A s<scp>ingle‐arm</scp> clinical trial investigating the feasibility of the zygomatic implant quad approach for Cawood and Howell Class 4 edentulous maxilla: An option for immediate loading
Bibliographic record
Abstract
INTRODUCTION: The traditional way to treat maxillary edentulous Cawood and Howell Class 4 (CH4) patients who exhibit the knife-edge ridge form of edentulous jaws that are adequate in height and inadequate in width is extensive autologous bone grafting for conventional implant placement. PURPOSE: To evaluate the feasibility of the zygomatic implant (ZI) quad approach in edentulous CH4 patients who presented a knife-edge ridge form in the anterior maxilla for immediate loading. MATERIAL AND METHODS: Eligible patients with maxillary CH4 edentulism treated with the ZI quad approach were enrolled. Bone reduction and implant placement were performed under the guidance of a navigation system according to preoperative planning. The outcome variable was the implant survival rate, and additional variables were the ratio of immediate loading, complications and the relationship of the zygomatic implant path to the sinus wall. Statistical analysis was performed with the SAS statistical package. RESULTS: Fifteen patients (3 men, 12 women; age range, 19-71 years; average age 47.2 years) eligible for the study received the ZI quad approach from January 2017 through January 2020. All ZIs achieved osseointegration, with no implant loss after early healing and a mean follow-up of 17.2 ± 6.2 months. Thirteen of 15 patients (86.7%) received immediate loading. No critical anatomic structure injuries occurred during surgery. Most mesially placed implants (23/30, 76.6%) presented ZAGA 2 and 3, and most distally placed implants were distributed in ZAGA 0 (20/30, 66.7%). DISCUSSION: In terms of realizing immediate loading in CH4 patients with a knife-edge ridge form in the anterior maxilla, quad approaches have advantages over other grafting methods. At the same time, it seems the survival rate of zygomatic implants is comparable with that of other indications. With the limitations of this study, the quad approach might be a feasible option to realize edentulous maxillary reconstruction and to make immediate loading possible.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".