Objectives
To assess the accuracy of a real‐time dynamic navigation system applied in zygomatic implant (ZI) surgery and summarize device‐related negative events and their management.
Material and methods
Patients who presented with severely maxillary atrophy or maxillary defects and received dynamic navigation‐supported ZI surgery were included. The deviations of entry, exit, and angle were measured after image data fusion. A linear mixed‐effects model was used. Statistical significance was defined as p < .05. Device‐related negative events and their management were also recorded and analyzed.
Results
Two hundred and thirty‐one zygomatic implants (ZIs) with navigation‐guided placement were planned in 74 consecutive patients between Jan 2015 and Aug 2020. Among them, 71 patients with 221 ZIs received navigation‐guided surgery finally. The deviations in entry, exit, and angle were 1.57 ± 0.71 mm, 2.1 ± 0.94 mm and 2.68 ± 1.25 degrees, respectively. Significant differences were found in entry and exit deviation according to the number of ZIs in the zygomata (p = .03 and .00, respectively). Patients with atrophic maxillary or maxillary defects showed a significant difference in exit deviation (p = .01). A total of 28 device‐related negative events occurred, and one resulted in 2 ZI failures due to implant malposition. The overall survival rate of ZIs was 98.64%, and the mean follow‐up time was 24.11 months (Standard Deviation [SD]: 12.62).
Conclusions
The navigation‐supported ZI implantation is an accurate and reliable surgical approach. However, relevant technical negative events in the navigation process are worthy of attention.
Background
This in vitro study aims to evaluate the accuracy of dental implant placement by a novel image‐guided hybrid robotic system for dental implant surgery (HRS‐DIS).
Methods
The HRS‐DIS with a 5 degree of freedom (DOF) serial manipulator and a 6 DOF Stewart platform was developed. To evaluate the accuracy of repeated drilling, the holes were prepared twice with a 2.2 mm drill. To evaluate the accuracy of dental implant placement, the entry, exit and angle deviations of dental implants were measured.
Results
Twenty‐four holes were prepared twice, and mean (±SD) of diameters were measured as 2.2 ± 0.02 mm. A total of 160 dental implants were placed in 32 phantoms by HRS‐DIS. The mean (±SD) of the entry, exit and angle deviation were 0.8 ± 0.54 mm, 0.87 ± 0.54 mm and 1.0 1 ± 0.44°, respectively.
Conclusions
The results of the in vitro study preliminarily validated that the HRS‐DIS could provide a high accuracy for dental implant surgery.
Introduction:The traditional way to treat maxillary edentulous Cawood and Howell Class 4 (CH4) patients who exhibit the knife-edge ridge form of edentulous jaws that are adequate in height and inadequate in width is extensive autologous bone grafting for conventional implant placement.Purpose: To evaluate the feasibility of the zygomatic implant (ZI) quad approach in edentulous CH4 patients who presented a knife-edge ridge form in the anterior maxilla for immediate loading.Material and methods: Eligible patients with maxillary CH4 edentulism treated with the ZI quad approach were enrolled. Bone reduction and implant placement were performed under the guidance of a navigation system according to preoperative planning. The outcome variable was the implant survival rate, and additional variables were the ratio of immediate loading, complications and the relationship of the zygomatic implant path to the sinus wall. Statistical analysis was performed with the SAS statistical package.Results: Fifteen patients (3 men, 12 women; age range, 19-71 years; average age 47.2 years) eligible for the study received the ZI quad approach from January 2017 through January 2020. All ZIs achieved osseointegration, with no implant loss after early healing and a mean follow-up of 17.2 ± 6.2 months. Thirteen of 15 patients (86.7%) received immediate loading. No critical anatomic structure injuries occurred during surgery. Most mesially placed implants (23/30, 76.6%) presented ZAGA 2 and 3, and most distally placed implants were distributed in ZAGA 0 (20/30, 66.7%).Discussion: In terms of realizing immediate loading in CH4 patients with a knife-edge ridge form in the anterior maxilla, quad approaches have advantages over other
Background
Dental implant placement navigation systems based on optical tracking have been widely used in clinics. However, electromagnetic (EM) navigation method that does not suffer from problems of hidden line‐of‐light has not yet been described.
Methods
This work proposes an EM‐guided navigation method named TianShu‐ESNS with virtual calibration. Model (12 implants) and animal experiments (pig head: six implants) were conducted to evaluate its performance and stability.
Result
The mean virtual calibration error was 0.83 ± 0.20 mm. The mean deviations at the entry point, end point and angle in the phantom experiment of TianShu‐ESNS were 1.23 ± 0.17 mm, 1.59 ± 0.20 mm and 1.83 ± 0.27°, respectively. In the animal experiment, the same deviations were 1.25 ± 0.07 mm, 1.57 ± 0.35 mm and 1.90 ± 0.60°, respectively.
Conclusions
The experimental results show that TianShu‐ESNS with the virtual calibration method could serve as a promising tool to eliminate the line‐of‐light hidden problem and simplify operation procedure in dental implant placement.
Background: Cone-beam computed tomography (CBCT) and conventional multislice CT (MSCT) are both used in zygomatic implant navigation surgery but the superiority of one technique versus the other remains unclear. Purpose: This study compared the accuracy of CBCT and MSCT in zygomatic implant navigation surgery by calculating the deviations of implants. Material and methods: Patients with severely atrophic maxillae were classified into two groups according to the use of CBCT-or MSCT-guided navigation system. The entry and apical distance deviation, and the angle deviation of zygomatic implants were measured on fused operation images. A linear effect model was used for analysis, with statistical significance set at P < .05. Results: A total of 72 zygomatic implants were inserted as planned in 23 patients. The comparison of deviations in CBCT and MSCT groups showed a mean (± SD) entry deviation of 1.69 ± 0.59 mm vs 2.04 ± 0.78 mm (P = .146), apical deviation of 2 ± 0.68 mm vs 2.55 ± 0.85 (P < .001), and angle deviation of 2.32 ± 1.02 vs 3.23 ± 1.21 (P = .038). Conclusion: Real-time zygomatic implant navigation surgery with CBCT may result in higher values for accuracy than MSCT.
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