Dynamic-Assisted Navigational System in Zygomatic Implant Surgery: A Qualitative and Quantitative Systematic Review of Current Clinical and Cadaver Studies.

PURPOSE: The goal of this systematic review is to assess the accuracy and complications (including failure) of dynamic navigation in placing zygomatic implants. METHODS: PubMed, Cochrane Library (CENTRAL), trial register (clinicaltrial.gov), and Google Scholar were searched systematically up to May 2020. In addition, the reference lists of included systematic reviews were hand searched. The New Castle Ottawa and Joanna Briggs Institute Critical Appraisal Checklist for Case Reports were used for quality assessment. RESULTS: Ninety-four studies were assessed, and finally, 12 articles were included. According to Joanna Briggs Institute tool, the mean score of case reports (+/-standard deviation) was 6.4 (range, 5/9 to 8/9) and the mean score of observational studies (+/-standard deviation) was 5.66 (range, 5/9 to 7/9) as measured by New Castle Ottawa tool. Included materials pointed out that higher accuracy and drastic cut down on the risk of perioperative/postoperative complications were reported by using the dynamic navigation system compared with freehand implant placement. CONCLUSIONS: Application of dynamic navigation systems is a reliable technology for zygomatic implant placement, especially in difficult cases with a history of maxillary deficiency. Evidence of reliability and accuracy of dynamic navigation technique in multicenter large randomized and prospective controlled studies is still lacking.