Accuracy of a novel minimally invasive registration method for dynamic navigation-assisted zygomatic implant surgery: a pilot prospective single-arm study.

This prospective single-arm study enrolled 10 patients with 33 zygomatic implants (ZIs) to prospectively evaluate the accuracy of a novel minimally invasive registration method for dynamic navigation-assisted ZI placement. A patient-specific minimally invasive registration plate was designed, featuring a base plate fixed with four pins and bilateral wings to position registration points adjacent to the zygomatic bone. Intraoperative registration was performed using this plate during dynamic navigation-guided ZI surgery. Postoperative cone-beam computed tomography was utilized to quantify trueness (deviation from planned position) and precision (inter-implant variability) of ZI placement. Statistical significance was set at P < 0.05. Mean deviations of ZIs at the platform, apex, and angle were 1.98 ± 0.84 mm, 1.55 ± 0.52 mm, and 2.3 ± 0.93°, respectively. The maximum deviation at apex was 2.68 mm. The precision measurements (inter-implant distances) were 0.97 ± 0.68 mm, 0.6 ± 0.43 mm, and 1.06 ± 0.78°, respectively. No significant differences in trueness were observed between left/right or mesial/distal implant subgroups (P > 0.05). No intraoperative or postoperative complications occurred, with a 100% implant survival rate over a mean follow-up of 3.21 ± 3.07 months. As the first clinical evaluation of this minimally invasive registration plate for ZI placement, the study confirms its feasibility and precision. The technique may enhance the safety, predictability, and accuracy of zygomatic implant procedures, warranting further validation in larger cohorts.