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Yu Z, Guo H, Han W, Jiang X, Lin Y. Peri-zygomatic complications on zygomatic implants with or without penetrating the external surface of zygoma: A 2-year retrospective study. Clin Implant Dent Relat Res 2024; 26:197-205. [PMID: 37674300 DOI: 10.1111/cid.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/29/2023] [Accepted: 08/14/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES The main purpose of this retrospective study was to assess the difference in the incidence of peri-zygomatic complications (PZCs) when zygomatic implants (ZIs) penetrate or do not penetrate the external surface of zygoma. MATERIALS AND METHODS This study included 32 patients with edentulous maxillae or potentially edentulous maxillae undergo zygomatic implantation. The patients were divided into the penetration group (P-group) and the non-penetration group (N-group) according to whether the apex of implants penetrated the external surface of zygoma in postoperative CBCT. The extension length, the penetration section of the implants, and the skin thickness at the corresponding position were simultaneously measured. Clinical follow-up was conducted regularly until 2 years after surgery. The occurrence of PZCs (including peri-zygomatic infection, skin numbness, non-infectious pain, and foreign body sensation) was recorded. A mixed effect logistic model was used to compare the difference of complication rate between the P-group and the N-group, and odds ratio (OR) was calculated. Then identify the impact of the extension length, penetration section and skin thickness in P-group with the same model. RESULTS A total of 71 ZIs were implanted in 32 patients, including 37 implants in the P-group and 34 implants in the N-group. During the 2-year follow-up, a total of 13 implants occurred PZCs, with an overall complication rate of 18.3%. Thereinto, the incidence rate was 29.7% in the P-group, and 5.9% in the N-group (OR = 6.77). In P-group, there was a significant difference in complication rate of different extension lengths, while the penetration section and skin thickness had no statistical significance on the complication rate. CONCLUSION Under the limitation of this study, to minimize the risk of PZCs, ZI should be placed in a manner that avoids the apex penetrating the external surface of the zygoma.
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Affiliation(s)
- Ziyang Yu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Houzuo Guo
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Weihua Han
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease, Beijing, China
| | - Xi Jiang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Jain DK, Pal U, Mohammad S, Mehrotra D, Katrolia R, Shandilya S, Yadav L, Tiwari AK. Comparative evaluation of extrasinus versus intrasinus approach for zygomatic implant placement. J Oral Biol Craniofac Res 2022; 12:863-872. [PMID: 36212616 PMCID: PMC9535122 DOI: 10.1016/j.jobcr.2022.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Edentulism, a common problem can occur either as a congenital defect or acquired later due to dental caries, periodontitis, as a consequence of aging, maxillofacial trauma or post-ablation in tumor resections. The rehabilitation of the missing teeth can be done using dental implants. To overcome the deficiency of available bone, processes like sinus augmentation with substituted bone graft and Le Fort I osteotomy with interpositional bone graft have been described in the literature. In order to overcome the associated limitations with these procedures, implants were designed that can be placed in specific anatomical areas like zygoma. This study aims to compare two different types of surgical approaches (Intrasinus vs Extrasinus) for the placement of zygomatic implants to treat atrophic maxilla. The placement of zygomatic implant through both extrasinus and intrasinus approaches were evaluated on the basis of different parameters and it was observed that postoperative pain and swelling was significantly found in intra sinus approach as compared to extra sinus approach. However, in the intranasal approach, poor patient compliance or low satisfaction rate was observed as compared to extra sinus approach. On the basis of the results of the study and post operative evaluation based on various criteria, it was concluded that extra sinus approach has got an edge over intra sinus approach.
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Affiliation(s)
- Deepika Kumari Jain
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - U.S. Pal
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shadab Mohammad
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Divya Mehrotra
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ravi Katrolia
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Saatvik Shandilya
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Lakshya Yadav
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Arunesh Kumar Tiwari
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Bryanskaya EO, Novikova IN, Dremin VV, Gneushev RY, Bibikova OA, Dunaev AV, Artyushenko VG. Optical Diagnostics of the Maxillary Sinuses by Digital Diaphanoscopy Technology. Diagnostics (Basel) 2021; 11:diagnostics11010077. [PMID: 33418891 PMCID: PMC7825049 DOI: 10.3390/diagnostics11010077] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 02/03/2023] Open
Abstract
The work is devoted to the development of a scientific and technical basis for instrument implementation of a digital diaphanoscopy technology for the diagnosis of maxillary sinus inflammatory diseases taking into account the anatomical features of patients (differences in skin structure, skull bone thickness, and sinus size), the optical properties of exercised tissues, and the age and gender characteristics of patients. The technology is based on visualization and analysis of scattering patterns of low-intensity radiation as it passes through the maxillary sinuses. The article presents the experimental data obtained using the digital diaphanoscopy method and the results of numerical simulation of the optical radiation passage through the study area. The experimental setup has been modernized through the installation of a a device for controlling the LED applicator brightness. The approach proposed may have considerable promise for creating diagnostic criteria for various pathological changes and can be used to assess the differences in the optical and anatomical features of males and females.
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Affiliation(s)
- Ekaterina O. Bryanskaya
- R&D Center of Biomedical Photonics, Orel State University, Orel 302026, Russia; (I.N.N.); (V.V.D.); (R.Y.G.); (A.V.D.)
- Correspondence: ; Tel.: +7-980-366-29-12
| | - Irina N. Novikova
- R&D Center of Biomedical Photonics, Orel State University, Orel 302026, Russia; (I.N.N.); (V.V.D.); (R.Y.G.); (A.V.D.)
| | - Viktor V. Dremin
- R&D Center of Biomedical Photonics, Orel State University, Orel 302026, Russia; (I.N.N.); (V.V.D.); (R.Y.G.); (A.V.D.)
- College of Engineering and Physical Sciences, Aston University, Birmingham B4 7ET, UK
| | - Roman Yu. Gneushev
- R&D Center of Biomedical Photonics, Orel State University, Orel 302026, Russia; (I.N.N.); (V.V.D.); (R.Y.G.); (A.V.D.)
| | | | - Andrey V. Dunaev
- R&D Center of Biomedical Photonics, Orel State University, Orel 302026, Russia; (I.N.N.); (V.V.D.); (R.Y.G.); (A.V.D.)
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Stephens H, Deans C, Schlect D, Kairn T. Development of a method for treating lower-eyelid carcinomas using superficial high dose rate brachytherapy. Phys Eng Sci Med 2020; 43:1317-1325. [PMID: 33123861 DOI: 10.1007/s13246-020-00935-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 10/03/2020] [Indexed: 11/26/2022]
Abstract
In this study, a method was developed for delivering high dose rate (HDR) brachytherapy treatments to basal cell carcinomas (BCCs) as well as squamous cell carcinomas (SCCs) of the lower eyelid via superficial catheters. Clinically-realistic BCC/SCC treatment areas were marked in the lower-eyelid region on a head phantom and several arrangements of catheters and bolus were trialled for treating those areas. The use of one or two catheters of different types was evaluated, and sources of dosimetric uncertainty (including air gaps) were evaluated and mitigated. Test treatments were planned for delivery with an iridium-192 source, using the Oncentra Brachy treatment planning system (Elekta AB, Stockholm, Sweden). Dose distributions were evaluated using radiochromic film. The proposed method was shown to be clinically viable, for using superficial HDR brachytherapy to overcome anatomical difficulties and create non-surgical treatments for BCC and SCC of the lower eyelid.
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Affiliation(s)
- H Stephens
- Chermside Medical Complex, Ground Floor, 956 Gympie Road, Chermside, Qld, 4032, Australia.
- School of Physical Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia.
| | - C Deans
- Chermside Medical Complex, Ground Floor, 956 Gympie Road, Chermside, Qld, 4032, Australia
- Icon Integrated Cancer Centre, 9 McLennan Ct, North Lakes, Qld, 4509, Australia
| | - D Schlect
- Chermside Medical Complex, Ground Floor, 956 Gympie Road, Chermside, Qld, 4032, Australia
| | - T Kairn
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Qld, 4029, Australia
- Science and Engineering Faculty, Queensland University of Technology, Gardens Point, Qld, 4001, Australia
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Pellegrino G, Grande F, Ferri A, Pisi P, Gandolfi MG, Marchetti C. Three-Dimensional Radiographic Evaluation of the Malar Bone Engagement Available for Ideal Zygomatic Implant Placement. Methods Protoc 2020; 3:mps3030052. [PMID: 32707931 PMCID: PMC7564428 DOI: 10.3390/mps3030052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/11/2020] [Accepted: 07/21/2020] [Indexed: 12/27/2022] Open
Abstract
Zygomatic implant rehabilitation is a challenging procedure that requires an accurate prosthetic and implant plan. The aim of this study was to evaluate the malar bone available for three-dimensional zygomatic implant placement on the possible trajectories exhibiting optimal occlusal emergence. After a preliminary analysis on 30 computed tomography (CT) scans of dentate patients to identify the ideal implant emergencies, we used 80 CT scans of edentulous patients to create two sagittal planes representing the possible trajectories of the anterior and posterior zygomatic implants. These planes were rotated clockwise on the ideal emergence points and three different hypothetical implant trajectories per zygoma were drawn for each slice. Then, the engageable malar bone and intra- and extra-sinus paths were measured. It was possible to identify the ideal implant emergences via anatomical landmarks with a high predictability. Significant differences were evident between males and females, between implants featuring anterior and those featuring posterior emergences, and between the different trajectories. The use of internal trajectories provided better bone engagement but required a higher intra-sinus path. A significant association was found between higher intra-sinus paths and lower crestal bone heights.
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Affiliation(s)
- Gerardo Pellegrino
- Oral and Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy; (A.F.); (C.M.)
- Correspondence: ; Tel.: +39-051-208-8157
| | - Francesco Grande
- Oral Surgery Unit, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy;
| | - Agnese Ferri
- Oral and Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy; (A.F.); (C.M.)
| | - Paolo Pisi
- Dental Radiology Unit, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy;
| | - Maria Giovanna Gandolfi
- Medical-technical Science, Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy;
| | - Claudio Marchetti
- Oral and Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy; (A.F.); (C.M.)
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Aleksandrowicz P, Kusa-Podkańska M, Tomkiewicz W, Kotuła L, Perek J, Wysokińska-Miszczuk J. Platform switch hybrid zygoma implants improve prosthetics and marginal bone protection after extra-sinus placement. Clin Implant Dent Relat Res 2020; 22:186-192. [PMID: 32043837 PMCID: PMC7187363 DOI: 10.1111/cid.12878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of our studdy is clinical evaluation of Platform switch hybrid zygoma implants. MATERIALS AND METHODS 117 zygomatic implants were followed up during this time. They included 55 Brånemark System zygoma implants, 38 Noris implants, and 24 novel iRES hybrid implants with platform switch. RESULTS Bone quality and quantity are the prerequisite for successful implant treatment. Zygomatic implants are intended for patients with severely resorbed maxilla that cannot accommodate conventional implants without prior extensive bone grafting. Such regenerative procedures, like sinus lifts, prolong implant rehabilitation to several months (12-18). Furthermore, extensive grafts are less predictable showing varying degrees of graft resorption. Zygoma implants enable full, often immediate, reconstruction of the upper dental arch without the need for sinus lift treatment. The original zygoma protocol runs the implants through the sinus, requires general anesthesia, and positions the prosthetic platform of the implants on the palate, which makes prosthesis cumbersome. It also induces risk for post-op sinusitis. Extra-sinus approach with novel zygoma hybrid implants bypasses sinuses and positions the implant prosthetic platform on the crest allowing for same good prosthetics as on conventional dental implants. Furthermore, crestal threads and a platform-switch, of the novel zygoma design, increase implant anchorage and minimize marginal bone loss. The study presents evolution of zygoma implant rehabilitation protocol and zygoma implant design in our clinical practice over 15 years (2004-2019). CONCLUSION Extra-sinus zygomatic implant placement lowers the risk of post-op sinusitis and makes procedure possible to be done in local anesthesia.
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Affiliation(s)
| | | | - Witold Tomkiewicz
- Departament of Oral Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Kotuła
- Department of Clinical Genetics, Medical University of Lublin, Lublin, Poland
| | - Jan Perek
- Departament of Oral Surgery, Medical University of Warsaw, Warsaw, Poland
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Stadlinger B, Valdec S, Wacht L, Essig H, Winklhofer S. 3D-cinematic rendering for dental and maxillofacial imaging. Dentomaxillofac Radiol 2019; 49:20190249. [PMID: 31356110 DOI: 10.1259/dmfr.20190249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Aim of this technical note is to show the applicability of cinematic rendering (CR) for a photorealistic 3-dimensional (3D) visualization of maxillofacial structures. The focus is on maxillofacial hard tissue pathologies. METHODS High density maxillofacial pathologies were selected in which CR is applicable. Data from both, CT and cone beam CT (CBCT) were postprocessed using a prototype CR software. RESULTS CR 3D postprocessing of CT and CBCT imaging data is applicable on high density structures and pathologies such as bones, teeth, and tissue calcifications. Image reconstruction allows for a detailed visualization of surface structures, their plasticity, and 3D configuration. CONCLUSIONS CR allows for the generation of photorealistic 3D reconstructions of high density structures and pathologies. Potential applications for maxillofacial bone and tooth imaging are given and examples for CT and CBCT images are displayed.
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Affiliation(s)
- Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, University of Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, University of Zurich, Switzerland
| | - Lorenz Wacht
- Department of Radiology and Nuclear Medicine, Triemli Hospital Zurich, Switzerland.,Department of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Harald Essig
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, University of Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
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