Zygomatic Implants

Zygomatic Implants
An Alternative for Severe Bone Loss Of the Upper Jaw

Many patients are told by their dentist that they don’t have enough bone for implants in the upper jaw. People often give up at that point. Some patients truly have “no bone” in the upper jaw. The bone has even dissolved under the nose.

What Are Zygomatic Dental Implants?

Zygomatic dental implants are the solution for patients that have the MOST SEVERE form of bone loss in the upper jaw. It is an alternative to bone grafting.

This procedure has a long track record of success.  They were introduced into the United States in 1998 but have been used in Europe since 1988.

Double zygomatics in the back with two regular implants in the front

Quad zygomatic implants in the upper jaw

How Do Zygomatic Implants Work?

Zygomatic implants are anchored in the cheek bone which is called the “zygoma” in human anatomy textbooks. The extra-long implant is placed from inside the mouth near the location of the bicuspid teeth.  It goes through or right next to the sinus and anchors into the thick and solid zygomatic bone. This bone is much more solid than what is found in the back part of the upper jaw. Zygomatic implants often go hand in hand with pterygoid implants that anchor near the upper wisdom teeth.

1-2 zygoma implants are used on each side in addition to 2-4 regular implants towards the front of the jaw in the area where the upper front teeth used to be. Having additional support in the upper jaw is always good for the longevity of dental implant restorations in the upper jaw where the bone is typically very soft.

It is a safe and predictable procedure.

Zygomatic Implants With Prettau Bridge performed by Dr. Amin

What Are The Advantages Of Zygomatic Implants?

  • The beauty of this procedure is that it is “graft-less.” This means that for the majority of patients, no major bone grafting is necessary.
  • The patient can leave with immediate loaded functioning fixed teeth on the same day of the surgery. The patient does not have to wait for complete healing to have teeth that are screwed in on the same day of the procedure. This allows for shorter “time-to-teeth.”
  • The upper denture is eliminated.
  • Patient always has teeth and does not have to be embarrassed.
  • Block bone grafting is unnecessary.
  • A sinus lift bone graft is unnecessary.
  • Reduces the time of a fixed implant screw retained zirconia Prettau dental implant bridge.
  • Reduces the timeline to completion of the upper jaw restoration.
  • It is one of the few times that the “All on 4” procedure can be done predictably in the upper jaw because the implants are much longer and stronger.
  • One extra-long zygomatic dental implant equals about 3-4 regular dental implants.
  • It is done under IV sedation while you sleep.
  • In some cases, it can reduce cost.
  • Double Zygomatic implants or “quad zygomatics” can be done on both sides of the upper jaw.
  • This allows for faster healing than bone grafting.
  • Natural teeth can be extracted and zygomatic cheek bone dental implants can be placed at the same appointment.
  • Old, failing “All on 4” dental implants with bone loss can be removed and replaced with zygomatic dental implants.

Is A Specialist Dentist Required?

This procedure is not as common because very few dentists are trained and skilled enough to provide this procedure. Dr. Ramsey Amin has been formally trained in zygomatic implants and placed his first one in 1999. The surgical skill involved in the placement of zygomatic implants requires a high level of experience, understanding of the anatomy and specialized surgical training.


A CBCT cone beam 3-D scan and a detailed two step exam and consult is mandatory. In that scan, Dr. Amin will also evaluate your sinuses to make sure that the normal sinus drainage passages are open. If they are not open, he may refer you to an ENT Otolaryngologist. He will review a virtual rendering of your procedure and take you through the pros and cons of zygomatic dental implant reconstruction or traditional sinus lift bone grafting reconstruction…. In our office we do both procedures routinely. Dr. Amin will help you decide which option is best for you.

Are Zygomatic Dental Implants Painful?

Although they may look a bit scary, the pain associated with zygomatic implants is about the same as regular bone grafting procedures. Dr. Amin administers a special anti-inflammatory in your shoulder and in your IV sedation to help reduce postoperative pain. Most patients get some degree of temporary bruising. Most of our patients do not need heavy pain killers and end up using a combination of Ibuprofen and Tylenol by the second day. Most of our patients are pretty amazed how easy it was.

What Are The Risks Of Zygomatic Implants?

When there is little to no bone present, all dental implant and bone grafting procedures carry some degree of risk. There are no procedures without risk. No discussion would be complete without discussing remote risks.

Surgical risks, although rare, can include bleeding, cuts on the lips, poor primary stability, zygomatic fracture, hematoma , entrance into the bone under the orbit or infratemporal fossa, paresthesia (numbness), pain, tenderness to touch, sinusitis, thread exposure, oral-antral communication, implant failure, zygomatic-cutaneous communication, and zygomatic implant fracture.

The final bridge on the tongue side often needs to be made a bit thicker than normal because the zygomatic dental implant is sometimes closer to the roof of the mouth than a regular implant.

Just like any other complex oral dental implant surgery there are risks.

Should You Have Zygomatic Implants?

Although zygomatic implants may look a bit scary to some, they offer a safe solution to patients with extreme bone loss.  The use of zygomatic implants are a predictable way to decrease patient cost and overall treatment time.  Often, this option is much less invasive than other dental implant treatments for severe bone loss of the upper jaw.