Quad Zygomatic Dental Implants To Replace Dentures Without Bone

The quad zygomatic implant bridge is a solution for the patient who truly has no bone on the upper jaw.  Quadruple zygomatic implants are intended to replace a full upper denture with a non-removable, fixed implant bridge within 24 hours.   A quad zygoma dental implant bridge requires no bone grafting of any kind!  

Most patients who require zygomatic implants have a hollow jaw and oversized sinuses; they have SEVERE bone loss.

A quad zygomatic implant is intended for a patient where even sinus lifting would not be that beneficial.  Many patients who need this procedure have been without teeth for a very long time.

Quadruple zygomatic implants are generally placed by implant dentists with many years of experience and advanced training.  This would not be the type of implant for a novice dental surgeon.

A quad zygomatic bridge is considered to be one of the most difficult dental implant surgeries besides nerve reposition for the lower jaw

For purposes of this article, zygoma =zygomatic = cheek bone.  The words mean the same in the dental implant world.  The implants go on or through the sinus and engage into the base of the cheekbone.

What is a quad zygomatic dental implant?

A quad zygoma is the use of 4 zygomatic implants on the upper jaw instead of a full upper denture. If you have been told you need zygomatic implants it is because you have very little or NO bone in the upper jaw.  Usually the standard is to have one zygomatic implant per side. 

In cases where there is no bone under the nose,  placing two zygomatic implants per side will allow a full arch all-on-4 style bridge to be made.

quad-zygomatic-dental-implants-xray
Quad zygomatic dental implant x-ray. The blue stars are the zygomatic implants. There are 2 zygoma implants on each side.

The additional 2 zygoma implants are used to position an implant in approximately the lateral incisor front tooth positions.  Remember that you need implants spread evenly throughout the jaw for good distribution and bite force balance.  If all of the implants are in the front or in the back, it will be like a stool that has unstable legs. 

So if there is enough bone under the nose, then you can get away without the quad zygomatic dental implants — just have a standard double zygomatic with some regular implants in the front under the nose. 

Sometimes a slight nasal lift is necessary to get implants engaged well.  Sometimes only a single zygomatic implant is needed on one side.  The surgery does not have to be symmetrical to have a great result.

Fixed a zirconia implant bridges on zygomatic implants
Fixed zirconia implant bridges on zygomatic implants

Being able to place for zygomatic implants into a patient oftentimes has most to do with how thick or thin your cheek bones are.  95% of patients will not feel the implant outside of their face. The lips can be supported very nicely as well.

How do pterygoid implants help zygoma implants?

Pterygoid implants are often placed in conjunction with zygomatic implants to give more stability and avoid a full denture.  Zygomatic implants are kind of like flag poles — they are stabilized by linking them to other implants.  Without linking them to other implants, they can slightly move at the tip, like a flag pole in high wind. 

Combination zygomatic, pterygoid and nasal dental implant x-ray.
Combination zygomatic, pterygoid and nasal dental implant x-ray. The pterygoid implants have yellow stars while zygomatic implants have blue stars in the image.

When the implants are splinted with one another, they become very strong.  Oftentimes the patient who has no bone has no areas for any other traditional bone implants so the pterygoid implant is used.  Pterygoid implants anchor in the upper wisdom tooth area.

Do quad zygomatic dental implants hurt?

Zygomatic implants do not hurt more than all-on-4 dental implants on the upper jaw.  In my office where I routinely do zygomatic implants it is rare for patients to use more than Tylenol and ibuprofen afterwards! 

In order to decrease pain I provide intravenous sedation, intravenous and intramuscular steroids, a special homeopathic medicine, special long-lasting Novocain and platelet gels (PRF) made from your own blood.

double-zygomatic-dental-implants-x-ray
Double (regular) zygomatic dental implant x-ray. The blue stars are the zygomatic implants — one zygoma implant on each side.

Are you a candidate for zygomatic implants?

Depending on the thickness or thinness of the cheek bone, a surgical guide can be used to place the dental implants.  Sometimes the surgical guide can add more predictability and safety to the procedure, but sometimes it can do just the reverse. 

The need for a surgical guide for zygomatic implants should be on a case by case basis.  Only certain surgical guides are actually any good.  Most of them are not well manufactured.

Zygomatic and pterygoid implants in my practice are used to allow patients to have teeth right away.  There is no need for bone grafting with these types of procedures.

To protect the double or quadruple zygomatic implants from gum recession I almost always move some of your natural cheek fat over the top of the implants.  It is sutured tightly to give more durability to the gums over time.

If you have any questions or comments about the quad zygomatic process, leave a comment below.  I actually train other dentists in person in the surgical technique and through cadaver courses.

Thank you! 😊

19 thoughts on “Quad Zygomatic Dental Implants To Replace Dentures Without Bone”

  1. I have three missing teeth (my upper back teeth). I have bone loss and a bone graft has already failed so my surgeon recommended a sinus lift and another bone graft but I am considering finding a surgeon that does zygomatic implants to avoid the sinus lift and extra healing time. Will one single zygomatic implant hold the 3 tooth bridge or will it require two? Also will this implant go through the roof of my mouth or through where my tooth (or root of my tooth) would be. I do not want anything touching the roof of my mouth. I have a flipper and it is extremely uncomfortable. Also does a zygomatic implant have more risks and complications that a regular implant? I may not be back on this site so would you mind emailing your response? Thank you in advance.

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  2. I had the quad zygomatic procedure done. They started surgery on December 26, 2020 & did the final in December 28, 2021. I don’t feel good about it & I’m very quiet to speak cause my teeth clack & my upper teeth bite little bites on inside of bottom lip & why did it take so long I still don’t understand. I still can’t smile naturally & I don’t like hearing my teeth clacking as I talk. I also have lots of saliva in my mouth & throat constantly spitting. I’ve never had this problem before. Please help I’m miserable.

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  3. I got zygo and all on 4 on the bottom I have full mouth implants. I got this done in august; i’m
    pretty much fully healed and the dentist said i’ve healed beautifully. I have temporary teeth in until dec 2nd. and today towards the back bottom cracked and broke off leaving some of my screw/implant exposed. it’s saturday night. i’m freaking out, will I be okay for right now. I have no pain or anything

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  4. Hello. I was given a treatment plan for lower jaw implants and zygomatic implants for the upper. I currently have full dentures. I have full confidence in the technical ability of the doctor who will be treating me but I’m not sure he’s understanding that the outcome I’m looking for is basically reversal, to whatever extent possible, of the terrible effects dentures have had on my face. Anything that could have gone wrong for a denture wearer did go wrong with me. Unless that’s addressed then I may as well just keep the dentures and look for a plastic surgeon. He never mentioned anything about facial scans, etc. Is that something that is usually standard with more complex treatments like this? I even scheduled a 2nd visit just to talk to him and make we were on the same page as far as the desired outcome but I didn’t leave there feeling assured. Do you have any suggestions on how I can be sure he understands what my expectations are? What can I say to make it perfectly clear that I’m not interested in going through any of this unless I’m assured my appearance will improve. This is a well-known office that you’ve probably heard of and they’ve been doing the zygo procedure for years. I assume you’ve probably heard of them. Thank you.

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  5. I live in central fla in 2010 I went to elcam dental deltona. Had a missing upper side tooth dew to. Root canal went bad. The dentist ground all top teeth to cap and make a bridge , a couple months later teeth started breaking off at gum line I called dr office to my horror the dentist went to jail I called America dentist ass. The dentist lost licenses. I am in early 60 . I want to know is there any one who dose low cost or pro bono ? I want to smile again.

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  6. Thank you for the great information.

    Do the zygomatic dental implants work if there is severe lower jaw bone loss? Asking for my mom who is 83 years old and has no lower jaw bone left for implants.

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  7. I just waited 8 months to get regular dentures…with the polydent. My face looks absolutely crazy. I look nothing like the 33 year old woman I did 8 months ago. The only insurance I have is through the state, since covid forced my out of a job. Times are tough. I feel like I really need help figuring out the right dentures. This is just ruining my life. I’m supposed to get married in 2 years and I cant even show my face. Please help me doc.

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