Survival Rate and Prosthetic and Sinus Complications of Zygomatic Dental Implants for the Rehabilitation of the Atrophic Edentulous Maxilla: A Systematic Review and Meta-Analysis

Abstract

The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Materials and methods: We conducted a systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Four databases were consulted during the literature search: Pubmed–Medline, Scopus, Embase, and Web of Science. After eliminating duplicate articles and applying the inclusion criteria, 46 articles were selected for the qualitative analysis and 32 for the quantitative analysis. Results: Four randomized controlled trials, 19 prospective clinical studies, 20 retrospective studies, and 3 case series were included in the meta-analysis. Conventional dental implants failure (n = 3549) were seen in 2.89% (IC-95% 1.83–3.96%), while zygomatic dental implants failure (n = 1895) were seen in 0.69% (IC-95% 0.21–1.16%). The measure of the effect size used was the Odds Ratio, which was estimated at 2.05 with a confidence interval of 95% between 1.22 and 3.44 (z test = 2.73; p-value = 0.006). The failure risk of conventional dental implants is 2.1 times higher than that of zygomatic dental implants. Slight heterogeneity was determined in the meta-analysis between 23 combined studies (Q test = 32.4; p-value = 0.070; I2 = 32.1%). Prosthetic complications were recorded in 4.9% (IC-95% 2.7–7.3%) and mild heterogeneity was observed in a meta-analysis of 28 combined studies (Q test = 88.2; p-value = 0.001; I2 = 69.4%). Sinus complications were seen in 4.7% (IC-95% 2.8–6.5%) and mild heterogeneity was observed in a meta-analysis of 32 combined studies (Q test = 75.3; p-value = 0.001; I2 = 58.8%). Conclusions: The high survival rate and low prosthetic and sinus complications related to zygomatic dental implants suggest the use of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla.

Assessment of the content and quality of YouTube videos related zygomatic implants: A content–quality analysis

“…Various bone augmentation procedures have been suggested which increase the bone level and allow rehabilitation with implant‐supported prostheses in cases of atrophic maxilla. These include grafting procedures, apposition graft with or without Le Fort I osteotomy, and sinus lift 3,4 . However, although most of these approaches have a high success rate (60%–90%), 4 they require two‐stage procedures, increasing the potential risk of postoperative complications 5 …”

“…Despite the advantages and success rates, complications associated with zygomatic implant treatment such as sinusitis, soft tissue infection, paresthesia, and orbital perforations can occur. However, the incidence of prosthetic complications is very low (4.9%) regardless of the type of prosthetic treatment 4 …”

“…These include grafting procedures, apposition graft with or without Le Fort I osteotomy, and sinus lift. 3,4 However, although most of these approaches have a high success rate (60%-90%), 4 they require twostage procedures, increasing the potential risk of postoperative complications. 5 Within the scope of recent developments in dentistry, zygomatic implants have been applied as an alternative to conventional methods in atrophic maxilla reconstruction.…”

“…However, the incidence of prosthetic complications is very low (4.9%) regardless of the type of prosthetic treatment. 4 Healthcare professionals and organizations have undertaken the task of providing support to patients via the sharing of medical information. However, due to recently increased access to the internet and patients' desire for education about their disease, there has been a significant increase in internet use by the public seeking medical information.…”

Accuracy of a Computer-Aided Dynamic Navigation System in the Placement of Zygomatic Dental Implants: An In Vitro Study

“…Specifically, ZIs provide a predictable treatment option that prevents long waiting times before prosthetic rehabilitation when compared with alternative techniques for conventional implant placement using grafting materials [ 3 ]. Additionally, a recent meta-analysis reported a failure rate of 2.89% (CI-95% 1.83–3.96%) associated with conventional-length dental implants ( n = 3549), while the failed implantation of ZIs ( n = 1895) had an estimated incidence rate of 0.69% (CI-95% 0.21–1.16%) over a follow-up period ranging from 3 to 163 months [ 4 ].…”