatic implants (ZI) (quad zygoma) (ZDI Simpladent, Switzerland) retained/supported complete maxillary denture. Assessment of stress, anxiety, masticatory performance and speech were determined using diurnal salivary cortisol level, Appearance Anxiety Inventory, multiple sieve technique and auditory perception analysis, respectively. Data were recorded at 6 different stages of rehabilitation (after maxillectomy, implant placement, and after prosthesis delivery (1 week, 1 month, 6 months and 1 year)). Demographic data were expressed as frequency distribution, while mean values were used to find differences between various rehabilitation stages using Friedman and chi-square test with statistical significance value at p < 0.05. Average daily salivary cortisol levels declined from post maxillectomy (22.80 ± 0.902) to 1 year after prosthesis wearing (8.65 ± 0.985), indicating stress reduction after ZI rehabilitation. Mean scores for appearance anxiety reduced from pre-prosthetic rehabilitation (27.350 ± 3.030) to 1 year (8.950 ± 0.887) following prosthesis wearing. Functional parameters for mastication and speech also improved significantly during the course of rehabilitation. All differences between pre-prosthetic to 1-year stage after prosthesis wearing were found to be statistically significant at p < 0.05. Post ROCM maxillectomy cases after prosthetic rehabilitation using zygomatic implants showed significant improvement in the psychological (stress and anxiety) as well as function (mastication and speech) characteristics. Rehabilitation post ROCM maxillectomy with the present approach of fixed prosthesis using zygomatic implants mitigates deficient mastication and speech. It also impacts positively on patient psychology by decreasing stress and anxiety.

Autonomous dental robotic surgery for zygomatic implants: A two-stage technique

Zygomatic implants (ZIs) can be a treatment option for patients with severe atrophy in the maxilla, but deviation during ZI placement could lead to serious complications. Surgical guides and dynamic navigation have been used to improve the accuracy of ZI placement, but both techniques are subject to human error. A 2-stage technique is described that enabled an autonomous dental robot to overcome mouth-opening restrictions for ZI placement. The technique enables the complete digitalization of ZI placement, further improving the accuracy of the drilling process.

Analog-digital workflow for complex rehabilitation of severe maxillary atrophy with zygomatic implants: a clinical case

Patients with a complete lack of teeth, severe maxillary atrophy and midface deformity create the most unfavorable conditions for their rehabilitation according to traditional protocols, including bone grafting, sinus lifting and implantation, which forms a complex clinical challenge. Today, zygomatic implants are successfully used as an alternative option for rehabilitation of patients with severe upper jaw atrophy, allowing to reduce the volume of surgical interventions, as well as to shorten the rehabilitation period. Until now, the question of finding an optimal treatment protocol with the use of zygomatic implants remains relevant.&#x0D; We proposed an integrated protocol of rehabilitation of patients with severe maxillary atrophy, based on the use of analogue-digital diagnostic tools and treatment outcome planning, as well as including the stages of surgical and prosthetic treatment using the developed technology of zygomatic implant placement and immediate loading with prosthetic jaw prosthesis constructions.&#x0D; This work presents a clinical case of the patient (62 years old), whose rehabilitation was performed in accordance with her own protocol: preoperative digital planning according to computer tomography data (Blue Sky Bio Plan., USA), virtual modeling and manufacturing of surgical template for positioning four zygomatic implants (Nobel Biocare, USA), installation of zygomatic implants and immediate fixation of temporary dental prosthesis. Based on the results of follow-up examinations, including X-ray assessment of the zygomatic bones over a period of 6 years no complications were detected.

Zygomatic Implants: A 20-Year Bibliometric Analysis of Science Citation Index Expanded Publications (2001-2021)

Zygomatic implants provide a valuable treatment option for rehabilitation in severely resorbed maxilla. However, none of the several scientific papers on this topic have included a detailed analysis that characterized the research outputs regarding journals, authors, citations, and institutions. The purpose of this study was to evaluate the characteristics of publications on zygomatic implants published between 2001 and 2021. A systematic literature survey on zygomatic implants was performed on the Web of Science core collection. A bibliometric analysis of 520 studies retrieved from the survey, was conducted using Citespace IV and VOSviewer v1.6.16. The International Journal of Oral and Maxillofacial Implants had the highest number of publications and citations. The country with the most contributions to zygomatic implants between 2001 and 2021 was the United States. However, Shanghai Jiao Tong University in China was the largest contributor to the literature and the most cited institution. Aparicio was the most co-cited author on zygomatic implants. The bibliometric indicators in this study demonstrated upward trends in zygomatic implants. Further bibliometric analysis will also provide important guidance to authors wishing to contribute to the expanding literature on zygomatic implants.

Three-Dimensional Evaluation of the Accuracy of Zygomatic Implant Placement Through an In-House Fully Guided Approach.

Purpose: To validate guided surgery for zygomatic implants (ZIs) by analyzing the final position of the implants relative to the preoperatively planned position. Material and Methods: Five patients with fully edentulous atrophic maxillae treated with four ZIs through a fully guided implant surgical approach were evaluated. The preoperative phase included digital planning, through which the surgical guide was designed and created. Analysis of the guided surgery accuracy was carried out by superimposing the digital planning over the final position of the implants using preoperative and postoperative CBCT. The radiologic evaluation included implant angular deviation, entrance deviation, exit deviation, platform deviation, and apex apicocoronal and mesiodistal deviation. Results: All five patients (two men and three women; mean age: 61.8 ± 3 years) were each treated with four ZIs using a fully guided approach with an extrasinusal path, obtaining ideal emergence of the implants. Superimposition comparison found a mean axial angular implant deviation of 0.79 ± 0.41 degrees and a mean implant entrance deviation of 0.95 ± 0.26 degrees. The platform deviation was 0.62 ± 0.19 mm buccopalatally and 0.76 ± 0.14 mm mesiodistally, while the apical deviation was 0.42 ± 0.13 mm buccopalatally and 1.06 ± 0.37 mm mesiodistally. Conclusions: Guided surgery in zygomatic implants appears to be sufficiently accurate to make it a safe and predictable technique.

Key clinical considerations and updates on the techniques for successful zygomatic implant: a systematic review

Introduction: In the context of implant dentistry, what represents a great burden in the aesthetic recovery of patients who have suffered dentoalveolar trauma is the lack of bone in the alveolar crest, compromising the quality of life due to tooth loss. Objective: Performed a systematic review to present key clinical considerations and updates on the best techniques for successful zygomatic implantation. Methods:The systematic review rules of the PRISMA Platform were followed. The research was carried out from February to May 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion:A total of 128 articles were found, 54 articles were evaluated in full and 34 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 32 studies that did not meet GRADE. Zygomatic implants can be placed with good precision. The application of these newly designed 3D-printed surgical guides results in the predictable placement of zygomatic implants and offers the possibility of immediate prosthetic rehabilitation. Preliminary data from one year after loading suggest that immediately loaded zygomatic implants were associated with statistically significantly fewer prosthetic failures. Also, zygomatic implants proved to be a better rehabilitation modality for severely atrophic jaws.

Application of titanium 3D-printed double-sleeve guide for zygomatic implants: A technique report.

The unique anatomical structure of the atrophic edentulous maxilla limits the placement of endosteal root form dental implants without bone grafting and augmentation. Surgical placement of zygomatic implants in an optimal position remains challenging. This technique report illustrates a novel digital guide technology, including the design workflow, application method, and indications for assisting with the placement of zygomatic implants using a bone-supported titanium double-sleeve guide. In addition, when the implant body reaches the zygomatic bone following an intra-sinus path, including ZAGA type 0 and ZAGA type 1 cases, a matching window osteotomy surgical guide is used to locate the lateral window boundary and protect the sinus membrane. With this technique, the surgical procedure is simplified, and the precision of guided zygomatic implant placement is improved.

Comparison of Two Types of Patient Specific Implants (PSI) and Quad Zygoma Implant (QZI) for Rehabilitation of Post-COVID Maxillary Mucormycosis Defect (PCMMD): Finite Element Analysis.

The residual post-COVID maxillary mucormycosis defect (PCMMD) were extensive, due to unilateral or bilateral maxillectomies. The Goal of rehabilitation of PCMMD is to deliver a prosthetically driven reconstruction. FEA was to evaluate the biomechanical response of PSI struts (PSI 1), PSI Screw retained (PSI 2) and QZI to masticatory load on virtual simulation to improve accuracy and enhance the design. To validate and compare the Biomechanical benefit of the PSI struts, PSI Screw retained, QZI in a case of rehabilitation of post-COVID maxillary mucormycosis defect (PCMMD) by FEA study. The result of stress to masticatory load on virtual simulation for (1) Maximum and minimum stress (Von Mises stress); (2) the Displacement (in three positions) and (3) the Deformation (Plastic strain) was compared on virtual simulation for PSI 1 and PSI 2 and QZI. The FEA and comparative evaluation of PSI 1, PSI 2 and QZI showed a good resistance to displacement. The stress and strain values are low and acceptable. In comparison QZI shows more stress in the anterior region.

Simplified Zygomatic Implant Perforated (Zip) Flap for Rehabilitation in Low Level Maxillary Defects

Rehabilitation in Low level maxillectomy cases has plethora of options right from local flaps to microvascular flaps. Subsequent to flap surgery, a maxillary dental rehabilitation can be demanding and a fixed or removable prosthesis is obligatory to provide them with near-normal function and aesthetics. Unlike the original ZIP flaps which were dedicated to microvascular flaps, we present here our unique experience with ZIP-Temporalis flap specifically for rehabilitation for patients of CAM (covid associated mucormycosis), its methods, advantages and limitations.

Autonomous robotic surgery for zygomatic implant placement and immediately loaded implant-supported full-arch prosthesis: a preliminary research

ObjectivesA patient with extensive atrophy of the alveolar ridge in the posterior portion of the maxilla was selected to complete an experimental and clinical case of the robotic zygomatic implant to investigate the viability of an implant robotic system in clinical use.MethodsThe preoperative digital information was collected, and the implantation position and personalized optimization marks needed for robot surgery were designed in advance in a repair-oriented way. The resin models and marks of the patient’s maxilla and mandible are all printed in 3D. Custom-made special precision drills and handpiece holders for robotic zygomatic implants were used to perform model experiments and compare the accuracy of the robotic zygomatic implant group (implant length = 52.5 mm, n = 10) with the alveolar implant group (implant length = 18 mm, n = 20). Based on the results of extraoral experiments, a clinical case of robotic surgery for zygomatic implant placement and immediate loading of implant-supported full arch prosthesis was carried out.ResultsIn the model experiment, the zygomatic implant group reported an entry point error of 0.78 ± 0.34 mm, an exit point error of 0.80 ± 0.25 mm, and an angle error of 1.33 ± 0.41degrees. In comparison, the alveolar implant group (control group) reported an entry point error of 0.81 ± 0.24 mm, an exit point error of 0.86 ± 0.32 mm, and an angle error of 1.71 ± 0.71 degrees. There was no significant difference between the two groups (p > 0.05). In clinical cases, the average entry point error of two zygomatic implants is 0.83 mm, the average exit point error is 1.10 mm and the angle error is 1.46 degrees.ConclusionsThe preoperative planning and surgical procedures developed in this study provide enough accuracy for robotic zygomatic implant surgery, and the overall deviation is small, which is not affected by the lateral wall deviation of maxillary sinus.

MAXILLOFACIAL REHABILITATION IN PATIENT WITH NEOPLASMS USING ZYGOMATIC IMPLANT-SUPPORTED PROSTHESES

Objective: The aim of this study was to report the clinical results of the use оf the zygomatic implants for prosthetic rehabilitation in patients with maxillectomy due to upper jaw tumors. Materials and Methods: The study included 12 patients who underwent prosthetic rehabilitation using a zygomatic implant after maxillectomy for the treatment of upper jaw tumors in the period from 2021 to 2023. There were 8 male patients and 4 female patients with an average age of 53.2 years old. The type of tumors was determined by CT, MRT methods and histopathological examination. The distribution of lesions was the following: benign 4 and malignant 8,7 patients have undergone radiation therapy before or after implant placement. After the tumor was removed, immediate surgical obdurators were placed. Main prosthetic rehabilitation performed 6-12 months after tumor removal, but before that, a temporary obturator had made and used. 6-12 months after tumor resection, 1-4 zygomatic implants were inserted into the zygomatic bone unilaterally or bilaterally. A total of 36 zygomatic implants were installed, 2 of which were unsuccessful and were removed in 1 patient. The implant systems used Zygoma TiUnite (Nobel Biocare, Zurich, Switzerland) and multi-unit abutments (MUA). The implants were placed using the surgical guide, which was planned and prepared digitally. After which they loaded immediately using prefabricated complete dentures. They verified, adapted and screwed by titanium bases onto the zygomatic implants. The palatal part of these prostheses is a separate unit, which attach to the main part of the prostheses with magnets. By detaching the palatal part of the prostheses, through the created opening, doctor or patient can keep track of the upper tissues, hygiene and antiseptic cleansing (irrigation, rinsing). Evaluation of functional efficiency of the treatment was assessed before and after prosthetic rehabilitation with zygomatic implants using the Oral Health Impact Profile (OHIP-14) and the masticatory functional index. QOL was evaluated using the University of Washington Quality of Life version 4 (UW-QOLv4) questionnaire. Results։ No postsurgical complications were seen, and the patients were discharged from the hospital after 7-10 days. The patients were able to return to a normal diet (hard) after just 7 days following surgery, with no further complaints regarding function or pain, apart from the residual swelling caused by the intervention. Patients' health-related quality of life (HR-QOL) before treatment was ≥48.3%. HR-QOL and overall quality of life after rehabilitation increased to 76.8%, and assessed as good. The improvement of chewing function was also the most important goal for the patients (pre- 26,4% and post- 67,3%), masticatory function scores increased after prosthetic treatment with implants. Conclusions: The use of prostheses fixed on zygomatic implants for patients with maxillary defects is an effective method of prosthodontic rehabilitation in complex clinical cases after maxillectomy

Accuracy of Zygomatic Implant Placement Using a Full Digital Planning and Custom-Made Bone-Supported Guide: A Retrospective Observational Cohort Study

The aim of the study was to evaluate the accuracy of zygomatic implant placement using customized bone-supported laser-sintered titanium templates. Pre-surgical computed tomography (CT) scans allowed to develop the ideal virtual planning for each patient. Direct metal laser-sintering was used to create the surgical guides for the implant placement. Post-operative CT scans were taken 6 months after surgery to assess any differences between the planned and placed zygomatic implants. Qualitative and quantitative three-dimensional analyses were performed with the software Slicer3D, recording linear and angular displacements after the surface registration of the planned and placed models of each implant. A total of 59 zygomatic implants were analyzed. Apical displacement showed a mean movement of 0.57 ± 0.49 mm on the X-axis, 1.1 ± 0.6 mm on the Y-axis, and 1.15 ± 0.69 mm on the Z-axis for the anterior implant, with a linear displacement of 0.51 ± 0.51 mm on the X-axis, 1.48 ± 0.9 mm on the Y-axis, and 1.34 ± 0.9 mm on the Z-axis for the posterior implant. The basal displacement showed a mean movement of 0.33 ± 0.25 mm on the X-axis, 0.66 ± 0.47 mm on the Y-axis, and 0.58 ± 0.4 mm on the Z-axis for the anterior implant, with a linear displacement of 0.39 ± 0.43 mm on the X-axis, 0.42 ± 0.35 mm on the Y-axis, and 0.66 ± 0.4 mm on the Z-axis for the posterior implant. The angular displacements recorded significative differences between the anterior implants (yaw: 0.56 ± 0.46°; pitch: 0.52 ± 0.45°; roll: 0.57 ± 0.44°) and posterior implants (yaw: 1.3 ± 0.8°; pitch: 1.3 ± 0.78°; roll: 1.28 ± 1.1°) (p < 0.05). Fully guided surgery showed good accuracy for zygomatic implant placement and it should be considered in the decision-making process.

Accelerating Midfacial Prosthetic Rehabilitation Using Zygomatic Implants and Intraoperative Facial Impression: A Case Report

Accelerating Midfacial Prosthetic Rehabilitation Using Zygomatic Implants and Intraoperative Facial Impression: A Case Report

Dental implants: what challenges and opportunities are there on our horizon?

Dental implantology has revolutionized the dental profession by providing a practical and aesthetically pleasing replacement for lost or missing teeth. This article takes a comprehensive look at the history of dental implantology from the discovery of osseo-integration to the current practice of using conventional to zygomatic implants with bone grafts and soft tissue grafts. CPD/Clinical Relevance: Knowledge regarding the current status of dental implants is of value to clinicians.