Purpose: The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided surgery (s-CAIS), and a free-hand approach in patients with severe atrophic edentulous maxilla and/or deficient maxilla. Methods: Electronic and manual literature searches until May 2023 were performed in the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases. Clinical trials and cadaver studies were selected. The primary outcome was planned/placed deviation. Secondary outcomes were to evaluate the survival of ZI and surgical complications. Random-effects meta-analyses were conducted and meta-regression was utilized to compare fiducial registration amounts for d-CAIS and the different designs of s-CAIS. Results: A total of 14 studies with 511 ZIs were included (Nobel Biocare: 274, Southern Implant: 42, SIN Implant: 16, non-mentioned: 179). The pooled mean ZI deviations from the d-CAIS group were 1.81 mm (95% CI: 1.34–2.29) at the entry point and 2.95 mm (95% CI: 1.66–4.24) at the apex point, and angular deviations were 3.49 degrees (95% CI: 2.04–4.93). The pooled mean ZI deviations from the s-CAIS group were 1.19 mm (95% CI: 0.83–1.54) at the entry point and 1.80 mm (95% CI: 1.10–2.50) at the apex point, and angular deviations were 2.15 degrees (95% CI: 1.43–2.88). The pooled mean ZI deviations from the free-hand group were 2.04 mm (95% CI: 1.69–2.39) at the entry point and 3.23 mm (95% CI: 2.34–4.12) at the apex point, and angular deviations were 4.92 degrees (95% CI: 3.86–5.98). There was strong evidence of differences in the average entry, apex, and angular deviation between the navigation, surgical guide, and free-hand groups (p < 0.01). A significant inverse correlation was observed between the number of fiducial screws and the planned/placed deviation regarding entry, apex, and angular measurements. Conclusion: Using d-CAIS and modified s-CAIS for ZI surgery has shown clinically acceptable outcomes regarding average entry, apex, and angular deviations. The maximal deviation values were predominantly observed in the conventional s-CAIS. Surgeons should be mindful of potential deviations and complications regardless of the decision making in different guide approaches.
9 September 2024 in Journal of Periodontal Research
Background/Objectives: Oral biomarkers have gained attention as non-invasive tools for assessing systemic diseases due to their potential to reflect physiological and pathological conditions. This review aims to explore the role of oral biomarkers in diagnosing and monitoring systemic diseases, emphasizing their diagnostic relevance and predictive capabilities in clinical practice. Methods: This narrative review synthesizes the current literature on biochemical, immunological, genetic, and microbiological oral biomarkers, with a focus on their sources, types, and clinical applications. Key studies were analyzed to identify associations between oral biomarkers and systemic diseases such as cardiovascular diseases, type 2 diabetes mellitus, autoimmune disorders, and cancers. Results: Oral fluids, including saliva and gingival crevicular fluid, contain diverse biomarkers such as matrix metalloproteinases, cytokines, and genetic indicators. These markers have demonstrated potential in diagnosing and monitoring systemic conditions. Among others, elevated levels of salivary glucose and inflammatory cytokines correlate with diabetes progression, while vascular endothelial growth factor (VEGF) and salivary C-reactive protein might be applicable as indicators for periodontal disease and cardiovascular risk. Additionally, salivary biomarkers like amyloid-beta and tau are promising in detecting neurodegenerative disorders. Conclusions: Oral biomarkers might represent a transformative and point-of-care approach to the early management of systemic diseases; however, challenges in measurement variability, standardization, and validation remain.
19 June 2023 in Clinical Implant Dentistry and Related Research