Evaluation of the Accuracy of Zygomatic Implant Placement Using CAD/CAM Guides in Patients with Post Maxillectomy Defects

Saleh, Mostafa Mohamed Abdel Moneam; Sleem, Heba Abdel Wahed; Taha, Moustafa Mohamed Sayed; Sayed, Hossam El-Dien Hany; Mobark, Fahmy Abdel Aal

doi:10.21608/asdj.2024.325910.1554

Evaluation of the Accuracy of Zygomatic Implant Placement Using CAD/CAM Guides in Patients with Post Maxillectomy Defects

Document Type : Original articles

Authors

¹ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt

² Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Ain-Shams University.

³ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt

10.21608/asdj.2024.325910.1554

Abstract

Aim: This prospective clinical study aimed to assess the accuracy of computer-guided preoperative planning for zygomatic implant positioning in post-maxillary resection patients.
Materials and Methods: Patients who had undergone partial or total maxillectomy and needed to rehabilitate their maxilla were enrolled based on eligibility criteria. Those patients underwent thorough full-skull multislice computed tomography (MSCT) scans to assess the condition of their maxilla and zygoma before undergoing zygomatic implant placement. Based on these scans, an individualized surgical plan was developed for each patient. The patients were undergoing zygomatic implant placement. The patients underwent another post-operative MSCT scan compared to the preoperative scan to assess the study outcomes.
Results: Four patients (one female and three male) aged 30 to 50 and in good physical health were seeking oral rehabilitation following maxillary resections. This study involved placing ten zygomatic implants in four patients; all patients received two zygomatic implants, except one patient, who only had four implants. The surgical procedures were completed without any significant issues. No significant differences existed between the virtual-planned and real-placed implants in all planes (p≥0.05). The average direct linear deviation was 6.88 ±4.45mm at the entry point and 4.27 ±2.45mm at the exit point, indicating no significant differences between the two points. The average angular deviation was 10.01° ±7.59 for anterior implants and 9.57° ±6.44 for posterior implants.
Conclusion: With the study’s limitations, virtual surgical planning and computer-guided templates consistently led to reliable and predictable outcomes for zygomatic implant placements while avoiding risks of negative consequences.

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