Zygomatic implants

Summary

• A zygomatic implant is a long implant used when the upper jaw has lost a great deal of bone. It starts inside the mouth and its tip anchors in the cheekbone (zygoma).
• It is considered for some patients in whom bone grafting or a sinus lift cannot provide enough bone, or is not thought suitable.
• It is technically demanding surgery that calls for experience in the field. Dr. Dt. Kıvanç Türkoğlu performs zygomatic implant treatment in suitable patients. Suitability is assessed with an examination and a CT scan.

When does it come up?

After years without teeth, the upper jaw becomes both thinner and shorter. At the back, enlarging sinuses reduce the remaining bone further. When there is no room for a standard implant, a zygomatic implant becomes one of the options.

Loss of an earlier graft or of earlier implants, and bone defects after a tumour or injury, may also fall into this group.

Compared with grafting and sinus lift

With grafting, bone volume is built up first and standard implants are placed later. This route can take longer and sometimes needs bone taken from another part of the body.

A zygomatic implant takes its support from the cheekbone without adding bone. When conditions allow, temporary fixed teeth can be fitted soon after surgery. On the other hand, the limited studies comparing the two routes found complications more often with zygomatic implants. The choice is made after discussing benefits and risks together.

Planning with CT

Planning requires a cone beam CT. It measures the volume of the cheekbone, the state of the sinuses, the distance to the floor of the eye socket and the path the implant will follow.

If the sinuses are inflamed or blocked, an ear, nose and throat assessment may be requested first. If there is bone at the front, zygomatic implants are combined with standard implants there. If bone is very thin everywhere, two zygomatic implants may be planned on each side.

Anaesthesia and the procedure

Because the procedure is long and extensive, it is often done under general anaesthesia or deep sedation. A hospital setting may therefore be needed.

The path of the implant is chosen to suit the individual bone anatomy. In some patients it passes through the sinus, in others along a line close to its outer wall. In suitable cases a screw-retained temporary fixed bridge is fitted on the same day or within a few days.

Recovery

Swelling and bruising of the cheek and under the eye can occur. Mild nosebleeds may appear in the first days. Avoid blowing your nose hard and sneeze with your mouth open to protect the sinus.

Soft food is advised while the implants heal. The final bridge is made once healing is complete.

Known risks

Sinusitis is among the most frequently reported problems. An opening between the mouth and the sinus can form. Where the implant emerges into the mouth, gum recession, inflammation and other soft tissue problems can occur.

Altered sensation of the cheek or lip is possible. Because the work is close to the eye socket, rare cases of the implant entering the eye socket, injury to the eye muscles and double vision have been reported. Some problems may need further surgery or removal of the implant.

Experience and follow-up

With this technique the surgeon's training and how often they perform it matter. Feel free to ask your clinician about this.

Treatment is planned by the surgeon and the prosthetic clinician together. Regular check-ups and daily cleaning are needed for the long term.

Frequently asked

Can zygomatic implants be used in the lower jaw?

No. They anchor in the cheekbone, so they are used only in the upper jaw.

Is it possible for everyone?

No. The cheekbone must have enough bone and general health must allow it. Any sinus disease is dealt with first.

Should grafting be tried first?

It depends on the person. Your clinician explains the expected time, risks and recovery for both routes, and the decision is made together.

Will the implant show on my face?

The implant sits inside the bone and is not visible from outside. Swelling and bruising in the first days settle with time.

Examination and treatment planning take place at Klinik 29 (Altunizade, Üsküdar). Klinik 29 website (English)

This information is for general guidance and does not replace an examination. Rapidly spreading facial swelling or difficulty swallowing or breathing is an emergency. Go to a hospital emergency department.