Two Digital Workflows for Immediate Zygomatic Implantation After Maxillary Tumor Resection in Different Defect Types.

Abstract

This report evaluates the feasibility and precision of 2 digital workflows for immediate zygomatic implant placement after maxillectomy. In 1 case, a unilateral defect was rehabilitated using dynamic navigation. In a second case, a bilateral defect with only 1 to 2 remaining teeth was treated with a dual-guide system stabilized with anchor pins. Both approaches integrated detailed virtual preoperative planning. All implants survived. Postoperative CT superimposition showed angular deviations under 5 degrees for all implants except 1. Translational deviations at the prosthetic platform ranged from 0.28 to 1.53 mm. Apical displacements ranged from 1.27 to 2.70 mm. In these 2 cases, the digital protocols helped preserve occlusal relationships. Dynamic navigation was advantageous when stable registration was possible using contralateral teeth and zygomatic bone. The anchor pin-based dual-guide system provided a solution for bilateral defects where few teeth remained after tumor resection. Whether these workflows reduce surgical interventions or shorten treatment time requires further investigation with larger samples. Both techniques may offer adaptable options for complex maxillary reconstruction, but broader validation is needed.