5 Key Differences Between Zygomatic and Conventional Implants

Dental implants have revolutionized the way we restore missing teeth, providing patients with long-term, functional, and aesthetically pleasing solutions. Traditional or conventional implants, which anchor into the alveolar bone of the upper or lower jaw, are the most commonly used type of implant. However, in cases of significant bone resorption or severe maxillary atrophy, conventional implants may not be viable. In these situations, zygomatic implants offer an alternative by anchoring into the zygomatic bone (cheekbone), bypassing the need for bone grafting or sinus lifts.

Despite both being used to replace missing teeth, zygomatic implants and conventional implants differ significantly in their design, placement technique, indications, and potential outcomes. Understanding these differences is critical for choosing the best approach for a patient. This article explores the five key differences between zygomatic and conventional implants to help dental professionals make informed decisions in complex cases.

1. Anatomical Considerations: Implant Placement

The most fundamental difference between zygomatic and conventional implants lies in their placement location. Conventional implants are placed directly into the alveolar bone, which is the bone that supports the teeth in both the upper and lower jaws. In contrast, zygomatic implants are placed into the zygomatic bone, which is the bone of the cheek, situated much higher and further back in the face.

A. Conventional Implants:

Conventional implants typically anchor into the alveolar ridge, which is the ridge of bone that holds the tooth sockets. This ridge is located in the upper and lower jaw and has adequate bone in most patients, especially those who are edentulous or have a healthy jawbone. The size and shape of the alveolar ridge may vary depending on the patient’s oral health, but it is generally the preferred site for implant placement due to its relatively accessible location and predictable outcomes.

B. Zygomatic Implants:

Zygomatic implants, however, are placed in the zygomatic bone, located in the lateral aspect of the maxilla, near the cheekbone. The zygomatic bone is significantly denser than the maxillary alveolar bone, providing an excellent anchorage for implants in patients who have suffered severe resorption of the maxillary ridge. Zygomatic implants are much longer (typically 30–52 mm) and are placed at an angle of approximately 45–60 degrees, angling towards the back of the maxilla.

Because zygomatic implants use a more posterior, lateral bone structure for anchorage, they are ideal for patients with severe atrophy or loss of the maxillary ridge where conventional implants cannot be placed.

2. Surgical Technique and Complexity

The placement technique for zygomatic implants is more advanced and technically demanding compared to conventional implants. While both types of implants require precision, the complexity of zygomatic implant surgery arises from the need to navigate a different anatomical region and the longer implant design.

A. Conventional Implants:

Placing conventional implants generally involves the following steps:

Incision in the gum tissue to expose the underlying bone.
Drilling into the alveolar ridge to create a site for the implant.
Placement of the implant into the bone.
Healing period of approximately 3–6 months for osseointegration before attaching the final restoration.

The procedure is typically straightforward and can be completed with local anesthesia in most cases. The surgical risks are generally low, with a shorter recovery time compared to zygomatic implants.

B. Zygomatic Implants:

The surgical process for zygomatic implants is more intricate and involves:

Incision and flap elevation to access the zygomatic bone, often in the posterior maxilla near the sinus cavity.
Specialized drilling to create a tunnel into the zygomatic bone, angling the implant at 45–60 degrees.
Implant placement into the zygomatic bone, often using longer implants to ensure stability.
Immediate loading may be possible, but often, healing time is required for osseointegration.

Because of the technical demands of the procedure, zygomatic implant placement typically requires advanced training and experience in implantology. Furthermore, there is a higher risk of complications such as sinus perforation, nerve damage, or improper implant angulation if the procedure is not performed correctly.