Zygomatic Implants & Full-Arch Rehabilitation
Advanced solutions for severe upper jaw bone loss
Some patients are told that they do not have enough upper jawbone for conventional dental implants. Zygomatic implants can provide an alternative for selected patients with severe bone loss, poorly fitting dentures, previous failed implant treatment or complex reconstructive needs.
A zygomatic implant is similar to a conventional dental implant but is considerably longer. Rather than relying only on the upper jawbone, it extends deeper through the upper jaw and anchors securely within the dense zygomatic bone, or cheekbone.
Associate Professor Christian Freudlsperger and Mr Nigel Parr provide specialist assessment and surgical management for complex implant rehabilitation, including severely atrophic jaws, failed grafting or implants, and reconstruction following trauma or tumour treatment.
UNDERSTANDING THE CONDITION
What Are Zygomatic Implants?
Zygomatic implants are specialised long implants used to support fixed upper-jaw teeth when there is insufficient bone for standard implants.
Conventional implants are anchored within the upper jawbone. Zygomatic implants extend into the cheekbone, which often remains strong and stable even after significant loss of upper jawbone.
This approach may reduce or avoid the need for extensive bone grafting and can provide a stable foundation for a full-arch fixed bridge or prosthesis.
Who Needs Zygomatic Implants?
Zygomatic implants may be considered for patients with:
Severe upper jawbone loss or atrophy
Long-term tooth loss and progressive bone resorption
Loose or poorly fitting upper dentures
Previous failed dental implants
Previous unsuccessful bone grafting
Enlarged maxillary sinuses with limited available bone
Extensive bone loss from periodontal disease
Congenital or developmental jaw conditions
Altered anatomy following facial trauma
Rehabilitation following tumour removal or jaw reconstruction
They are not suitable for every patient. Oral health, medical history, sinus health, anatomy and the intended final restoration must all be assessed carefully.
Patients who have previously been advised that conventional implants are not possible may benefit from specialist reassessment.
PROCEDURE & TREATMENT OPTIONS
Assessment & Planning
Successful full-arch rehabilitation begins with detailed surgical and prosthetic planning.
Assessment may include:
Clinical examination of the mouth, gums and existing teeth
Review of medical history, medications and previous implant treatment
CBCT or medical CT imaging of the upper jaw, sinuses and cheekbones
Digital intraoral scans and photographs
Assessment of the bite and available restorative space
Evaluation of sinus health and relevant anatomical structures
Discussion with the restorative dentist, prosthodontist and dental technician
Digital planning allows the implant path, prosthetic position and surrounding anatomy to be assessed in three dimensions. The proposed implants should be planned according to the final fixed bridge rather than placed independently of the restorative design.
For referring clinicians, this coordinated planning supports accurate implant positioning, predictable prosthetic access and clear communication throughout treatment.
The Surgical Procedure
Zygomatic implant placement is advanced surgery and is usually performed under general anaesthesia or deep intravenous sedation in an appropriate surgical environment.
Depending on the anatomy and treatment plan, surgery may involve:
Placement of one or more zygomatic implants on each side
Placement of conventional implants in the front of the upper jaw where bone permits
Removal of failing teeth where necessary
Preparation of the sites using the digital surgical plan
Placement of a temporary fixed prosthesis where adequate implant stability is achieved
Some patients can receive fixed temporary teeth shortly after surgery. This is known as immediate loading. It is only recommended when implant stability, bone quality, bite and overall treatment conditions are suitable.
The exact implant configuration varies. Some patients require a combination of zygomatic and conventional implants, while others may require multiple zygomatic implants because very little upper jawbone remains.
Full-Arch Rehabilitation
Full-arch rehabilitation uses strategically positioned implants to support a complete fixed bridge or prosthesis.
Treatment planning considers:
The number and position of implants
Available upper jaw and cheekbone anatomy
Lip and facial support
The relationship between the upper and lower jaws
Speech and chewing function
Aesthetic goals
Cleaning access and long-term maintenance
Whether immediate temporary teeth are appropriate
This differs from a routine All-on-4 treatment because zygomatic implants use the cheekbone for anchorage and are generally reserved for more complex upper-jaw cases with severe bone deficiency.
Recovery & Final Restoration
Follow a soft-food diet during early healing
Take prescribed pain relief and other medications as directed
Maintain careful oral hygiene
Avoid smoking and vaping
Avoid excessive pressure on the temporary teeth
Attend all surgical and restorative follow-up appointments
The implants continue to integrate with the bone over several months. A temporary prosthesis may remain in place during this period.
Once healing is complete, the restorative dentist or prosthodontist prepares the definitive fixed bridge. This phase may involve digital scans, impressions, bite records, trial restorations and aesthetic adjustments before the final prosthesis is fitted.
Why Choose Oral and Facial Surgery, Remuera?
Specialist Craniofacial and Reconstructive Expertise: Associate Professor Christian Freudlsperger and Mr Nigel Parr are specialist oral and maxillofacial surgeons with extensive experience in complex implant surgery, severe jawbone loss and facial reconstruction.
Advanced Digital Planning: Detailed three-dimensional imaging and digital restorative planning are used to assess the cheekbone, upper jaw, sinuses and intended prosthesis before surgery.
Comprehensive Complex-Case Management: Specialist care is particularly valuable for patients with previous implant or graft failure, severe atrophy, altered sinus anatomy, facial trauma or reconstruction following tumour treatment.
Collaborative Full-Arch Care: We work closely with experienced dentists, prosthodontists and dental technicians to coordinate implant placement, temporary teeth, definitive restoration and long-term maintenance.
Risks & Recovery
Long-term success depends on excellent maintenance of both the implants and the fixed prosthesis.
Ongoing care includes:
Daily brushing and cleaning beneath the bridge
Use of interdental brushes, floss or a water flosser as advised
Regular dental and hygiene appointments
Periodic clinical and radiographic implant review
Monitoring of the sinuses where appropriate
Avoiding smoking
Wearing a protective appliance if significant grinding or clenching is present
Early assessment of pain, swelling, mobility or difficulty cleaning
With careful planning, appropriate case selection and regular maintenance, zygomatic implants can provide stable full-arch tooth replacement for patients who may otherwise have limited restorative options.
BOOK YOUR APPOINTMENT
Discover If Zygomatic Implants are right for you
IIf you have severe upper jawbone loss, failing implants, an unstable upper denture or have been told that conventional dental implants are not possible, please contact the practice to arrange a specialist assessment.
We welcome referrals from dentists, prosthodontists, periodontists, orthodontists, medical specialists and general practitioners.