Zygomatic implants: when are they considered?
Zygomatic implants are a complex surgical technique for patients with significant bone loss in the upper jaw (typically after multiple extractions, advanced gum disease, illness or trauma) that prevents the use of conventional dental implants. For these patients, zygomatic implants are one of the options for a fixed restoration, alongside bone-building procedures and removable solutions. At this dental clinic in Jerusalem, zygomatic implants are placed on site, under local anesthesia.
Zygomatic implant planning relies on 3D imaging (CBCT), taken at the clinic with a Planmeca ProMax 3D, which allows the implant path to be planned precisely and nearby structures to be avoided.
Because the procedure is more complex than regular dental implants, each case is assessed carefully to decide whether zygomatic implants are appropriate. The consultation covers every aspect: benefits, risks, alternatives and the expected recovery.
What are zygomatic implants, and who are they for?
Zygomatic implants are extra-long dental implants anchored in the zygomatic bone (the cheekbone) instead of the upper jawbone. The cheekbone is made of dense cortical bone around a core of spongy bone, so it gives stable anchorage even when the upper jaw has resorbed. Its dimensions vary between people, so bone thickness and nearby structures (the eye socket, the infraorbital nerve and the maxillary sinus) are measured on 3D imaging before any surgery.
These implants are usually 30 to 52.5 mm long (Neugarten et al., International Journal of Oral and Maxillofacial Implants, 2017), several times the length of a regular implant. They are designed to bypass the maxillary sinus and use the zygomatic bone as an anchor, allowing the upper jaw to be restored even with significant bone loss.
30-52.5 mm
length of zygomatic implants
Zygomatic implant placement: how the surgery works
1. Anesthesia and gum incision
Because of its complexity and duration, zygomatic surgery is often described in the literature under general anesthesia or deep sedation. At this clinic, it is performed under local anesthesia, with light oral sedation on prescription when needed; the clinic does not provide general anesthesia or IV sedation. The procedure starts with an incision in the gum at the back of the upper jaw, exposing the upper jawbone and the lower part of the zygomatic bone. The surgeon then opens a small window in the side wall of the maxillary sinus to guide the implant precisely through the sinus into the zygomatic bone.
2. Creating the path and placing the implant
With special extra-long drills, the surgeon creates the planned path through the jawbone, across the sinus and into the zygomatic bone, following the CT-based plan and limiting heat in the bone. The zygomatic implant is then inserted along this path, with its top part emerging in the mouth at the gum ridge.
3. Temporary and permanent restoration
For a full upper-jaw restoration, two zygomatic implants are usually placed on each side (four in total), or one on each side combined with 2 to 4 regular implants in the front. Impressions are then taken so that a temporary restoration can be fitted on the implants the same day or within a few days. The permanent restoration is usually fitted after a few months, once the implants are fully integrated and stable.
Although the procedure is more complex than regular implants, zygomatic implants have a high survival rate: according to a systematic review of 4,556 implants, about 95% survived 12 years, and most failures occurred in the first six months (Chrcanovic et al., Journal of Oral and Maxillofacial Surgery, 2016). Reported complications include sinusitis (about 2.4%), altered sensation (about 1%) and an opening between the mouth and the sinus (about 0.4%); sinusitis can also appear years after surgery. Success also depends on the surgeon's experience, so a surgeon with specific experience in zygomatic implants is recommended.
Who performs the surgery
The surgery is performed by Dr Yves Weinberg, head of the Oral and Maxillofacial Surgery Department at Barzilai Medical Center, who operates at the clinic. Zygomatic implants are placed at the clinic itself, under local anesthesia.
Benefits of zygomatic implants
Zygomatic implants offer a solution for patients with significant bone loss in the upper jaw. Regular implants need enough bone volume; zygomatic implants use the cheekbone as an anchor and so bypass the lack of bone at the back of the upper jaw. This allows many patients once considered unsuitable for implants to receive a fixed, natural-looking restoration.
- No complex bone-building procedures such as a sinus lift or a dental bone graft, and no months of waiting, in many cases
- Possible immediate loading: temporary teeth the same day or within a few days, including for full mouth dental implants; according to a systematic review, failure rates with immediate loading were lower than with delayed loading
- Survival of about 95% after 12 years, according to a systematic review
- Anchorage in the dense zygomatic bone
According to a systematic review of studies with at least 5 years of follow-up, the survival rate of zygomatic implants was about 96.5%, with no significant difference compared with regular implants (Moraschini et al., Clinical Implant Dentistry and Related Research, 2023). They are an alternative for patients who previously had to settle for removable dentures.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
How much do zygomatic implants cost?
Zygomatic implant treatment usually costs more than regular dental implants, for several reasons. The surgical complexity requires a skilled surgeon with specific training and experience in zygomatic implants. The surgery is also longer, and planning includes 3D imaging and, when needed, a 3D-printed surgical guide.
The full financial picture
Despite the higher cost, it is worth comparing the whole picture: once the cost of sinus lifts, bone grafts and other procedures needed for regular implants is taken into account, the difference in total cost may narrow. Overall treatment time also matters to many patients.
A detailed written quote
A detailed written quote is given after an examination and imaging. Check that it covers every part of treatment: preliminary imaging, surgery and anesthesia, the temporary and the permanent restoration. Itemized receipts can be submitted to your insurer (reimbursement depends on your policy).
The choice between zygomatic implants, bone building or a removable solution is made according to the bone, general health and the patient's preferences, not on price alone. See also dental implant cost.
Zygomatic implants vs regular implants
| Criterion | Regular implants | Zygomatic implants |
|---|---|---|
| Length | Much shorter | About 30 to 52.5 mm |
| Anchorage | Placed directly in the jawbone | Anchored in the zygomatic bone (cheekbone) |
| Loading | Often a healing period of a few months before loading | Usually fixed temporary teeth shortly after surgery |
Basal implants are another alternative when bone is lacking, using the basal bone of the jaw; zygomatic implants are specific to the upper jaw, especially with significant bone loss at the back. They sometimes allow a full upper-jaw restoration on just four implants (two regular implants in front and two zygomatic implants at the back).
Recovery and follow-up after zygomatic implants
Patients may have swelling, bruising and discomfort in the first days after surgery; these usually pass within a week to ten days. You receive detailed recovery instructions; medicines such as pain relievers, and antibiotics when needed, are given by prescription only, as decided by the surgeon.
01
Regular check-ups
A separate implant uncovering visit is usually not needed, because zygomatic implants are generally loaded immediately. The first check-up is usually about a week after surgery, then visits follow your healing pace.
02
Careful oral hygiene
Success depends largely on careful oral hygiene. Patients are shown cleaning techniques suited to their restoration, and regular visits to the dental hygienist are part of the long-term plan, at a frequency set according to individual risk.
03
The permanent restoration
The switch from temporary teeth to the permanent restoration usually takes place after a few months, once healing is complete and the implants are stable; follow-up continues afterwards to catch any problem early.
Zygomatic implants in Jerusalem: consultation at Dr Haim Aseriel's clinic
A thorough professional assessment is the basis for choosing between zygomatic implants and other restorative options. At the consultation, the bone in your upper jaw is assessed, 3D imaging (CT) is reviewed together with your medical history, and alternatives such as short dental implants are discussed, as part of an overall full mouth rehabilitation plan. Dr Haim Aseriel (DDS, NYU College of Dentistry) and the clinic team explain the process in English, with transparency on costs and timelines. The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem, open Sun 8:00–19:00 · Mon 9:00–19:00 · Tue–Wed 9:00–21:00 · Thu 8:30–21:00 · Fri 8:00–14:00. You can also read patient reviews.
Zygomatic implants: frequently asked questions
Zygomatic implants are extra-long dental implants anchored in the zygomatic bone (the cheekbone) rather than only in the upper jawbone. They are about 30 to 52.5 mm long, several times the length of a regular implant, and are used when there is not enough bone in the upper jaw for regular implants.
Zygomatic implants are mainly for patients with no teeth in the upper jaw and extensive bone loss that rules out regular implants, for example after multiple extractions, advanced gum disease or long-term bone resorption. Suitability is determined with 3D imaging and an examination by an oral and maxillofacial surgeon.
Zygomatic implants have a high survival rate: according to a systematic review, about 95% of the implants survived 12 years, and most failures occurred in the first months after surgery. Another review found no significant difference in survival compared with regular implants. The most common complication is sinusitis.
Treatment with zygomatic implants usually costs more than regular implants, because of the complexity of the surgery, the 3D imaging, the anesthesia and the length of treatment. On the other hand, it may avoid bone-building procedures. A detailed written quote is given only after an examination and imaging.
After zygomatic implant surgery, swelling, bruising and discomfort are expected in the first days and usually pass within a week to ten days. Close follow-up is needed, and careful oral hygiene is essential for long-term success.
Sources
- Chrcanovic BR et al., Journal of Oral and Maxillofacial Surgery, 2016 – Link to study
- Moraschini V et al., Clinical Implant Dentistry and Related Research, 2023 – Link to study
- Neugarten J et al., International Journal of Oral and Maxillofacial Implants, 2017 – Link to study
