Short answer: A zygomatic implant is a long type of implant anchored in the cheekbone (zygoma), used in patients who have severe bone loss in the upper jaw and do not have enough bone for a conventional implant. In most cases it can reduce or eliminate the need for a sinus lift or bone graft. It is performed under general anesthesia or sedation by an experienced surgeon, and suitability is determined with three-dimensional CT.
When teeth in the upper jaw were lost many years ago, the bone that held them gradually resorbs and becomes thinner. Enlargement of the sinus cavities can add to this loss. In such a situation, there may not be enough bone left to place conventional implants, and patients often have to live with removable dentures that have poor retention. A zygomatic implant is a specialized implant method that makes fixed teeth possible in these cases of severe bone loss by taking support from the cheekbone.
In this article we cover what a zygomatic implant is, who it is used for, how it serves as an alternative to sinus lift and graft procedures, the surgical process, the risks and the success rates reported in scientific studies.
What is a zygomatic implant?
A zygomatic implant is a titanium screw, much longer than a conventional implant, that is placed from inside the mouth with its tip anchored in the cheekbone. While conventional implants are usually 8-15 mm long, zygomatic implants can exceed 30 mm.
The cheekbone is one of the densest and strongest areas of the facial skeleton. Even when the upper jawbone resorbs, the cheekbone usually retains its structure. A zygomatic implant bypasses the deficiency in the upper jawbone and moves the support area to this solid region. This allows a fixed dental bridge to be placed on the implants.
There are different ways of using them depending on the plan:
- One zygomatic implant on each side plus conventional implants at the front: Commonly chosen when there is enough bone in the front region.
- Two zygomatic implants on each side: May be used when bone is also very scarce in the front region of the upper jaw.
- One-sided use: May be planned when bone loss is limited to one area, for example after tumor surgery.
Who is it used for?
Zygomatic implants are used for patients who do not have enough bone in the upper jaw for a conventional implant and for whom rebuilding this bone with grafts is not appropriate or not preferred. This method is not the first option for every patient without teeth; it is an advanced surgical treatment with specific indications.
The main areas of use are:
- Severe bone resorption in the upper jaw due to long-term tooth loss
- Failure of previous bone graft or sinus lift procedures
- Extensive bone loss after failed conventional implants
- Bone loss in the upper jaw after a tumor, cyst or trauma
- Major loss of bone support as a result of severe gum disease
Three-dimensional dental CT is the primary tool in assessing suitability. The volume of the cheekbone, the condition of the sinuses and the distances to the eye socket are examined in detail with these images. The person's general health, medications, smoking habits and oral hygiene are also assessed. Conditions such as uncontrolled diabetes, advanced cardiovascular disease, certain medications affecting bone metabolism and active sinus infection can affect planning.
How does it compare as an alternative to sinus lifts and grafts?
In patients with severe bone loss, zygomatic implants often provide an alternative to bone augmentation procedures such as sinus lifts and bone grafts. In the conventional approach, bone volume is first increased with a graft, there is usually a wait of several months for this bone to mature, and then the implants are placed. This process can take up to a year in total and may require more than one surgery.
Compared with zygomatic implants, the main differences are:
- Number of surgeries: Because no bone augmentation is needed, a single surgical stage may be enough in most cases.
- Treatment time: Since there is no wait for the graft to mature, the overall duration may be shorter.
- Donor site: There may be no need to harvest bone from areas such as the hip or jaw.
- Early loading: In suitable cases, temporary fixed teeth can be attached shortly after surgery.
That said, grafting procedures are also an important option and are still commonly preferred for moderate bone loss. Which path is more suitable is decided together with the dentist based on the degree of bone loss, the patient's general health and expectations.
How does the surgical process work?
Zygomatic implant surgery is usually performed under general anesthesia or deep sedation by an oral and maxillofacial surgeon experienced in this method. The procedure is carried out after a detailed planning phase.
- Planning: Digital planning is done on the CT scan, and the angle and length of the implants are determined. Surgical guides are used if needed.
- Preparation: General health checks and anesthesia assessment are completed. Any teeth that are a source of infection in the mouth are treated or extracted.
- Surgery: The gum is opened to reach the upper jaw and cheekbone area. The implant is placed starting from the upper jaw and extending into the cheekbone. The length of the procedure depends on the number of implants to be placed.
- Temporary teeth: In suitable cases, a temporary fixed bridge can be attached to the implants within days after surgery.
- Final prosthesis: After healing is complete, usually within a few months, the final prosthesis is made.
Facial swelling, bruising and tenderness can be expected in the first days after surgery. During this period, follow the medications and care instructions recommended by your surgeon, eat soft foods and do not miss follow-up appointments. Because smoking has a negative effect on healing, quitting is recommended.
What are the risks and success rate?
Scientific studies report high long-term survival rates for zygomatic implants; many systematic reviews have reported rates of 95 percent and above. However, as with any surgical procedure, there are risks, and these should be discussed openly with the patient before treatment.
The main complications reported are:
- Sinusitis: One of the most frequently reported problems; most cases can be controlled with medication, while some may require additional intervention.
- Soft tissue infection and gum recession: Inflammation may develop around the implant; good oral hygiene reduces this risk.
- A connection between the mouth and sinus (oroantral fistula): Rare, and may require surgical repair.
- Sensory changes: Temporary numbness of the cheek or lip may occur.
- Problems around the eye socket: Very rare; the risk is reduced with detailed planning.
- Prosthetic problems: Mechanical problems such as screw loosening or prosthesis fracture may occasionally occur.
The most important factors affecting success are correct patient selection, the surgeon's experience, careful planning, the patient's general health, not smoking and attending regular check-ups. Like conventional implants, zygomatic implants require lifelong care. Interdental brushes, water flossers and professional cleanings are part of this care.
Questions to ask before a zygomatic implant
Before deciding on treatment, it is useful to discuss the following with your dentist: Is bone augmentation with conventional implants an option for you? How many implants are planned, and why? When can temporary teeth be attached? Under which type of anesthesia and where will the surgery be performed? What will be done in the event of possible complications? Fees are communicated in writing after a comprehensive examination and planning. For general information on implant treatments, you can also see our frequently asked questions page.
Assessment in Ankara
If your upper denture does not stay in place, you have previously been told that your bone is insufficient for implants, or you have had problems after a graft, reassessing your current situation with CT can clarify your options. At our clinic in Oran, Çankaya, suitable implant approaches are explained after an intraoral examination and imaging; in cases requiring advanced surgery, the process is planned together with the relevant specialty.
Frequently asked questions
Can teeth be attached on the same day with zygomatic implants?
In suitable cases, a temporary fixed bridge can be attached shortly after surgery, often within days. Whether this is possible depends on the initial stability of the implants and the surgeon's assessment. The final prosthesis is made after healing is complete.
Is zygomatic implant surgery painful?
Because the surgery is performed under general anesthesia or deep sedation, no pain is felt during the procedure. In the following days there may be swelling, bruising and tenderness; these symptoms are usually controlled with the medications recommended by the surgeon and ease within a few days.
Can zygomatic implants be placed in the lower jaw?
No. Because zygomatic implants are anchored in the cheekbone, they are used only in the upper jaw. In cases of severe bone loss in the lower jaw, short implants, bone augmentation methods or other prosthetic options are considered.
How long do zygomatic implants last?
Long-term studies show that, with regular care and check-ups, zygomatic implants can function for many years. Their lifespan is determined by factors such as oral hygiene, smoking, general health and attending regular check-ups.
