Reliability and accuracy of dynamic navigation for zygomatic implant placement

Abstract

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.