Zygomatic Implants, What You Need To Know

Zygomatic (Zygoma) implants offer a solution for individuals seeking dental implants but experiencing significant bone loss in the upper jaw. This method eliminates the necessity for bone grafting (bone augmentation). Unlike standard ‘root form’ dental implants that are inserted into the jawbone to replace teeth, these implants are anchored in the zygomatic bone (cheekbone) to support upper jaw (maxillary) teeth, bridges, and dentures.

If you’ve been informed that you require dental implants but are not eligible due to insufficient bone volume in your upper jaw, you might think there’s no alternative. These implants can reconstruct the upper teeth when the quality or quantity of upper jaw bone is inadequate for regular ‘root form’ dental implants.

Bone atrophy (resorption) refers to the wasting away of body tissue (bone in this context) due to cell degeneration. This natural process occurs after tooth extraction and can be worsened by prolonged denture use. Long-term denture wearers with severe jaw atrophy often lack the bone quality or volume necessary for dental implants.

Loss of upper jaw (maxillary) bone volume can result from bone resorption (teeth no longer transmit stress to the jawbone to maintain bone mass when missing) and pneumatization of the maxillary sinus (the sinus air volume increases with age while bone volume decreases), or both.

When the upper jaw bone height is less than 10 mm (vertical height), regular ‘root form’ implants require bone grafting (alveolar augmentation, sinus lift grafting) to stabilize the implants and enhance their longevity.

While bone grafting procedures in the jaw are generally successful, they come with the drawback of extended treatment time (additional stages for bone graft placement, healing, maturation, and then implant placement). A denture is needed during the 3-4 month healing period of the bone grafts. Bone grafts sometimes fail to heal properly, resulting in rejection, and certain types of bone grafts (block) can cause more pain and swelling.

Even with existing teeth, gum disease (periodontal disease) or severe infections can destroy the jawbone, making conventional dental implant treatment unsuitable. For such patients, zygomatic implants can be the ideal solution. So, what exactly are zygomatic implants, and why might they be necessary?

What Are Zygomatic Implants?

Zygomatic implants anchor into the denser zygomatic bone (cheekbone), offering a robust foundation for implant support. This solid base distributes stress over a wide area and enables the immediate placement of dental bridges during surgery, eliminating the need for dentures or going without teeth for any period.

These implants have been successfully used since the late 1980s. They are particularly effective for dental rehabilitation in patients with insufficient bone in the posterior upper jaw due to various conditions, such as increased bone loss with age, early tooth loss or denture use, tumor resection, trauma, or severe bone resorption (atrophy).

Zygomatic implants, also known as ‘Zygoma’, provide an alternative to bone grafting procedures in the upper jaw. They traverse the poor bone area of the upper jaw to anchor into the cheekbones through the sinuses. These implants are inserted from within the mouth into the back section and can be combined with one or more regular (root form) implants in the front part of the jaw.

Depending on patient needs, either two (one on each side) or four (two on each side) implants are placed to support full or partial dental bridges. The procedure is safe and predictable when performed by specialist surgeons experienced in the technique. It is done under anesthesia as day surgery, with a full set of immediate teeth connected to the implants on the same day.

What Type of Patients Do Zygomatic Implants Suit?

Zygomatic implants are a reliable treatment option for patients with severely resorbed upper jaws, often told they cannot have implant treatments due to insufficient jaw bone. These implants are designed to attach immediate fixed replacement teeth (dental bridges).

In more severe cases of advanced bone volume loss, two zygomatic implants (or quad zygoma) may be placed on each side of the upper jaw to support a full set of upper replacement teeth. This treatment is also used for the dental rehabilitation of cleft palate patients.

What Is The Difference Between Zygomatic and Normal Dental Implants?

Zygoma implants are significantly longer than conventional (root form) dental implants. Although they are still inserted through the mouth, they anchor into the cheekbone (zygomatic bone) instead of the dental arches (alveolar bone) within the mouth. The dense bone in the cheeks provides high immediate stability, making zygomatic implants an excellent foundation for the immediate placement of replacement teeth (dental bridges) on the same day.

Why Are Zygoma Implants Inserted Into the Back of the Jaw?

The alveolar bone at the back of the upper jaw is more susceptible to resorption (atrophy) than other areas of tooth-bearing bone. Thus, zygoma implants bypass the need for extensive bone grafting that would typically be necessary for regular (root form) dental implants. Compared to bone grafting procedures, the surgery for zygomatic implants is less invasive, has a quicker recovery time, does not require the patient to wear a denture or go without teeth, and causes significantly less discomfort.

How Is a Treatment Plan for Zygomatic Implants Prepared?

Treatment plans for zygomatic implants utilize digital technology (CT-based virtual planning with custom surgical guides), reducing operating time (less anesthesia) and allowing for precise creation of the final dental bridge (prosthetically driven treatment planning). Historically, such treatments were unpredictable in effectiveness, and problems during procedures were difficult to anticipate. With state-of-the-art equipment, specialist surgeons can now perform these treatments with exceptional accuracy and safety.

1. Consultation and assessment by a specialist surgeon. This treatment is less common than regular dental implants and requires a surgeon with extensive experience in the technique. Many dentists might not be aware of this option.
2. Thorough examination, investigation (CBCT or CT scans covered by Medicare rebates), and digital planning using the latest virtual surgery software. Detailed quotes (including Health Fund codes and Medicare rebates) are provided for the planned treatment.
3. Booking the day surgery procedure for implant placement (with or without tooth removal) and dental bridge insertion.
4. Recovery period (2-3 days), with a return to normal activities within 7 days.

What Are Some of the Benefits of Having Zygomatic Implants?

Zygomatic implants help patients regain self-confidence through improved smile aesthetics and better oral function (speech, eating, and swallowing) associated with fixed dental bridges (implant-retained prosthetics).

• Enhanced appearance
• Better speech
• Increased self-esteem
• Natural-looking teeth and gums
• Freedom to eat desired foods
• Confidence to laugh
• Teeth that remain in place
• Elimination of denture sore spots
• Long-term tooth support
• Faster healing compared to bone grafting
• Low maintenance

Additional benefits include:

• Bone grafting is rarely needed, making the procedure suitable for most patients.
• Ideal for patients with severe bone loss, even those previously told implant treatment is not possible through conventional means.
• Dental bridges are attached to implants on the same day as surgery (Teeth in a Day, All-on-Four, Immediate Implant Bridge Placement), eliminating time without teeth and the need for dentures.
• Zygomatic implants are beneficial for cleft lip and palate patients who cannot tolerate conventional treatments.
• One zygomatic implant can support 3-4 teeth, whereas one regular dental implant supports 1-2 teeth.
• Four zygomatic implants can support a full upper dental bridge.
• Immediate placement (when teeth are removed and zygomatic implants are placed simultaneously) can be planned predictably.
• Zygomatic implants can salvage other failed or failing dental implant treatments (All-on-Four, mini-implants, failed bone grafts, severe periodontal breakdown of existing teeth).

How Successful Are Zygomatic Implant Treatments?

Zygomatic implant treatments have a high success rate, especially considering advancements in dental implant technology over the past twenty years. However, the success of any dental implant treatment also hinges on the patient’s overall health and commitment to regular maintenance. To maintain functionality, patients must brush and floss at least twice a day to keep both the implants and the implant prosthetics clean.

Regular appointments with a dental hygienist are also advised to clean areas that are hard to reach with a standard toothbrush. By adhering to their dentist’s recommendations and guidelines, patients can ensure that their zygomatic implants last a lifetime.

Can a Zygomatic Implant Be Combined with a Normal Dental Implant?

Yes, zygomatic implants can be combined with regular (root form) dental implants to achieve successful outcomes. Some patients may have sufficient bone for implant placement at the front of their mouth but not at the back. In such cases, a combination of both implant types is planned.

Final Words

While zygomatic implants may be the way to go for many, they are not the right treatment for anybody. The best way to know if they are right for you is to consult with a professional such as Dr. Horiyat and take the course recommended by them. To book a consultation session, click here, visit our website at Ariadentalcare.com or click on the banner below.