Zygomatic Implants

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Zygomatic implants have been documented as an alternative for the rehabilitation of the atrophic posterior maxilla with both the classical two stage and immediate loading protocols. Zygomatic implants avoid grafting and sinus lift procedures and therefore contribute to a shorter and more comfortable treatment. Further indications include failed conventional implant placement, failed sinus augmentation or grafting procedures, rehabilitation after tumor and trauma resections.

Zygomatic Implants for older adultsIn the atrophic posterior maxilla, in general one implant is placed on each side of the maxilla, in combination with 2-4 conventional implants in the anterior region.

For the totally resorbed maxilla, when placement of anterior implants is not possible the concept can be expanded by inserting 2 additional implants in a more anterior position (Quad zygoma). Zygomatic implants nowadays are usually immediately loaded with a fixed bridge.

The implant is placed subsequently and is located at the inner aspect of the sinus wall, often without membrane perforation.

Long-term prospective studies with the classical 2-stage and immediate loading approaches document high success rates with only minimal complications. The cumulative survival rate of the implants is 96% after 12 years.

The most common complication associated with zygomatic implants is sinusitis. Appropriate pre-surgical diagnostics and evaluation of the sinus as well as using the extra-sinus surgical approach and immediate loading of the implants seem to reduce or even eliminate this complication.

Other complications reported during and after the insertion of zygoma implants include infraorbital nerve paresthesia, orosinusal fistula and perforation of the orbit.

What are zygomatic implants?

  • They are an evidence-based surgical and prosthetic solution for both two-stage and immediate loading protocols
  • Today, they are usually placed using an immediate loading protocol
  • The main indication for zygomatic implants is the severely resorbed edentulous maxilla, but they can also be used in partially edentulous situations
  • Indications for implant insertion include: alternative for sinus augmentation, failed sinus augmentation, rehabilitation after tumor resection or trauma, failure of conventional implants, failure of previous bone grafts
  • The placement of the implants requires adequate training and surgical experience

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