Zygomatic Implants in Modern Implant Dentistry: A Comprehensive Review
DOI:
https://doi.org/10.48165/ajm.2026.9.02.03Keywords:
Zygomatic implants, Implant rehabilitation, Digital dentistryAbstract
Zygomatic implants have emerged as a predictable graftless solution for the rehabilitation of patients with severe maxillary atrophy, extensive bone loss, and failed conventional implant therapy. By anchoring in the zygomatic bone, they reduce the need for complex bone grafting and facilitate immediate loading in selected cases. Recent advances in implant design, digital planning, guided surgery, and prosthetic rehabilitation have significantly improved treatment outcomes. This review highlights the evolution, indications, implant design, surgical techniques, digital workflow, clinical outcomes, complications, and recent innovations in zygomatic implantology. Current evidence supports zygomatic implants as a reliable and effective treatment option with high long-term survival rates for the rehabilitation of the severely resorbed maxilla.
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Davó, R., Bankauskas, S., Laurinčikas, R., Koçyigit, I. D., & Mate Sanchez de Val, J. E. (2020). Clinical performance of zygomatic implants: Retrospective multicenter study. Journal of Clinical Medicine, 9(2), 480. https://doi.org/10.3390/jcm9020480
Esposito, M., & Worthington, H. V. (2013). Interventions for replacing missing teeth: Dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla. Cochrane Database of Systematic Reviews, 2013, CD004151. https://doi.org/10.1002/14651858.CD004151.pub3
Davó, R. (2012). Sinus reactions to zygomatic implants. In C. Aparicio (Ed.), Zygomatic implants: The anatomy guided approach (pp. 59–76). Quintessence Publishing Co., Inc.
Aeran, H., Singh, G., Seth, J., & Agarwal, A. (2022). Zygomatic implants: Changing face of implant dentistry. International Journal of Oral Health Dentistry, 8(1), 5–8.
Breine, U., & Brånemark, P. I. (1980). Reconstruction of alveolar jawbone: An experimental and clinical study of immediate and preformed autologous bone grafts in combination with osseointegrated implants. Scandinavian Journal of Plastic and Reconstructive Surgery, 14(1), 23–48.
Isaksson, S., Ekfeldt, A., Alberius, P., & Blomqvist, J. E. (1993). Early results from reconstruction of severely atrophic (Class VI) maxillas by immediate endosseous implants in conjunction with bone grafting and Le Fort I osteotomy. International Journal of Oral and Maxillofacial Surgery, 22(3), 144–148.
Moiduddin, K., Mian, S. H., Umer, U., Alkhalefah, H., Ahmed, F., & Hashmi, F. H. (2023). Design, analysis, and 3D printing of a patient-specific polyetheretherketone implant for the reconstruction of zygomatic deformities. Polymers, 15(4), 886. https://doi.org/10.3390/polym15040886
Le, M. N., Tran, T. M., Nguyen, P. N., Vo, H. C., & Tran, L. H. (2025). Optimal bone-implant contact sites in the zygomatic region for quad zygomatic implants placement: A retrospective study in Vietnamese patients on CBCT. BDJ Open, 11(1), 61. https://doi.org/10.1038/s41405-025-00327-7
Aalam, A. A., Krivitsky, A., & Kurtzman, G. M. (2022). Decision making with zygomatic and pterygoid dental implants in the severely atrophic maxilla: A narrative review. Dental Review, 2(3), 100054. https://doi.org/10.1016/j.dentre.2022.100054
Chen, J., Shen, Y., Tao, B., Wu, Y., & Wang, F. (2025). A fully digital planning protocol for dynamic computer-assisted zygomatic implant surgery based on virtual surgery simulation: A dental technique. The Journal of Prosthetic Dentistry, 134(5), 1524–1529. https://doi.org/10.1016/j.prosdent.2025.05.018
Gao, B. X., Iglesias-Velázquez, O., Tresguerres, F. G., Rodríguez González Cortes, A., Tresguerres, I. F., Ortega Aranegui, R., López-Pintor, R. M., López-Quiles, J., & Torres, J. (2021). Accuracy of digital planning in zygomatic implants. International Journal of Implant Dentistry, 7(1), 65. https://doi.org/10.1186/s40729-021-00348-3
Kafedzhieva, A., Vlahova, A., & Chuchulska, B. (2025). Digital technologies in implantology: A narrative review. Bioengineering, 12(9), 927. https://doi.org/10.3390/bioengineering12090927
Mangano, F., Shibli, J. A., & Fortin, T. (2016). Digital dentistry: New materials and techniques. International Journal of Dentistry, 2016, 5261247. https://doi.org/10.1155/2016/5261247
Att, W., Witkowski, S., & Strub, J. R. (2019). Digital workflow in reconstructive dentistry. Quintessence International, 50, 538–550.
Candel-Martí, E., Carrillo-García, C., Peñarrocha-Oltra, D., & Peñarrocha-Diago, M. (2012). Rehabilitation of atrophic posterior maxilla with zygomatic implants: Review. Journal of Oral Implantology, 38(5), 653–657.
Duarte, L. R., Filho, H. N., Francischone, C. E., Peredo, L. G., & Brånemark, P. I. (2007). The establishment of a protocol for the total rehabilitation of atrophic maxillae employing four zygomatic fixtures in an immediate loading system: A 30-month clinical and radiographic follow-up. Clinical Implant Dentistry and Related Research, 9(4), 186–196.
Fernandes, G., Aras, M. A., Coutinho, I., Da Costa, G. C., & Karthikeyan, P. (2024). Zygomatic implant rehabilitation: A prosthodontic driven approach: A review. International Journal of Science & Healthcare Research, 9(2), 1–7.
Ponnusamy, S., & Miloro, M. (2020). A novel prosthetically driven workflow using zygomatic implants: The restoratively aimed zygomatic implant routine. Journal of Oral and Maxillofacial Surgery, 78(9), 1518–1528. https://doi.org/10.1016/j.joms.2020.04.028
Aparicio, C., Polido, W. D., & Zarrinkelk, H. M. (2021). The zygoma anatomy-guided approach for placement of zygomatic implants. Atlas of the Oral and Maxillofacial Surgery Clinics of North America, 29(2), 203–231. https://doi.org/10.1016/j.cxom.2021.05.004
Gandhi, N., Gandhi, S., Talwar, H., & Dhawan, K. (2022). Zygomatic implant-supported prosthetic rehabilitation of a patient with Brown et al. Class IIc maxillary defect: A clinical report. The Journal of Indian Prosthodontic Society, 22(1), 92–96. https://doi.org/10.4103/jips.jips_347_21
Kurt Bayrakdar, S., Orhan, K., Bayrakdar, I. S., Bilgir, E., Ezhov, M., Gusarev, M., & Shumilov, E. (2021). A deep learning approach for dental implant planning in cone-beam computed tomography images. BMC Medical Imaging, 21(1), 86. https://doi.org/10.1186/s12880-021-00616-3
Berta, G. M., Luigi, C., Miguel, P. D., & Carlos, B. J. (2025). Prospective clinical study on the accuracy of static computer assisted implant surgery in patients with distal free-end implants: Conventional versus CAD-CAM surgical guides. Clinical Oral Implants Research, 36(3), 314–324.
Matvijenko, K., & Borusevičius, R. (2025). Comparison of dynamic navigation systems in dental implantology: A systematic literature review of in vitro studies. International Journal of Oral and Maxillofacial Surgery, 54(7), 647–656.
Aparicio, C., Polido, W. D., & Zarrinkelk, H. M. (2021). The zygoma anatomy-guided approach for placement of zygomatic implants. Atlas of the Oral and Maxillofacial Surgery Clinics of North America, 29(2), 203–231. https://doi.org/10.1016/j.cxom.2021.05.004
Kligman, S., Ren, Z., Chung, C. H., Perillo, M. A., Chang, Y. C., Koo, H., Zheng, Z., & Li, C. (2021). The impact of dental implant surface modifications on osseointegration and biofilm formation. Journal of Clinical Medicine, 10(8), 1641. https://doi.org/10.3390/jcm10081641
Kafedzhieva, A., Vlahova, A., & Chuchulska, B. (2025). Digital technologies in implantology: A narrative review. Bioengineering, 12(9), 927. https://doi.org/10.3390/bioengineering12090927
Tao, B., Fan, X., Wang, F., Chen, X., Shen, Y., & Wu, Y. (2024). Comparison of the accuracy of dental implant placement using dynamic and augmented reality-based dynamic navigation: An in vitro study. Journal of Dental Sciences, 19(1), 196–202. https://doi.org/10.1016/j.jds.2023.07.021
