Dynamic Navigation for Zygomatic Implant Rehabilitation Using an Intraoral Reference System: Evaluation of a New Zygomatic Implant Design

Inclusion Criteria: Patients requiring partial or full rehabilitation of the atrophic maxilla Candidates for placement of at least one zygomatic implant per side (right and left), connected to at least one standard or zygomatic implant Severe maxillary atrophy confirmed by CT scan, with insufficient bone for conventional implants or only sufficient bone for 2 frontal implants (minimum diameter 3.5 mm, length 8 mm) Residual alveolar crest height ≤ 4 mm beneath the maxillary sinus Age ≥ 18 years Signed informed consent Exclusion Criteria: General contraindications to oral surgery History of radiation therapy to the head and neck exceeding 70 Gy Compromised or suppressed immune system Current or past use of intravenous bisphosphonates Uncontrolled diabetes mellitus Alcohol or drug dependency Psychiatric disorders Pregnancy or breastfeeding Participation in other clinical trials Inability to attend a 5-year follow-up Limited mouth opening (\< 3.5 cm interincisal distance) Absence of opposing dentition or lower prosthesis Acute or chronic infection in the intended implant site Untreated active periodontal disease Poor oral hygiene motivation Radiographic signs of sinus membrane inflammation or ostium obstruction