Currently there is the possibility of replacing missing teeth using zygomatic implants. It is an alternative to conventional treatment so that even patients with little bone tissue can obtain aesthetic and functional results.
Many times, when a conventional implant is placed, the lack of sufficient bone to support it is an impediment to using this type of rehabilitation. In this article we detail this different option that uses a deeper anchor.
Read on and find out more about this surgical technique capable of restoring the lost smile.
zygomatic bone anatomy
To better understand the area of the face where zygomatic implants are placed, it is necessary to understand the anatomy of this area. Next, we detail where the malar bone and maxillary sinuses are located, structures involved in this type of surgery.
The roots of the upper teeth are housed in the alveolar portion of the upper jaw bones. These are two bony structures, one on each side of the face, joined in the center of the face. Inside they have an air cavity covered with mucous membrane, called maxillary sinus.
The maxillary sinuses, together with the frontal, ethmoid, and sphenoid sinuses, make up the paranasal sinuses. These are 8 cavities present in the bones, 4 on each side, which communicate with the nostrils. They play important roles in respiration and phonation.
The jaws articulate with the malar or zygomatic bone backwards and out of the face. This structure forms a sector of the orbit and It constitutes the bony portion of the cheekbone in the outermost part of the face.
What are Zygomatic Implants?
Zygomatic implants work in the same way as conventional ones, acting as a support for a denture to replace missing teeth. In this way the patient can recover the smile and the functions of the mouth.
They are used in those cases where it is not possible to place a common implant due to the absence of sufficient or quality bone to support the abutment.
The implant is placed diagonally into the zygomatic bone, which is the bony arch of the cheekbones. For this reason they are longer than the conventional ones, measuring between 30 and 55 millimeters. There is also the possibility of placing them on the pterygoid bone. The advantage of these bone tissues is that they are not reabsorbed, ensuring adequate anchorage.
What are zygomatic implants used for?
As we have already mentioned, zygomatic implants are useful in those cases of patients who they have lost their teeth and lack adequate bone structure to support conventional attacks. The bone may have resorbed and may not be high enough or the quality is not suitable. Other factors, such as age, gender, bone disease, or trauma, make it impossible to place a common implant.
The zygomatic bone is a stable tissue that offers an adequate surface for osseointegration of implants. In any case, given the complexity of the operation and the fact that it is a fairly invasive act, the use of this surgical alternative is generally reserved for specific cases, when other options are not feasible. For example, for full upper jaw restorations after several years of toothless and bone loss is extreme.
What is the intervention?
When all other rehabilitation options have been exhausted and placement of a zygomatic implant is the most cost-effective alternative, It is essential to seek a professional who is trained to perform this type of treatment. The dentist will carry out the necessary examinations and studies in order to plan the intervention in a personalized way.
The operation is performed under local anesthesia and, in some cases, if the patient needs it, it is integrated with conscious sedation or general anesthesia is performed directly. Then the surgery is completed where holes are drilled into the bone to insert the implant. This is done diagonally, using an angle previously defined by the specialist when planning the surgery.
There are several surgical techniques for inserting the implant into the zygomatic bone. Some pass through the maxillary sinus to reach the bone tissue. Others, however, are extrasinusal and the attachment goes beyond the maxilla. It is inserted directly above the cheekbone, covered only by soft tissue.
The choice of the type of surgical maneuver to be used is made on the basis of the anatomy of the area, the particularities of the sinus and the surrounding bone tissue and the patient’s needs. In some cases, it is also combined with the placement of conventional implants in areas where the jaw bone allows.
The operation allows the immediate positioning of the prosthesisTherefore, the patient can leave with the new fixed prosthesis in place on the same day of the operation. In any case, most practitioners prefer to place a provisional until the tissues finish healing.
Once the recovery time of the gingival and bone tissues has elapsed, the definitive fixed prosthesis is inserted. This will return the lost aesthetics and function to the oral cavity.
Possible complications of zygomatic implants
We already anticipate it surgery for the placement of zygomatic implants is complex and invasive. The attachments must be introduced up to the cheekbone area with a precise angle, usually bilateral.
That is why it is essential that it is performed by a specialized and experienced surgeon.. The use of specific devices for the intervention is also fundamental.
In any case, given the depth of the area and the difficulty of the surgical process, there is a risk of some of the following complications:
- Inflammation of the area.
- Ache.
- bleeding.
- Sinusitis or rhinosinusitis.
- Paresthesia of the zygomatic nerve.
- Peri-implantitis.
- Postoperative infections.
Cases where zygomatic implants are not recommended
Zygomatic implants are only reserved for specific cases where there are no other possible treatment options. For this reason, it is not recommended to use them when conventional implants or other rehabilitation options can be placed.
In cases of patients with systemic diseases, the general state of health should be carefully evaluated before proceeding with this type of procedure. These surgeries should be avoided in people with decompensated or uncontrolled conditions.
In patients with untreated diabetes or poor sugar regulation, due to hyperglycemia, osseointegration of the implants is reduced and increases the risk of infections. Patients with liver problems have a higher risk of suffering from bleeding during and after surgery due to lack of hemostasis.
Zygomatic implants should also not be used in patients with osteoporosis, smokers, alcoholics, who consume bisphosphonates or who have undergone radiation to the head and neck area. Well, these factors could complicate oral rehabilitation and lead to failure of the intervention.
When there are no other options
Zygomatic implants are a suitable option to restore a beautiful and functional smile when jaw bone loss does not allow for other forms of rehabilitation. And although it is an invasive and complicated surgery, if carried out by expert hands the possibilities of success they are tall.
The bone structure of the zygomatic provides the stability and support that the implant needs to support the fixed prosthesis. Therefore, with this technique it is possible to improve the patient’s quality of life and restore his smile.
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