Zygomatic (Zygoma) implants provide a solution for patients wanting dental implants, but who have severe bone loss in the upper jaw. This treatment avoids the need for bone grafting (bone augmentation). These implants (unlike conventional ‘root form’ dental implants that are placed into the jaws to replace teeth) are placed into the zygomatic bone (cheekbone) to provide support for upper jaw (maxillary) teeth, bridges and dentures.
Perhaps you have been told that you need dental implants, BUT you are not a candidate for implants because of a lack of bone volume in your upper jaw, then you may believe there is nothing else to be done? These implants may be used to reconstruct the upper teeth when upper jaw bone quality or quantity is reduced and is thus unsuitable for the placement of regular ‘root form’ dental implants.
Bone atrophy (resorption) basically describes the process of wasting away of body tissue (bone in this case) as a result of cell degeneration. It is a natural phenomenon that occurs after the extraction of teeth, which can be exacerbated over time due to dentures. Patients who have worn dentures for many years and have advanced atrophy of the jaw sometimes don’t have the necessary quality or volume of bone that’s required for dental implants.
Upper jaw (maxillary) bone volume loss may occur as a result of bone resorption (lost when the teeth are missing, they no longer transmit stress to the jaw bone to maintain bone mass) and pneumatization of the maxillary sinus (the air volume of the sinus increases with age and the bone volume decreases) or a combination of both.
When the jaw bone height of the upper jaw is less than 10 mm (vertical height), regular ‘root form’ implants will need bone grafting (alveolar augmentation, sinus lift grafting) to stabilise the implants and increase their length of survival.
Bone grafting procedures in the jaws are successful but the disadvantage is prolonged treatment time (extra stages needed for bone graft placement, healing and maturation and then implant placement). Additionally, a denture will be needed while the bone grafts heal (for 3-4 months). Sometimes the bone graft is rejected (if it doesn’t heal properly) and you often experience more pain and swelling when certain types of bone graft (block) are used.
Even when teeth are still present, they can be affected by gum disease (periodontal disease) or severe infections that cause the destruction of the jawbone. Such patients are also often deemed unsuitable for conventional dental implant treatment and zygomatic implants can be the ideal solution. But what are zygomatic implants and why might you need them?
What are zygomatic implants?
Zygoma implants anchor into the zygomatic bone (cheek bone), where the bone is denser than upper jaw. This solid basis for implant support spreads stress across a broad area and allows for successful immediate placement of dental bridges at the time of surgery (no need to use a denture or good without teeth for any period).
These implants have been in use since the late 1980’s and have a long history of success. Zygomatic implants have been used for dental rehabilitation in patients with insufficient bone in the posterior upper jaw secondary to a number of conditions – for example increased bone loss with advancing age (patients who have lost teeth or worn dentures from an early age), after resection of tumours, trauma, or severe bone resorption (atrophy).
Zygomatic also known as ‘Zygoma’ provide an alternative to bone grafting procedures in the upper jaw and are dental implants that transverse inside the poor area of your upper jaw to anchor into the underside of the cheekbones through your sinuses. These Implants are inserted into the back section from within your mouth and can be combined with one or more regular (root form) implants in the front part of your jaw
Depending on the patient needs, either 2 (one each side) or 4 (2 each side) implants are placed to support full or partial dental bridges.
The procedure is safe and predictable when performed by Specialist Surgeons with experience in the technique. The treatment is performed under anaesthetic as a day stay surgery and a full set of immediate teeth can be connected to the implants on the same day of surgery.
What type of patients do zygomatic implants suit?
Zygomatic implants are a valid reliable treatment for patients with severely resorbed upper jaws; these patients have often been told that they ‘cannot have implant treatments as there is not enough jaw bone left’.
The zygomatic implants are designed to attach immediate ﬁxed replacement teeth (dental bridges).
In more severe cases (advanced bone volume loss), two zygomatic implants (or quad zygoma) may be placed on each side of the upper jaw to support a full upper set of replacement teeth. This treatment is also used for dental rehabilitation of cleft palate patients.
What is the difference between these and normal dental implants?
A zygoma implant is considerably longer than a conventional (root form) dental implant; it is still inserted through the mouth, but it anchors into the cheekbone (zygomatic bone) as opposed to the dental arches (alveolar bone) in the mouth. Due to the solid bone in the cheeks, zygomatic implants have a high immediate stability that is the perfect foundation for immediate placement (same day teeth) of replacement teeth (dental bridges).
Why are zygoma implants inserted into the back of the jaw?
The jaw bone (alveolar bone) at the back of the upper jaw is prone to resorption (atrophy) much more than other areas of tooth bearing bone. As such, the zygoma implant bypasses the need for extensive bone grafting that might otherwise be required to place regular (root form) dental implants (compared to bone grafting procedures, the surgery for zygomatic implants is less invasive, quicker to recover from, doesn’t require the patient to wear a denture or go without teeth for any period and causes a lot less discomfort).
How is a treatment plan for zygomatic implants prepared?
Treatment for zygomatic implants are planned using digital technology (CT based virtual planning with creation of custom surgical guides) which saves operating time (less anaesthetic) and allows for accurate creation of the final dental bridge (prosthetically driven treatment planning). In the past, treatments of this kind were unpredictable in terms of the effectiveness of a treatment and problems were difficult to foresee during a procedure. With the help of state-of-the-art equipment, Specialist Surgeons are able to execute treatments with the utmost accuracy and in the safest environment possible
- Consultation and assessment by a Specialist Surgeon. This treatment is not as common as regular dental implant treatment and requires a Specialist Surgeon with extensive experience and skills in the technique. Unfortunately, Dentists may not even be aware of this type of treatment as an option for appropriate patients.
- Thorough examination, investigation (CBCT or CT scans – Medicare rebates cover costs) and digital planning utilising the latest virtual surgery software. Detailed quotes (with Health Fund codes and Medicare rebates listed) for treatment planned.
- Day surgery procedure booking for implant placement (+/- removal of teeth) + dental bridge insertion.
- Recovery period (2-3 days); return to normal timetable within 7 days.
What are some of the benefits of having zygomatic implants?
Zygomatic implants allow patients to regain their self-confidence through improved smile appearance and aesthetics; they also ensure a return to the enjoyment of social outings and interactions as a result better oral function (speech, eating and swallowing) associated with fixed dental bridges (implant retained prosthetics).
- Improved appearance
- Improved speech
- Improved self-esteem
- Normal looking teeth and gums
- The freedom to eat what you like
- The confidence to laugh
- Teeth that don’t come out
- The elimination of denture sore spots
- Long term tooth support
- Faster healing than bone grafting
- Low maintenance
Other benefits include:
- The major advantage of this technique is that bone grafting is rarely needed. This means that for the majority of patients, no bone grafting is necessary.
- The treatment is suitable patients with severe bone loss. Even those patients who have been told that implant treatment is not possible by conventional means.
- Dental bridges are attached to the implants on the same day as surgery (Teeth in a day; All on four; Immediate implant bridge placement) so there is no time without teeth and no need for a denture.
- Zygomatic implants have a role in providing dental support in cleft lip and palate patients who are unable to tolerate more conventional treatments.
- One zygomatic implant can support 3-4 teeth; one regular dental implant supports 1-2 teeth.
- Four zygomatic implants can support a full upper dental bridge.
- Immediate placement (when teeth are removed and zygomatic implants are placed at the same time) can be planned predictably.
- Zygomatic implants can be used to salvage other failed or failing dental implant treatments (All on 4; mini-implants; failed bone grafts; severe periodontal breakdown of the existing teeth).
How successful are zygomatic implant treatments?
Zygomatic implant treatments are extremely successful, particularly when you consider how dental implant technology has evolved over the last twenty years. However, the success of all dental implant treatments depends on the patient’s general health and ability to continue with regular maintenance as well. In order to maintain functionality, patients need to care for their implant by brushing and flossing at least twice a day to keep both the implants and teeth (implant prosthetics) clean.
Regular appointments with a dental hygienist are also recommended to clean areas that can’t be reached with a regular toothbrush. If patients follow their dentist’s advice and guidelines, zygomatic implants can last a lifetime.
Can a zygomatic implant be combined with a normal dental implant?
Zygomatic implants and regular (root form) dental implant can be combined to achieve a successful outcome. Some patients will have sufficient bone for implant placement at the front of their mouth, but not at the back; in these patients a combination of the two implants is planned.
What is the cost of zygomatic implant surgery?
Zygomatic implants cost a little more than regular (root form) implants, but because less of them are needed (2-4 zygomatic implants versus 4-6 regular dental implants) for each treatment, the overall costs are similar.
After your Specialist Consultation, you will be given a detailed quote for the entire treatment; all aspects of treatment (implant placement and fabrication of the final implant retained bridges) are completed with the same Specialist.
The quotes provided will include details of both Health fund codes (to receive Health Insurance rebates) and Medicare codes (to receive Medicare rebates – only available to patients of Specialist Surgeons).
Like to know more about the pros and cons of zygomatic implant surgery? Contact the experts at the Dental Implant & Specialist Centre today on (07) 5503 1744.