Zygomatic Implants: When the Upper Jaw Is Severely Resorbed

Overview

When the upper jaw has lost too much bone for conventional implants — and the patient prefers not to undergo prolonged sinus and ridge grafting — zygomatic implants offer a same-week functional full-arch reconstruction. The implants are 30–55 mm long and engage the dense cortical bone of the zygomatic (cheek) bone rather than the resorbed alveolar ridge.

When zygomatic implants are considered

• Severely atrophic maxilla where conventional implants would require major grafting.
• Failed prior augmentations.
• Post-tumour resection or maxillary defects.
• Patients who decline staged grafting and want a same-week solution.

Common configurations

• Two zygomatic + two anterior conventional implants — the classic hybrid for moderate atrophy.
• Quad zygomatic (four zygomatic implants) — for the most severely atrophic maxilla with no usable anterior bone.
• Immediate loading is standard: a screw-retained provisional bridge is delivered within 24–48 hours.

Risks specific to zygomatic placement

• Sinusitis (the implant traverses the maxillary sinus in most techniques).
• Soft-tissue dehiscence at the palatal emergence in the anatomy-conscious extra-maxillary approach.
• Orbital or infratemporal misplacement in inexperienced hands (rare but serious).
• Periprosthetic infection at the implant–prosthesis junction.

Outcomes

Long-term cumulative survival of zygomatic implants in high-volume centres is commonly reported above 95% at 5–10 years. Patient satisfaction is high because grafting and months of healing are avoided^[2]. The technique is technique-sensitive and should be performed by surgeons with specific training and adequate case volume.

Frequently asked questions

Related reading

• All-on-4 / full-arch guide
• Bone grafting and sinus lifts