The long-term use of zygomatic implants: a 10-year clinical and radiographic report

Clin Implant Dent Relat Res. 2014 Jun;16(3):447-59. doi: 10.1111/cid.12007. Epub 2012 Oct 18.


Background: The zygoma implant has been an effective option in the short-term management of the atrophic edentulous maxilla.

Purpose: To report on long-term outcomes in the rehabilitation of the atrophic maxilla using zygomatic (ZI) and regular implants (RI).

Material and methods: 22 consecutive zygomatic patients in a maintenance program were included. Cumulative survival rate (CSR) of ZI, RI, prostheses, and complications were recorded during, at least, 10 years of loading. Implant mobility was tested using Periotest(®). Sinus health was radiographically and clinically assessed according to Lund-Mackay (L-M) score and Lanza and Kennedy survey, respectively. A satisfaction questionnaire and anatomical measurements were also performed.

Results: Patients received 22 prostheses, anchored on 172 implants. Forty-one were ZI. Three RI failed (10 years CSR = 97.71%). Two ZI were partly removed due to perimplant infection (10 years CSR = 95.12%). All patients maintained functional prostheses. One patient fractured framework twice. Loosening or fracturing screws happened in 11 patients. Seven patients fractured occlusal material. Four ZI abutments in two patients were disconnected because of uncomfortable prostheses. Alveolar height at the ZI head level on the right and left sides was 2.64 mm and 2.25 mm, respectively. Mean distance of ZI head center to ridge center, on the right and left sides was 4.54 mm and 5.67 mm, respectively. Mean Periotest values (PTv) of ZI were -4.375 PTv and -4.941 PTv before prostheses placement and after 10 years, respectively. Six patients experienced sinusitis 14-127 months postoperatively. 54.55% of the L-M scores did not present opacification (L-M = 0) in any sinus. Osteomeatal obstruction happened in eight patients (two bilateral). Two (9.09%) were diagnosed with sinusitis. Eighty-four percent reported satisfaction levels above 80%. 31.81% reported maximum satisfaction score (100%).

Conclusions: The long-term rehabilitation of the severely atrophic maxillae using ZI is a predictable procedure.

Keywords: cone beam CT; long-term retrospective study; maxillary atrophy; patient satisfaction; zygomatic implants.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dental Implants*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Zygoma / diagnostic imaging
  • Zygoma / surgery*


  • Dental Implants