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Wang W, Yu X, Wang F, Wu Y. Clinical efficacy of computer-assisted zygomatic implant surgery: A systematic scoping review. J Prosthet Dent 2023:S0022-3913(23)00717-5. [PMID: 38007293 DOI: 10.1016/j.prosdent.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/27/2023]
Abstract
STATEMENT OF PROBLEM Digital technology can improve the success of zygomatic implant (ZI) surgery. However, the reliability and efficacy of computer-assisted zygomatic implant surgery (CAZIS) need further analysis. PURPOSE The purpose of this scoping review was to provide an overview of the placement accuracy, implant survival, and complications of CAZIS. MATERIAL AND METHODS A systematic search of English and Mandarin Chinese publications up to May 2023 was conducted in PubMed, Web of Science, Embase, and Wanfang database. The nonpeer-reviewed literature was searched in the trial register (clinicaltrials.gov). Clinical studies and cadaver studies on CAZIS were included. After data extraction and collection, the findings were critically reviewed, analyzed, interpreted, and discussed. RESULTS Forty-one studies met the inclusion criteria. After excluding publications with duplicate data, retaining the most recent, 28 articles were included in this scoping review. Of these, 18 were on static computer-assisted zygomatic implant surgery (sCAZIS), 8 on dynamic computer-assisted zygomatic implant surgery (dCAZIS), and 2 on robot-assisted zygomatic implant surgery (rAZIS). Excluding the outliers, the mean deviations of ZIs in the sCAZIS group (with 8 articles reporting implant placement accuracy, 183 ZIs involved) were: 1.15 ±1.37 mm (coronal deviation), 2.29 ±1.95 mm (apical deviation), and 3.32 ±3.36 degrees (angular deviation). The mean deviations of dCAZIS (3 articles, 251 ZIs) were: 1.60 ±0.74 mm (coronal), 2.27 ±1.05 mm (apical), and 2.89 ±1.69 degrees (angular). The mean deviations of rAZIS (2 articles, 5 ZIs) were: 0.82 ±0.21 mm (coronal), 1.25 ±0.52 mm (apical), and 1.46 ±0.35 degrees (angular). Among the CAZIS reported in the literature, the implant survival rate was high (96.3% for sCAZIS, 98.2% for dCAZIS, and 100% for rAZIS, specified in 14 of 21 clinical studies). The incidence of complications was low, but, because of the few relevant studies (4/21 specified), valid conclusions regarding complications could not be drawn. CONCLUSIONS CAZIS has demonstrated clinical efficacy with high implant survival rates and placement accuracy. Of the 3 guided approaches, rAZIS showed the smallest 3-dimensional deviation.
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Affiliation(s)
- Wenying Wang
- Graduate student, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Xinbo Yu
- Undergraduate student, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Feng Wang
- Professor, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Yiqun Wu
- Professor, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China.
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Kachlan MO, Yang J, Balshi TJ, Wolfinger GJ, Balshi SF. Incidental Findings in Cone Beam Computed Tomography for Dental Implants in 1002 Patients. J Prosthodont 2021; 30:665-675. [PMID: 33433043 DOI: 10.1111/jopr.13329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The purpose of this study is to analyze the frequency and elevate the awareness of the prevalence of nondental pathology in cone beam computed tomography (CBCT) scans taken for implant placement treatment planning and postplacement evaluation. The data from the CBCT should be read by an oral and maxillofacial radiologist for proper diagnosis of dental and nondental pathology and referred to the medical specialist for proper management when necessary. MATERIALS AND METHODS This retrospective study analyzed 1002 consecutive CBCT scans taken at a single private practice noting the prevalence of nondental pathology in CBCT images for all dental implant procedures. All scans were taken from November 2007 to March 2020. One board certified oral and maxillofacial radiologist systemically read all scans and reported all findings in the maxilla and mandible, condyles and TMJ, paranasal sinuses, nasal fossa, pharyngeal airway, skull base and temporal bone, neck soft tissues, and cervical spine. The incidental findings, variation of normal anatomy, or pathology reported in these structures were categorized based on anatomic location and significance and the incidence was investigated. RESULTS Pathologies ranged from innocuous sinusitis, to more serious atherosclerotic calcification of the carotid arteries, narrowed airways, and neoplastic lesions. Fifty-one different findings were noted, of which 36 were pathologies that required referral or follow-up. CONCLUSIONS Incidental findings can be detected in CBCT scans for dental implants. The clinician must be familiar with the radiographic diagnosis of head and neck pathology, and/or must refer these images to an appropriate specialist for the radiographic interpretation of the full volume.
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Affiliation(s)
| | - Jie Yang
- Department of Oral Pathology, Medicine, & Surgery, Temple University Kornberg School of Dentistry, Philadelphia, PA
| | - Thomas J Balshi
- Department of Prosthodontics, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL
| | | | - Stephen F Balshi
- Biomedical Engineering & Research, Pi Dental Center, Fort Washington, PA
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Araujo RZ, Santiago Júnior JF, Cardoso CL, Benites Condezo AF, Moreira Júnior R, Curi MM. Clinical outcomes of pterygoid implants: Systematic review and meta-analysis. J Craniomaxillofac Surg 2019; 47:651-660. [PMID: 30799134 DOI: 10.1016/j.jcms.2019.01.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/21/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022] Open
Abstract
The aim of this systematic literature review was to analyze clinical outcomes of pterygoid implant for the treatment of patients with atrophic posterior maxillae and to provide clinical recommendations for this dental implant technique. An extensive search of electronic databases (PubMed/Medline, Science Direct, Lilacs, Embase, and Cochrane Library) was conducted, for articles published between January 1995 and January 2018, to identify literature presenting clinical outcomes of pterygoid implants in the treatment of patients with atrophic posterior maxillae. The systematic review was performed in accordance with PRISMA/PICO statement guidelines, and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk of implant failure was analyzed within a 95% confidence interval (95% CI). After screening 331 abstracts from the electronic databases, 36 full-text articles were accessed for eligibility, and a total of 6 studies were included in this systematic review (after applying the inclusion and exclusion criteria). All studies were retrospective in nature and were classified with a poor level of evidence. A total of 634 patients received 1.893 pterygoid implants, with a mean implant survival rate of 94.87%. The mean prevalence of implant failure was 0.056 with a 95% CI of 0.04-0.077. This study demonstrates that pterygoid implants can be successfully used in patients with atrophic posterior maxilla. However, the results should be interpreted with caution, given the presence of uncontrolled confounding factors in the included studies.
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Affiliation(s)
- Rafael Zetehaku Araujo
- Department of Oral Implantology and Dental Prosthesis, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | | | - Camila Lopes Cardoso
- Department of Oral Implantology, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | | | - Rosenvaldo Moreira Júnior
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | - Marcos Martins Curi
- Department of Oral and Maxillofacial Surgery, Hospital Santa Catarina, São Paulo, Brazil
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Peñarrocha D, Candel E, Guirado JLC, Canullo L, Peñarrocha M. Implants placed in the nasopalatine canal to rehabilitate severely atrophic maxillae: a retrospective study with long follow-up. J ORAL IMPLANTOL 2015; 40:699-706. [PMID: 23397941 DOI: 10.1563/aaid-joi-d-12-00145] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients with atrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between 2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell's class V) rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. A preoperative computed tomography scan was obtained of all patients and all surgeries were performed by the same surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using the pointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al; patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a mean age of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatine canal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 in other locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, which disappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures (after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of 84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with the prosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease of cleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy. This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patients using implant-supported prostheses.
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Affiliation(s)
- David Peñarrocha
- 1 Department of Stomatology, Valencia University Medical and Dental School
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Wen H, Guo W, Liang R, Xiang L, Long G, Wang T, Deng M, Tian W. Finite element analysis of three zygomatic implant techniques for the severely atrophic edentulous maxilla. J Prosthet Dent 2014; 111:203-15. [PMID: 24314571 DOI: 10.1016/j.prosdent.2013.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 05/10/2013] [Accepted: 05/16/2013] [Indexed: 01/13/2023]
Abstract
STATEMENT OF PROBLEM A variety of zygomatic implantation techniques currently exist; however, a consensus regarding the most suitable method has not yet been reached. PURPOSE The purpose of this study was to evaluate and compare 3 zygomatic implantation techniques and to clarify the optimal number and position of zygomatic and dental implants for the reconstruction of the severely atrophied edentulous maxilla. MATERIAL AND METHODS A 3-dimensional finite element analysis craniofacial model was constructed from the computed tomography data of a selected patient with a severely atrophic edentulous maxilla. Modeled zygomatic implants were inserted into the craniofacial model with 3 surgical techniques (classic Brånemark, exteriorized, and extramaxillary), and with 3 model variations that involved the number and position of zygomatic and dental implants. The zygomatic implants were loaded with a vertical force of 150 N and a lateral force of 50 N. The stresses on and deformations of the bones and implants were then observed and compared. RESULTS No obvious differences in the amount and distribution of stress on the external craniofacial bones were detected in the models. The lowest stresses on the zygomatic implants were observed in the exteriorized technique group. The lowest deformations of the bone that surrounds zygomatic implants and dental implants were observed in the exteriorized technique and classic Brånemark technique groups. For the exteriorized technique group, the model with 1 dental implant in the site of the maxillary lateral incisor exhibited the lowest stress on the zygomatic implants and the least deformation of the bone surrounding the zygomatic and dental implants. CONCLUSIONS All 3 zygomatic implant techniques resulted in more or less homogeneous transference of force and thus could reconstruct the edentulous maxilla; however, the exteriorized technique with 1 dental implant in the lateral incisor appeared to be the most appropriate reconstruction method for the severely atrophied edentulous maxilla.
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Affiliation(s)
- Hailin Wen
- Postgraduate student, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University; National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weihua Guo
- Associate Professor, Department of Pedodontics, West China College of Stomatology, Sichuan University; National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rui Liang
- Postgraduate student, College of Architecture and Environment, Sichuan University; National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Xiang
- Postgraduate student, Department of Implantology, West China College of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Gang Long
- Postgraduate student, Department of Implantology, West China College of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tingting Wang
- Postgraduate student, Department of Endodontics, West China College of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Meng Deng
- Postgraduate student, Department of Endodontics, West China College of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weidong Tian
- Professor and Director, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University; National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Farret MM, Farret MM, Carlesso J, Carlesso O. Orthodontic treatment and implant-prosthetic rehabilitation of a partially edentulous patient. J Prosthodont 2013; 22:587-590. [PMID: 23551750 DOI: 10.1111/jopr.12033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 11/25/2022] Open
Abstract
This article describes the treatment of a 61-year-old man who had a completely edentulous maxillary arch and partially edentulous mandibular arch. The patient was orthodontically treated to correct an anterior crossbite by distalization of the mandibular teeth using a removable prosthesis serving as an anchorage unit. Subsequently, the patient received two zygomatic implants, five conventional implants in the maxillary arch, and six conventional implants in the mandibular arch. By the end of treatment, the convexity of the facial profile improved, and esthetic and functional occlusion was established.
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Affiliation(s)
- Milton Mb Farret
- Department of Orthodontics, Federal University of Santa Maria, Santa Maria, Brazil
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Balshi TJ, Wolfinger GJ, Shuscavage NJ, Balshi SF. Zygomatic Bone-to-Implant Contact in 77 Patients With Partially or Completely Edentulous Maxillas. J Oral Maxillofac Surg 2012; 70:2065-9. [DOI: 10.1016/j.joms.2012.05.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 05/07/2012] [Accepted: 05/09/2012] [Indexed: 01/31/2023]
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