In brief: A zygomatic implant is a long implant that runs from the upper gum to the cheekbone (zygoma), so it can hold fixed teeth when the upper jaw has too little bone for regular implants. It usually avoids a sinus lift or bone graft, so fixed provisional teeth are often fitted on the day of surgery and the final bridge follows in 3 to 6 months.
What a zygomatic implant is
Regular implants anchor in the ridge of jawbone that once held the tooth roots. That ridge shrinks after tooth loss. The cheekbone does not: it is dense, mostly cortical bone that does not waste away when teeth are lost, even after decades without teeth.
A zygomatic implant is much longer than a regular one, usually between about 30 and 52.5 mm. It enters the mouth at the top of the upper ridge and is angled upwards so its tip locks into the body of the cheekbone. Because the tip grips several layers of hard cortical bone, it gets firm hold where a regular implant would sit in soft bone or none at all.
The technique was developed in Sweden by Professor Brånemark's team, and published follow-up now stretches back more than two decades. It is used only in the upper jaw.
Who is a candidate
- Severe upper-jaw bone loss: people who have had no upper teeth for many years, or lost bone to gum disease, where even the tilted implants of All-on-4 cannot get firm hold.
- Failed sinus lifts or bone grafts: a failed graft often leaves the ridge thinner, but it does not affect the cheekbone.
- Failed upper implants: the cheekbone is separate from the sites where earlier implants were lost.
- People who want to avoid staged grafting: grafting followed by implants often takes 12 to 18 months before final teeth.
Health still matters. Uncontrolled diabetes, heavy smoking, past radiation to the jaws, some bone-strengthening drugs and active sinus disease all raise risk and are checked before surgery. Many patients who think they need zygomatic implants turn out to be suitable for regular or tilted implants; our article on choosing between zygomatic, pterygoid and All-on-4 explains how that decision is made.
Planning with CBCT
Every zygomatic case is planned from a CBCT scan. The 3D data shows the volume and shape of each cheekbone, the sinus floor and walls, the remaining front ridge, and the position of the eye socket floor and the infraorbital nerve.
The implant path is designed in planning software before surgery, together with an intraoral scan so the bridge can be designed for the same implant positions. At Dazzle, implants are placed with ClaroNav Navident guided surgery, which shows the drill position against the CBCT plan in real time.
How the surgery is done
The implant is placed entirely from inside the mouth. Nothing passes through the skin of the cheek and nothing is visible from outside. Surgery is done with local anaesthetic, and IV conscious sedation is available as an option.
Surgical approaches
- Original intrasinus approach: the implant passes through the maxillary sinus to reach the cheekbone.
- Sinus slot approach: the implant runs in a narrow slot cut in the side wall of the sinus.
- Extra-sinus (extra-maxillary) approach: the implant runs outside the sinus wall, along the curve of the jaw. Many centres prefer it when the anatomy allows, because the implant head sits in a better position for the bridge and sinus problems may be less frequent.
The CBCT shows which path fits each side, and the two sides of the same jaw may get different approaches.
Common layouts
Most often, two zygomatic implants (one per side) are combined with two regular implants in the front. When the front ridge is also too thin, four zygomatic implants (quad-zygoma) carry the whole bridge. If bone loss is one-sided, a single zygomatic implant can be combined with regular implants.
Same-day teeth and the timeline
Because the cheekbone gives high initial stability, zygomatic implants are usually loaded immediately: a fixed provisional bridge is attached on the day of surgery when every implant is stable enough. Studies report stability readings at placement well above the levels usually used for immediate loading.
The implants then bond with bone (osseointegration) over 3 to 6 months. After that, the final bridge is made from new scans in our in-house lab and fitted. Compared with grafting first, which needs 6 to 8 months or more of graft healing before implants even go in, this removes most of the waiting time.
Risks and complications
Zygomatic surgery is more complex than regular implant surgery and should be done by a surgeon trained in it. The risks reported in the literature include:
- Sinusitis: the most commonly reported complication. Most cases settle with antibiotics and nasal rinses without removing the implant.
- Soft tissue problems: gum irritation or recession around the implant head, which is why the implant path and bridge shape are planned together.
- Numbness: temporary tingling of the cheek or lip from pressure on the infraorbital nerve.
- Eye socket injury: rare, and the reason the path is planned in 3D and checked during surgery.
- Oroantral communication: an opening between mouth and sinus, uncommon and usually repaired with minor surgery.
Recovery and long-term results
Swelling and bruising of the cheeks are common, peak at around 48 to 72 hours and usually settle over 10 to 14 days. Some patients notice a nosebleed or sinus stuffiness for a few days. A soft diet is needed for 6 to 8 weeks while the implants bond.
Published reviews report long-term zygomatic implant survival comparable to regular implants, often 95% or higher at around ten years. Long-term success depends on cleaning under the bridge, not smoking and attending regular reviews, as with any implant bridge.
International patients typically plan two trips: one for surgery and provisional teeth, and a second after 3 to 6 months for the final bridge. The provisional bridge is designed to function during that gap.
Cost
Zygomatic implants are listed on our fees page at ₹1,00,000 per implant. A full-arch total depends on the number of zygomatic and regular implants, the implant system, sedation or anaesthesia, and the final bridge material. An itemised quote follows the consultation and CBCT.
FAQs
Will zygomatic implants change the shape of my face?
No part of the implant shows on the cheek. The new bridge often improves lip and cheek support that was lost with the teeth and bone.
Can zygomatic implants be used in the lower jaw?
No. The cheekbone is above the upper jaw only. Lower-jaw bone loss is handled with tilted, short or basal implants, or grafting.
My bone grafts failed. Can I still have zygomatic implants?
Usually, yes. A failed graft affects the ridge, not the cheekbone. A CBCT confirms the cheekbone volume on each side.
How long does the surgery take?
It usually takes a few hours, longer for quad-zygoma or when both jaws are treated together. Your surgeon gives you a time estimate with the plan.
Want to know if zygomatic implants suit your bone? Read about our zygomatic implant treatment or Book a Consult at our Bandra West or Kemps Corner clinic.
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