The influence of preoperative planning on the accuracy of dynamic navigation-assisted zygomatic implant placement: a retrospective study.

This study was designed to investigate the correlation between preoperative planning-related factors and the accuracy of dynamic navigation-assisted zygomatic implant placement. Data were collected from patients who underwent dynamic navigation-assisted zygomatic implant placement between 2019 and 2024. Preoperative planning-related factors, including the density and engagement of the alveolar and zygomatic bone, type of zygomatic anatomy-guided approach, implant strategy, and implant site, were recorded, and the deviations of entry, exit, and angle were measured. Correlations between the preoperative planning-related factors and surgical deviations were analysed using generalized estimating equations. In addition, mechanical and biological complications were recorded during the postoperative follow-up. Fifty-four zygomatic implants were placed in 23 patients using a dynamic navigation system. The maximum entry, exit, and angle deviation was 5.18 mm, 8.99 mm, and 8.71°, respectively. Zygoma engagement was significantly correlated with entry deviation (P = 0.010). Furthermore, the implant site (anterior/posterior) was significantly correlated with angle deviation (P = 0.005). However, the effects of the other factors on the deviations were not significant. Dynamic navigation-assisted zygomatic implant placement is a reliable surgical approach. Nevertheless, attention should be paid to long zygoma engagement and posterior implant placement, as these factors may cause greater surgical deviations.