Dynamic navigation for quad zygomatic implant placement in an ectodermal dysplasia patient with total anodontia: a case report with 5-year follow-up

Ectodermal dysplasia (ED) is a hereditary condition stemming from genetic defects that disrupt the development of ectoderm-derived tissues, affecting structures such as hair, teeth, nails, and sweat glands. A rare manifestation of ED is anodontia, the complete congenital absence of both primary and permanent dentition. This absence leads to underdeveloped alveolar ridges, significantly complicating dental rehabilitation efforts. This case report details the management of a 27-year-old female patient with ED and anodontia who presented with a fragile zygomatic bone and a heightened risk of orbital complications associated with traditional, free-hand zygomatic implant placement. To address these challenges, a fully digital workflow was implemented, encompassing diagnosis, treatment planning, surgical procedures, and prosthetic fabrication. The maxillary arch was rehabilitated with four zygomatic implants placed using dynamic navigation. Immediate loading was achieved by delivering a provisional fixed prosthesis within 48 h post-surgery. After a six-month healing period, the definitive restoration was fabricated using a Biocompatible High Performance Polymer (BioHPP) framework and Zirconia porcelain. Over a five-year follow-up period, all zygomatic and standard implants remained successful, with no evidence of inflammation, sinusitis, or bone loss. The final prosthetic rehabilitation significantly improved the patient’s oral function and aesthetics, consequently enhancing quality of life and facilitating confident social integration and communication. The described protocol offers a feasible and predictable approach to managing severe atrophic edentulous cases, particularly in patients with ectodermal dysplasia.