title: Accuracy of a flapless protocol for computer-guided zygomatic implant placement in human cadavers: expectations and reality.
abstract: BACKGROUND
  This work evaluated the accuracy and safety of a protocol for minimally-invasive flapless zygomatic implant placement that uses computer-guided stereolithographic mucosa-supported surgical templates.
  
  
  METHODS
  A total of six zygomatic implants were placed in three formalin-fixed human cadaver heads, with edentulous and severely atrophic posterior maxillae. CT scans of each cadaver head were performed after zygomatic implant placement, to evaluate the lateral error (LE) at implant tip and base, and the angular error (AE) of the implant body.
  
  
  RESULTS
  Excluding the implant placed outside the drilling channel, the LE at the implant base was less than 1 mm in all cases. The average LE at the tip was 3.86 mm, and the AE was less than 6° in all cases, with an average of 4.5°.
  
  
  CONCLUSIONS
  Computer-guided minimally-invasive flapless zygomatic implant surgery remains challenging. Careful planning and perfect stability of the surgical guide are essential.
authors.affiliation: University of Genoa.
authors.forename: Guido
authors.initials: G
authors.lastname: Schiroli
authors.affiliation: University of Genoa.
authors.forename: Francesca
authors.initials: F
authors.lastname: Angiero
authors.affiliation: Department of Cranio-Maxillo-Facial Surgery, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Antoniettel
authors.initials: A
authors.lastname: Zangerl
authors.affiliation: University of Genoa.
authors.forename: Stefano
authors.initials: S
authors.lastname: Benedicenti
authors.affiliation: University of Genoa.
authors.forename: Franco
authors.initials: F
authors.lastname: Ferrante
authors.affiliation: Section of Microinvasive Therapy, Department of Radiology, Innsbruck, Austria.
authors.forename: Gerlig
authors.initials: G
authors.lastname: Widmann
mesh_terms: D002102:Cadaver; D003757:Dental Implantation / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D015050:Zygoma / Q000601:surgery*
keywords: flapless protocol; zygomatic implant