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Zygomatic Implant

Long anchorage implant in the zygomatic bone for severe maxillary atrophy

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Zygomatic Implant?

Zygomatic implants were introduced by P-I Brånemark in 1989 for maxillary reconstruction following oncologic surgery and have since been adapted for severely atrophic edentulous maxillae. The implants are 30-55 mm long titanium fixtures placed through the maxillary alveolar ridge, traversing the maxillary sinus, and anchored in the zygomatic bone. Two zygomatic implants in the posterior maxilla, combined with two anterior conventional implants (Quad zygoma uses four zygomatics for severely atrophic cases), support a fixed full-arch prosthesis.

Indications include severely atrophic edentulous maxilla with insufficient alveolar bone for conventional implants or sinus floor elevation, failed prior implant treatment, post-oncologic maxillary defects, post-trauma maxillary deficiency, and avoidance of extensive bone grafting and prolonged treatment timelines. The technique allows immediate or early loading with fixed provisional prosthesis, eliminating the need for staged grafting.

Treatment workflow includes CBCT-based virtual surgical planning, anesthesia (general or sedation), maxillary crestal incision with subperiosteal flap elevation, anterior implant placement, sinus elevation or sinus slot for zygoma implant trajectory, zygomatic implant placement, prosthetic loading typically immediate or 24-72 hours later, and lifelong maintenance. Reported success rates exceed 95% at 10 years. Complications include sinusitis (most common), oroantral communication, paresthesia, infection, and rare orbital complications. Specialized surgical training is essential.

Symptoms

Severely atrophic edentulous maxilla
Insufficient alveolar bone for conventional implants
Failed conventional implants in posterior maxilla
Failed sinus floor elevation procedures
Failed maxillary bone grafts
Avoidance of extensive grafting timelines
Post-oncologic maxillary defects
Post-traumatic maxillary deficiency
Post-resection of maxillary tumors
Severe maxillary alveolar resorption
Long-term denture wear with severe ridge atrophy
Failure to retain conventional dentures
Cleft maxillary deformity in selected cases
Combined oncologic and dental rehabilitation need
Patient preference for fixed prosthesis
Avoidance of multiple staged procedures
Compromised systemic health limiting bone grafting
Esthetic concerns from missing maxillary teeth
Functional impairment from poor maxillary prosthesis
Quality-of-life impairment

Risk Factors

Maxillary sinus disease (chronic sinusitis, polyposis)
Smoking (significant impact)
Uncontrolled diabetes mellitus
Bisphosphonate or denosumab therapy
Prior radiation therapy to head and neck
Active periodontal disease at remaining teeth
Compromised oral hygiene
Active untreated infection
Severe parafunctional habits
Immunosuppressive medications
Severely compromised vascularity
Anatomical limitations (proximity to optic nerve, infraorbital nerve)
Limited surgical access
Compromised systemic health
Older age (relative consideration)
Allergy or hypersensitivity to titanium (rare)
Significant zygomatic bone pathology
Mental disorders affecting compliance
Pregnancy
Active oncologic disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severely atrophic edentulous maxilla
  • Insufficient bone for conventional implants
  • Failed conventional implants
  • Failed sinus elevation procedures
  • Avoidance of extensive bone grafting
  • Post-oncologic maxillary defect
  • Post-traumatic maxillary deficiency
  • Considering fixed maxillary prosthesis
  • Failed maxillary denture retention
  • Same-day rehabilitation interest
  • Comprehensive multidisciplinary planning need
  • Compromised systemic health limiting grafting
  • Cleft palate maxillary deficiency

Treatment Methods

01
Comprehensive evaluation by oral and maxillofacial surgeon with zygomatic implant training
02
Detailed history including sinus health, prior surgeries, systemic conditions, smoking, parafunctional habits
03
Clinical examination with intraoral and extraoral assessment
04
CBCT imaging with attention to zygomatic bone, maxillary sinuses, infraorbital nerve, optic structures
05
Sinus health optimization (treat sinusitis, polyposis preoperatively)
06
Smoking cessation
07
Glycemic control
08
Periodontal therapy at remaining teeth
09
Multidisciplinary planning with prosthodontist
10
Virtual surgical planning with CAD/CAM software
11
Custom surgical guide fabrication when feasible
12
Provisional prosthesis design
13
Two zygomatic implants posteriorly with two anterior conventional implants (Quad zygoma uses four zygomatics)
14
ZAGA (Zygoma Anatomy-Guided Approach) classification for technique selection (intra-sinus vs extra-sinus trajectory)
15
Surgery under general anesthesia or sedation
16
Crestal incision and subperiosteal flap elevation
17
Anterior implant placement
18
Zygomatic implant placement with chosen trajectory
19
Multi-unit abutment placement
20
Immediate or early provisional prosthesis loading (24-72 hours)
21
Healing phase 3-6 months
22
Definitive prosthesis fabrication and delivery
23
Antibiotic prophylaxis (broad-spectrum, often extended)
24
Antiseptic mouth rinses
25
Postoperative imaging to confirm placement
26
Sinus health monitoring
27
Lifelong professional maintenance
28
Home hygiene with water flosser and interdental brushes
29
Treatment of complications (sinusitis, oroantral fistula, paresthesia)
30
Multidisciplinary care: oral surgery, prosthodontics, otolaryngology for sinus health
31
Long-term follow-up

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.