Zygomatic Implants: What They Are and Who Needs Them

Ordinary implants sit in the jawbone that once held the roots of your teeth. In the upper back jaw that bone often shrinks after teeth are lost, and the sinus above it grows downward. Eventually there may be too little bone to hold a normal implant.

A zygomatic implant is much longer, often several centimetres, and runs from the upper jaw up past the sinus into the cheekbone, which is dense and stays strong. It gives a firm anchor where the jaw has none. It is mostly a full-arch solution and is also described in types of dental implants.

The typical person has had upper teeth missing or failing for many years, wears a loose denture, has severe bone loss in the back of the upper jaw and wants fixed teeth. It is also considered after cancer surgery or injury, or when bone grafts have failed. A CBCT scan is essential to see whether the cheekbone offers enough solid bone.

General health matters. Poorly controlled diabetes, smoking and active sinus disease raise the risk, and a history of sinus problems needs specialist assessment. Not everyone with bone loss needs this; many people have another route. It is generally considered only after the simpler options have been looked at and found unsuitable, and the decision should rest on a scan, not on a quote.

A bone graft or sinus lift rebuilds bone so that ordinary implants can be placed. It works well for many people, though it adds months and a second surgery, and the graft can fail. Short implants may fit where there is moderate height.

Tilted implants, as in All-on-4, angle the back implants forward to use the denser bone in front of the sinus, which can avoid a graft. They need enough bone toward the front of the jaw. If all of these are unsuitable, an implant-supported denture or a well-made conventional denture remains a valid choice. The wider range is on the dental implants page.

It is longer and more technical than a standard implant. It is often done under general anaesthetic or deep sedation, and the surgeon needs to be trained and experienced in the technique. Usually two zygomatic implants are placed on each side, sometimes with ordinary implants in the front, and a fixed bridge is attached, often within a day or two if the implants grip well.

Because the long implants emerge in a different position, the final bridge may sit slightly toward the palate. Cleaning and speech can feel different at first.

The risks include sinus infection or sinusitis, swelling around the eye and cheek, numbness of the cheek, and, rarely, injury to nearby structures, a fistula or an implant that fails. Peri-implantitis around the implant remains a long-term concern. The overall success is high in experienced hands, but fewer people have had this done, so long-term evidence is smaller than for ordinary implants.

It is specialised surgery that not every dental clinic performs. Ask who would do it, how many they have done and what happens if it fails. Call the clinic to ask whether this treatment is available and whether your scan suggests it.

Expect more swelling and bruising than after a standard implant, often spreading to the cheek and sometimes beneath the eye, and a stay of a night in some cases. Nose-blowing is usually forbidden for a couple of weeks because it pushes air through the sinus. Sinus care instructions, soft food and strict cleaning are part of the plan.

If a fixed temporary bridge is fitted soon after surgery, it is kept light on the bite while the implants bond with the cheekbone and jaw. The final bridge is made after healing, typically some months later. Reviews are frequent in the first year so that sinus symptoms, screw tightness and cleaning are checked early.

Ask whether a scan shows enough cheekbone, whether a graft or tilted implants were considered, and why those were rejected. Ask who is doing the surgery, what their training is, and where it will be done, since general anaesthetic needs a proper operating setting.

Ask what the back-up plan is if an implant fails, and how the bridge will be cleaned. A reasonable answer names the risks plainly rather than promising a guaranteed result. If you want a second opinion with your scan in hand, that is a normal request.