title: Accuracy of a real-time surgical navigation system for the placement of quad zygomatic implants in the severe atrophic maxilla: A pilot clinical study.
abstract: BACKGROUND
  A real-time surgical navigation system potentially increases the accuracy when used for quad-zygomatic implant placement.
  
  
  OBJECTIVE
  To evaluate the accuracy of a real-time surgical navigation system when used for quad zygomatic implant placement.
  
  
  METHODS
  Patients with severely atrophic maxillae were prospectively recruited. Four trajectories for implants were planned, and zygomatic implants were placed using a real-time surgical navigation system. The planned-placed distance deviations at entry (entry deviation）points, exit (exit deviation) points, and angle deviation of axes (angle deviation) were measured on fused operation images. The differences of all the deviations between different groups, classified based on the lengths and locations of implants, were analysed. A P value of < 0.05 indicated statistical significance.
  
  
  RESULTS
  Forty zygomatic implants were placed as planned in 10 patients. The entry deviation, exit deviation and angle deviation were 1.35 ± 0.75 mm, 2.15 mm ± 0.95 mm, and 2.05 ± 1.02 degrees, respectively. The differences of all deviations were not significant, irrespective of the lengths (P = .259, .158, and .914, respectively) or locations of the placed implants (P = .698, .072, and .602, respectively).
  
  
  CONCLUSIONS
  A real-time surgical navigation system used for the placement of quad zygomatic implants demonstrated a high level of accuracy with only minimal planned-placed deviations, irrespective of the lengths or locations of the implants.
authors.affiliation: Department of Oral-Maxillofacial Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
authors.forename: Kuo-Feng
authors.initials: KF
authors.lastname: Hung
authors.affiliation: Department of Oral-Maxillofacial Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Oral-Maxillofacial Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Wang
authors.affiliation: Department of Oral-Maxillofacial Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Zhou
authors.affiliation: Department of Oral-Maxillofacial Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Oral-Maxillofacial Implantology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
authors.forename: Yi-Qun
authors.initials: YQ
authors.lastname: Wu
mesh_terms: D001284:Atrophy; D006801:Humans; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008439:Maxillary Diseases / Q000601:surgery*; D010865:Pilot Projects; D019736:Prostheses and Implants; D015050:Zygoma / Q000601:surgery*
keywords: accuracy; computer-assisted surgery; edentulous maxilla; real-time surgical navigation system; zygomatic implants