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Zygomatic implants

Also known as: Zygoma implant, Zygomatic fixture

Long implants that take their main anchorage from the zygomatic (cheek) bone rather than the alveolar ridge, used to restore a severely resorbed upper jaw without first grafting bone.

Key facts

AnchorageAnchored in the zygomatic bone; described as machined-surface, self-tapping commercially pure titanium screws with a 45-degree angulated prosthetic headVerified spec[1]
Available lengthsAvailable in lengths from 30 to 52.5 mmVerified spec[1]
Typical useUsed for the severely atrophic edentulous maxilla, as an approach that avoids extensive graftingVerified spec[1]
Clinical evidenceAn umbrella review of seven systematic reviews reported survival ranging from 95.2% to 100% in non-resected maxillae; 78.57% survival was reported in resected maxillaeClinical evidence
LimitationsReported complications include sinusitis in 2.4–3.9%, soft tissue infection in 2.0%, paraesthesia in 1.0% and oro-antral fistula in 0.4%; the review describes complications as usually manageable but records rare serious events such as penetration of the orbital cavityClinical evidence

Overview

A zygomatic implant bypasses the upper jaw ridge altogether, passing up alongside or through the sinus wall to anchor in the cheek bone, which stays dense even when the jaw itself has resorbed away. It exists for one situation: an upper jaw with too little bone for conventional implants, in a patient for whom major grafting is unattractive or has already failed. Reported survival in the published reviews is high, but the figures come mainly from experienced surgical centres, and the complication profile is different from ordinary implant surgery — sinusitis is the most frequently reported problem, and rare but serious events involving the orbit are documented. This is not a routine procedure, and the length of the implant is a poor guide to how demanding it is; the difficulty lies in the angle of approach and the anatomy it crosses. Whether it is appropriate can only be judged from examination and three-dimensional imaging.

Sources

Numbers match the citations beside each claim above.

Clinical evidence

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