Zygomatic Implants

What are zygomatic implants?

Zygomatic implants in Istanbul are used for the most difficult upper-jaw cases: those where years of denture wear, advanced gum disease, previous failed implants or trauma have left the maxilla too thin to hold conventional fixtures. Instead of relying on the jaw, the implant passes upward through or alongside the sinus region and anchors in the zygoma, the cheekbone, which is dense and does not resorb after tooth loss.

Two zygomatic implants, one each side, are usually combined with two to four conventional implants at the front to support a full-arch bridge. In the most severe cases, four zygomatic implants carry the bridge alone. The treatment is a specialised branch of implant dentistry and requires detailed three-dimensional planning and experience.

Who is a candidate for zygomatic implants?

Candidates are patients with severe resorption of the upper jaw who want a fixed solution and wish to avoid a long cycle of bone grafting and waiting. Your dentist confirms suitability after examination and CBCT imaging that shows the zygoma, the sinus anatomy and the remaining maxillary bone.

• Long-term upper denture wearers with a flat, resorbed ridge
• Patients told elsewhere that they have no bone for implants
• Patients who have had grafts or sinus lifts that failed or resorbed
• Patients with previous implant loss in the upper jaw
• Patients after tumour surgery or trauma affecting the maxilla, assessed case by case

When the standard protocols still apply

Many patients who fear they have too little bone are in fact well served by All-on-4, whose tilted rear implants avoid the sinus, or by a sinus lift with conventional implants. Zygomatic implants are reserved for cases where those options are genuinely unavailable or unreliable.

The procedure and anaesthesia

Zygomatic surgery is more involved than conventional implant placement and is usually carried out under intravenous sedation or general anaesthesia, decided with you and the anaesthetist in advance. The operation typically takes two to four hours for a full arch.

• Assessment: examination, photographs, digital scan and a CBCT scan extending to the cheekbones and orbits.
• Planning: implant paths are simulated in three dimensions to pass safely between the sinus, the orbit and the facial soft tissues; a guide or navigation may be used.
• Surgery: remaining teeth are removed, the zygomatic implants are placed along the planned paths, and anterior implants are added where bone permits.
• Same-day teeth: because zygomatic implants achieve high initial stability, a fixed temporary bridge is usually fitted within a day.
• Integration and final bridge: after healing, a permanent bridge is made in the same way as for other full-arch cases.

Benefits and drawbacks

The principal benefit is that patients previously considered untreatable without extensive grafting can receive a fixed bridge in a single surgical phase, frequently with teeth the same day. Treatment time falls from a year or more to a few months, and the unpredictability of large grafts is avoided.

The drawbacks are that the surgery is technically demanding, the implants pass close to the sinus, and the bridge at the back may emerge slightly toward the palate, which some patients notice with speech at first. Meticulous hygiene around the emergence points is essential. These factors are explained fully before you decide.

Recovery and aftercare

Expect facial swelling and bruising that peak on day two or three and settle over ten to fourteen days; some patients also notice temporary nasal congestion or minor nosebleeds. Prescribed medication, cold compresses, sleeping with the head raised and avoiding forceful nose-blowing all help. Most patients are comfortable to fly home five to seven days after surgery.

The soft-to-medium diet during integration protects the temporary bridge and the healing sites. Cleaning around the zygomatic emergence points uses a water flosser and interdental brushes, shown to you before departure and detailed in the aftercare guide.

Alternatives and how they compare

The main alternative is staged reconstruction: sinus lifts and block or particulate grafts, several months of healing, then conventional implants and eventually a bridge. It is a legitimate path and is still chosen in some cases, particularly for younger patients with moderate rather than severe loss. Its cost is time, additional surgeries and the possibility that grafted bone partly resorbs.

An implant-retained overdenture on short or narrow implants at the front of the jaw is another option for patients who accept a removable prosthesis. Zygomatic implants are the only route that delivers fixed teeth in one phase when the maxilla is severely atrophied.

Planning as an international patient

The first trip requires seven to ten days: pre-operative assessment and anaesthetic review, surgery, at least two post-operative checks and enough time for swelling to subside before a long flight. The second trip for the permanent bridge takes six to eight days, as for other full-arch cases.

Remote follow-up is more structured than for routine implants, with scheduled photograph reviews and a checklist of symptoms to report. A home dentist or physician may be asked to assist with a mid-point check. Practical arrangements are described on the international patients page and the visits page.

• Trip one: 7–10 days, assessment, surgery under sedation or GA, temporary bridge
• At home: 3–6 months with structured remote follow-up
• Trip two: 6–8 days, impressions, try-in and permanent bridge

Risks and what to watch for

Specific risks include sinusitis, oro-antral communication, infection around the implant, temporary altered sensation of the cheek, and, rarely, complications involving the orbit that careful planning is designed to exclude. Early loss of a zygomatic implant is uncommon but is managed with a replacement along a modified path.

Contact the clinic promptly for persistent nasal discharge, facial pain or pressure that increases after the first week, fever, swelling near the eye, or a bridge that feels loose. Most issues are identified early through the remote follow-up schedule and resolved without an unplanned trip.