Design and Manufacturing of Surgical Guides for Minimally Invasive Guided Surgery in Innovative Zygomatic Implant Placement

Guided implant surgery has emerged as a major advancement in contemporary implant dentistry through the integration of three-dimensional imaging, digital planning, and customized surgical guides. This thesis provides a systematic evaluation of the state of the art of computer-assisted surgery and the technological principles underlying these procedures, with the aim of evaluating their clinical reliability and operational accuracy compared to conventional freehand surgery. The research methodology is based on a critical review of the scientific literature combined with direct clinical and technical involvement during my internship at Laboratorio Dentale Santa Teresa Srl based in Ravenna, where I actively contributed to digital planning workflows and the realization of guided surgical protocols. This experience enabled a practical understanding of the interaction between the clinician and the dental technician within a fully digital environment. Furthermore, comparative analysis indicates that computer-assisted implant placement improves the correspondence between virtual planning and surgical execution, particularly in full-arch rehabilitations, where implant positioning plays a crucial role in biomechanical stability and long-term prosthetic success. Complex clinical scenarios, including severe maxillary atrophy, were also investigated. In such cases, pterygoid and zygomatic implants represent advanced therapeutic options. In this context, the thesis introduces and describes an innovative protocol for the placement of zygomatic implants based on stackable surgical guides. This methodology allows a sequential and controlled execution of surgical phases, improving operative precision, procedural standardization, and minimally invasive management in the rehabilitation of severe maxillary atrophy. This workflow represents a concrete step toward greater predictability and reproducibility in complex implant surgery.