Zygomatic dental implantation – Zygoma and Zygomatic implants

Instead of bone grafting Who is suitable for Zygoma? Implantation Process Risks Alternatives - Pterygoids
What are Zygoma zygomatic implants and why are they needed? Let's consider both the advantages of the system and possible risks that patients should be aware of before deciding to undergo surgery.

The advent of implants has improved the quality of life for many people. After all, before this, patients had to be content with removable dentures, which rubbed, tended to fall out and cause allergies.

Missing teeth leads to many problems:

  • chewing function is impaired;
  • diseases of the gastrointestinal tract occur;
  • the jaw sinks, the smile ages;
  • posture changes due to a shift in the center of gravity;
  • self-esteem decreases.

Thanks to implantation, hundreds of thousands of people not only received a beautiful smile, but also improved their quality of life in general.

However, there has always been a large group of patients for whom conventional implantation was not suitable.

An implant is a titanium pin that is screwed into the jaw bone, in the place where the root was. As soon as we lose a tooth, adequate nutrition ceases to flow into this place on the gum. The bone begins to shrink. The more time passes, the thinner the bone becomes. Quite often it happens that there is nowhere to screw the pin - the bone has become very thin. This is especially important for the upper jaw, where there is already less bone tissue, because the maxillary sinuses occupy a large place there.

Implantologists proposed different ways to solve this problem: transplantation or tissue extension, splitting of the alveolar process. But if the tissue did not take root or surgical methods were contraindicated, patients were left with one alternative - removable dentures.

Zygoma instead of bone grafting

Nobel Biocare specialists have found a solution. They have developed a completely new type of implants - zygomatic. The fact is that deep bone layers are not subject to atrophy. They contain enough bone tissue to install an implant even many years after tooth loss. Implantologists and engineers have proposed super-long implants that can be installed in dense cheekbones. These implants were called Nobel Zygoma, from the Latin word for cheekbone.

What does it give:

  • implants can be installed without bone grafting
    ;
  • the list of contraindications for installation is much smaller than for conventional ones;
  • more possibilities for orthopedic solutions.

Nobel Biocare has been manufacturing and installing zygomatic pins for 25 years

.
During this time, scientific facts have accumulated that prove that the survival rate of zygomatic implants is higher
[2] than conventional ones.
The cortical layers are dense and provide a high level of primary stability. Zygoma zygomatic implants take root not only easily, but also quickly - the time frame is reduced to 3 months
.

Contraindications for installation

Peculiarities Pterygoids Zygoma
Children's age (up to 18 years) Yes Yes
Pregnancy Yes Yes
Immune system diseases Yes Yes
Inflammation of the maxillary sinuses. sinusitis Yes
Mental illness Yes Yes
Inflammation of the nasal mucosa, ARVI, allergic rhinitis Yes

Key Features

  • The length reaches 52.5 mm
    , despite the fact that conventional implants are no longer than 25 mm;
  • The pin design consists of a smooth part and a screw at the end. The thread is needed to stabilize the implant in the bone, and the smooth part reduces the risk of bacterial complications
    ;
  • The special surface treatment of TiUnit accelerates osseointegration
    and ensures an influx of platelets - the bone immediately receives nutrition and tissue exchange begins.

What are pterygoid implants?

Pterygoid implants are a type of zigoma.

They are less traumatic, suitable for all clinical cases, and have fewer contraindications.

They penetrate not into the zygomatic, but into the pterygoid processes of the bone. The most famous types of implants of this variety are pterygoids of the ROOTT P

.

They have the ideal configuration and dimensions to suit almost any occasion.

When using them, the risk of developing bacterial complications and rejection of structures is minimized.

Who is suitable for Zygoma implants?

The main indicator for installing zygomatic implants is bone atrophy. Therefore, such implantation is recommended:

  • Cancer patients. Zygomatic pins were also developed for cancer patients whose bone loss is caused by chemotherapy and radiation therapy.
  • In case of bone atrophy as a result of medical manipulations or as a result of injury
  • After unsuccessful bone grafting or inability to perform it
  • With severe bone resorption and complete edentia
  • For osteoporosis
  • For stage 3-4 periodontitis
  • If there are contraindications to implantation with conventional pins.

Zygomatic implants can be installed in patients with HIV, type 2 diabetes, and cancer patients after chemotherapy and radiation.

Possibilities of subsequent prosthetics

Titanium implantation rods are first implanted into the bone tissue. Over the course of several days (the exact period depends on the individual physiological characteristics of the body), they will be fixed with special structures. Please note that they are designed for each patient individually so that the jaw structure is maintained or straightened if required. The structures are necessary so that the person continues to use the jaws, but the load does not move the titanium rods.

Bridge and bar construction on zygomatic implants

The full adaptation period takes approximately six months. During the process, you can screw in any prostheses. However, the installation process must be carried out under the strict supervision of a specialist, just as he must observe the condition of the jaws for some time. And only after this permanent dentures are installed.

How is Zygoma zygomatic implantation performed?

Zygomatic implants are used only for full jaw prosthetics. This, for example, is the usual All-on-4 system from the Nobel company, but instead of classic implants they use zygomatic ones.

  1. Diagnostics
    . Do not think that zygomatic implantation is suitable for everyone. The implantologist decides whether it is worth placing Zygoma based on CT data, tests and anamnesis. Only after analyzing all the information is a decision made about installing implants.
  2. Modeling
    using a special program. Software for installing implants allows you to create an accurate 3D model of the jaw, on which the places for the pins to fit are already marked.
  3. The actual implantation
    . During the operation, modern anesthetics are used, which completely eliminate pain. The implantologist makes incisions in the gums and screws in the implants.
  4. Prosthetics
    . Zygoma – implants with immediate loading. The temporary jaw is installed immediately. The load on it stimulates blood circulation and metabolic processes, accelerating osseointegration.
  5. The final stage. Once the osseointegration process is complete, a permanent prosthesis
    .

Two options for prosthetics on Zygoma implants

Possible alternatives

There are cases when Zygoma zygomatic implantation is not possible. In this situation, experts advise considering alternative options. This:

  1. Pterygoid implants ROOTT P;
  2. Carrying out a sinus lift procedure;
  3. Bone grafting;
  4. Implantation with basal implants;
  5. Use of removable dentures.

The use of zygomatic supports is considered a last resort measure of treatment when the bone tissue is severely atrophied and the maxillary sinuses are located so close that it is not possible to install classic pins. In other situations, you can get by with a sinus lift or bone grafting in combination with classical implantation. In addition, much depends on the financial capabilities of the client. If there are not enough funds for implantation, removable dentures are recommended, which, unfortunately, will not prevent further atrophy of bone tissue.

Risks

Zygomatic implants are long, they run along the edge of the maxillary sinus, coming close to the nerve endings and eyes. Installation of such implants requires pinpoint precision from an oral and maxillofacial surgeon.

Common complications:

  • Sinusitis. A titanium pin can cause inflammation of the maxillary sinus.
  • Rejection. The survival rate of zygomatic implants is high
    [2], but still some of them do not take root and a complex operation is carried out in vain.
  • Fistula formation. A fistula is a “passage” between the oral cavity and the sinus. Through it, microbes penetrate the sinus and cause inflammation.
  • Paresthesia (feeling of pins and needles on the skin). If the doctor touches the infraorbital or zygomatic-facial nerve during implantation, the consequence may be long-term paresthesia.
  • Orbital injury. A rare complication caused by a surgeon's error.
  • Complications of TMJ (temporomandibular joint)

Of course, zygomatic implants are a breakthrough in dentistry, but their installation requires extensive experience, special training, and modern equipment. Complications after surgery can develop into a serious problem. A psychological factor cannot be ruled out. Many patients, seeing a photo of a jaw with such pins, literally panic. Therefore, implantologists offer alternatives:

  • removable prosthetics;
  • bone plastic;
  • pterygoid implants.

Expert opinion

Tupikov Alexey Sergeevich

implant surgeon

Experience: more than 8 years

People have many fears and misconceptions about zygomatic implantation. When a patient takes a responsible approach to his health, he will choose a clinic where such operations are successfully practiced and where experts in their field work. If the doctor has extensive experience, has the necessary knowledge, and the dental center has all the necessary equipment, you can be sure that this will be one of the conditions for a successful procedure. Of course, we should not forget about possible complications and contraindications that must be excluded. In my work, I usually try to use traditional or pterygoid implants (implanted into the pterygoid processes, and not into the zygomatic bone), and only in cases where a person has severe bone degradation and other serious indications, do I resort to transzygomatic implantation.

Advantages of the system over the classical method

The surgical protocol for the classical technique of implanting the upper lateral units usually involves a preliminary sinus lift to build up the bone while simultaneously raising the floor of the maxillary sinus. This takes a lot of time and involves additional expenses.

Zygoma implants allow you to quickly restore the entire dentition without waiting for an increase in bone volume.

The difference between implantation with Zygoma systems and the traditional method is the immediate loading of structures with prostheses , the possibility of carrying them out in cases of oncological diseases. An undeniable advantage is the cost of implants. Fewer steps in the procedure significantly saves costs.

What is the difference between Zygoma implants and Nobel Biocare Active (Nobel Active)

Nobel Active designs are famous for their practicality and reliability. Widely used due to internal connection, ease of installation in confined spaces. The same cannot be said about Zygoma implants, which require general anesthesia due to the high trauma and complexity of the process. However, the latter are the only ones effective in solving the most complex problems of edentia.

The size of the pins is the main difference between these two models of the world famous American manufacturer of dental products Nobel Biocar. The method of implantation also differs. Nobel Active is mostly used in a two-step method, while Zygoma is always installed at once. The rehabilitation period for zygomatic implants is shorter. Plus, they allow you to immediately fix the prosthesis, which significantly improves the patient’s quality of life.

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