Getting dental implants to replace missing teeth is not easy when your teeth have been missing for some time.

The longer you are without teeth, the more time there will be for your jawbone to get resorbed by your body.

This lack of bone means that dentists must use alternate methods such as zygomatic implants.

Zygomatic Bone

When bone loss has occurred in the upper jaw, normal-sized dental implants are not going to hold well.

After attaching a set of full dentures, there is a limited chance of success.

To overcome this deficiency of available bone, it means that the dentist must place the dental implants deeper into a location where solid bone can be found.

The cheekbones, also called zygoma, will serve well to anchor the new dental implants. 

In order for the implant to reach the zygoma at the correct angle, the dentist must put them through the palate, rather than the alveolar ridge, which is standard for implants. 

No Bone Grafting Needed

One powerful advantage of zygomatic implants is that they don’t require any bone grafting.

This step simply is not needed because of the placement in the zygoma. It does mean, however, that the dental implants need to be much longer than standard implants.

Another step that’s avoided by this process is a sinus lift.

Bone grafting typically requires a lengthy process. It may require multiple surgeries and a wait time of around six to nine months. This also means that a patient will not get teeth for some time.

With zygomatic implants, teeth are immediately placed and they are stable from day one.

The Sinuses

A zygomatic dental implant needs to pass through the sinus cavity to reach the zygoma.

Sinus cavities. Shutterstock/Elen Bushe

A skilled dentist can usually do this without damaging the sinus membrane.

Detailed 3-D scans are necessary during the planning stage to ensure there will be no complications. 

The sinus slot technique involves placing the dental implant more directly through the bone.

This minimizes the amount of the implant that is touching the sinuses, and it eliminates the need to detach the membrane from the bone.

The technique also helps to improve the orientation of the implant, and it reduces symptoms that may show up after the surgery. 

The Evaluation Test

In a study, dentists wanted to check on the quality of zygomatic implant placement when compared with that of traditional placement.

They also wanted to know about patient satisfaction, implant survival rate and the overall health of the maxillary sinuses.

For the test, 28 participants were selected for one group. Each one was given a combination of implants – both conventional and zygomatic.

A second group consisted of 14 participants, and each one was only given conventional implants.

In this test, which used Stella and Warner’s method, which minimizes how much of the implant is in the maxillary sinus cavity, the results proved very successful.

In fact, all of the implants – both conventional and zygomatic – survived. It was a 100 percent success.

They were checked at 15 months up to 53 months. The test subjects were given radiographs to determine the results.

They revealed good bone levels, no sinus disease and no symptoms of peri-implantitis (the bacterial infection that causes bone destruction). 

Three of the participants did report that they had some nasal obstruction.

One of them said it was from a cold, and the other two said they treated the problem with antihistamines – which eliminated the problem within one week of the evaluation.

One patient had reported having headaches and pressure in the sinus area.

A nasal fibroscopy was done and determined that it was not from sinusitis. 

Situations when Zygomatic Implants Could Be Used

The placement of zygomatic dental implants can be recommended for tooth replacement for several circumstances including patients who meet the following criteria:

  • Want an alternative to bone grafts (sinus augmentation)
  • Had trauma or need rehabilitation after cancer treatment
  • Had a sinus augmentation that failed
  • Had the failure of conventional dental implants. 

The Success Rate

Zygomatic implants have a very good success rate. The overall survival rate for this type of dental implant currently stands at 96 percent after 12 years. 

Steps that will increase the likelihood of success include following the dentist’s instructions for recovery precisely; making regular dental visits as directed; avoid smoking, and brushing and flossing daily. If you do not follow these steps, your implants are likely to fail.

dr. vadivel

Dr. Vadivel, DDS, is a board certified periodontal surgeon, and Founder-CEO of Implants & Gumcare of Texas, offering affordable restorative and cosmetic dental procedures. Dr. Vadivel has over 25 years of experience.



Top image: Shutterstock/Sheff