Current status of zygomatic implantation: technological evolution and clinical application

doi:10.12337/zgkqzzxzz.2025.06.008

Abstract

Abstract: Zygomatic implantation, a clinical solution for patients with severe maxillary atrophy, overcomes the limitations of traditional implant procedures and enables the combined retention of maxilla-zygomatic implants. This paper systematically reviews the development of zygomatic implant technology, focusing on its application in the restoration of complex maxillary bone defects, the evolution of indications, and innovative treatment strategies. The purpose is to provide a theoretical basis and clinical support for precision treatment in the field of oral and maxillofacial repair.

Key words: Zygomatic implant, Safety, Digitalization

Chen Jingxia, Zhou Yanmin. Current status of zygomatic implantation: technological evolution and clinical application[J]. Chinese Journal of Oral Implantology, 2025, 30(3): 250-254.

References

[1] 褚壮壮, 黎强, 高振华, 等. 上颌重度骨萎缩患者穿颧骨种植修复临床回顾研究[J].南京医科大学学报(自然科学版), 2020,40(6):903-908. DOI: 10.7655/NYDXBNS20200625.
Chu ZZ, Li Q, Gao ZH, et al.Clinical review study on zygomatic bone implant repair in patients with severe maxillary bone atrophy[J]. J Nanjing Med Univ (Nat Sci), 2020,40(6):903-908. DOI: 10.7655/NYDXBNS20200625.
[2] Osorio CC, Escobar LM, González MC, et al.Evaluation of density, volume, height and rate of bone resorption of substitutes of autologous bone grafts for the repair of alveolar clefts in humans: a systematic review[J]. Heliyon, 2020,6(9):e04646. DOI: 10.1016/j.heliyon.2020.e04646.
[3] Wang W, Yeung K.Bone grafts and biomaterials substitutes for bone defect repair: a review[J]. Bioact Mater, 2017,2(4):224-247. DOI: 10.1016/j.bioactmat.2017.05.007.
[4] 吴轶群, 张志愿, 张志勇, 等. 颧种植体在上颌骨缺损重建中的应用探讨[J].上海口腔医学, 2005,14(3):210-214. DOI: 10.3969/j.issn.1006-7248.2005.03.002.
Wu YQ, Zhang ZY, Zhang ZY, et al.Zygomatic implants anchorage for the rehabilitation of maxillary defects[J].Shanghai J Stomatol,2005,14(3):210-214. DOI: 10.3969/j.issn.1006-7248.2005.03.002.
[5] 麦合甫孜·艾山, 迪丽努尔·阿吉. 颧种植体在上颌骨缺损修复中的应用[J].口腔颌面修复学杂志,2009,10(2):125-127,105. DOI: 10.3969/j.issn. 1009-3761. 2009.02.019.
Maihepuzi AS, Dilinuer AJ.Application of the zygomatic bone implantation to the reconstruction of maxillary defect[J].Chin J Prosthodot,2009,10(2):125-127,105. DOI: 10.3969/j.issn.1009-3761.2009.02.019.
[6] 罗之琳, 曹颖光. 口腔种植机器人的精度及应用现状[J].口腔医学研究, 2024,40(11):950-955. DOI: 10.13701/j.cnki.kqyxyj.2024.11.002.
Luo ZL, Cao YG.Accuracy and application status of robotic-assisted implant surgery[J].J Oral Sci Res ,2024, 40(11):950-955. DOI: 10.13701/j.cnki.kqyxyj.2024.11.002.
[7] Polido WD, Machado-Fernandez A, Lin WS, et al.Indications for zygomatic implants: a systematic review[J]. Int J Implant Dent, 2023,9(1):17. DOI: 10.1186/s40729-023-00480-4.
[8] Bedrossian E, Stumpel LJ 3rd. Immediate stabilization at stage II of zygomatic implants: rationale and technique[J]. J Prosthet Dent, 2001,86(1):10-14. DOI: 10.1067/mpr.2001.115890.
[9] Brånemark PI, Gröndahl K, Ohrnell LO, et al.Zygoma fixture in the management of advanced atrophy of the maxilla: technique and long-term results[J]. Scand J Plast Reconstr Surg Hand Surg, 2004,38(2):70-85. DOI: 10.1080/02844310310023918.
[10] Aparicio C, Manresa C, Francisco K, et al.Zygomatic implants: indications, techniques and outcomes, and the zygomatic success code[J]. Periodontol 2000, 2014,66(1):41-58. DOI: 10.1111/prd.12038.
[11] Davó R, Malevez C, Rojas J, et al.Clinical outcome of 42 patients treated with 81 immediately loaded zygomatic implants: a 12- to 42-month retrospective study[J]. Eur J Oral Implantol, 2008,9
[Suppl 1(2)]:141-150.
[12] 沈毅, 孙坚, 李军, 等. 上颌骨功能性重建中用钛植入体重建颧上颌支柱的生物力学研究[J].中国口腔颌面外科杂志, 2011,09(3):198-203.
Shen Y, Sun J, Li J, et al.Biomechanical study of zygomatic-maxillary buttress restoration with titanium alloplastic implant in functional maxillary reconstruction[J].Chin J Oral Maxillofac Surg,2011,9(3):198-203.
[13] Aparicio C.A proposed classification for zygomatic implant patient based on the zygoma anatomy guided approach (ZAGA): a cross-sectional survey[J]. Eur J Oral Implantol,2011,4(3):269-275.DOI:10.1111/j.1399-0012.2011.01463.x.
[14] Stella JP, Warner MR.Sinus slot technique for simplification and improved orientation of zygomaticus dental implants: a technical note[J]. Int J Oral Maxillofac Implants, 2000,15(6):889-893.
[15] Migliorança RM, Sotto-Maior BS, Senna PM, et al.Immediate occlusal loading of extrasinus zygomatic implants: a prospective cohort study with a follow-up period of 8 years[J]. Int J Oral Maxillofac Surg, 2012, 41(9): 1072-1076. DOI: 10.1016/j.ijom.2012.05.029.
[16] 王鲲鹏, 朱嘉琪, 张婷婷. 穿颧种植技术的研究进展[J].中华口腔医学杂志,2020,55(03):196-200. DOI: 10.3760/cma.j.issn.1002-0098.2020.03.011.
Wang KP, Zhu JQ, Zhang TT.Research progress in zygomatic implant technique[J].Chin J Stomatol,2020,55(3):196-200. DOI: 10.3760/cma.j.issn.1002-0098.2020.03.011.
[17] Ujigawa K, Kato Y, Kizu Y, et al.Three-dimensional finite elemental analysis of zygomatic implants in craniofacial structures[J]. Int J Oral Maxillofac Surg, 2007,36(7):620-625. DOI: 10.1016/j.ijom.2007.03.007.
[18] Leroy C, Longis J, Bertin H, et al.Complications and risk factors associated with zygomatic implants: retrospective analysis with 73 consecutive patients followed for 3.5 years[J]. Quintessence Int, 2025,56(1):46-59. DOI: 10.3290/j.qi.b5841085.
[19] Tran AQ, Reyes-Capó DP, Patel NA, et al.Zygomatic dental implant induced orbital fracture and inferior oblique trauma[J]. Orbit, 2019,38(3):236-239. DOI: 10.1080/01676830.2018.1444063.
[20] Frost HM. A 2003 update of bone physiology and Wolff's Law for clinicians[J]. Angle Orthod, 2004,74(1):3-15. DOI: 10.1043/0003-3219(2004)074<0003:AUOBPA>2.0.CO;2.
[21] 吴迪, 汤春波. 穿颧种植用于上颌后部骨量不足种植修复的研究进展[J].口腔医学, 2020,40(7):639-643. DOI: 10.13591/j.cnki.kqyx.2020.07.013.
Wu D, Tang CB.Research progress on the application of zygomatic implants in dental implant restoration for patients with alveolar bone defi-ciency in posterior maxilla[J].Stomatology,2020,40(7):639-643. DOI: 10.13591/j.cnki.kqyx.2020.07.013.
[22] Lang NP, T Karring. Proceedings of the 1st European Workshop on periodontology[J]. 1994,126(4):424.DOI:10.14219/jada.archive.1995.0202.
[23] Aparicio C, López-Piriz R, Albrektsson T.ORIS criteria of success for the zygoma-related rehabilitation: the (revisited) zygoma success code[J]. Int J Oral Maxillofac Implants, 2020,35(2):366-378. DOI: 10.11607/jomi.7488.
[24] Zielinski R, Okulski J, Simka W, et al.The zygomatic anatomy-guided approach, zygomatic orbital floor classification, and ORIS criteria-A 10-year follow-Up[J].J Clin Med, 2023,12(20):6681. DOI: 10.3390/jcm12206681.
[25] Lanza DC, Kennedy DW.Adult rhinosinusitis defined[J]. Otolaryngol Head Neck Surg, 1997,117(3 Pt 2):S1-S7. DOI: 10.1016/S0194-59989770001-9.
[26] Lund VJ, Mackay IS.Staging in rhinosinusitus[J]. Rhinology, 1993,31(4):183-184.
[27] 李一鸣, 孙海鹏, 邓飞龙. 颧骨种植体植入术的研究进展[J].国际口腔医学杂志,2016,43(3):361-365. DOI: 10.7518/gjkq.2016.03.024.
Li YM, Sun HP, Deng FL.Research progress on the zygomatic implant technique[J].Int J Stomato, 2016,43(3):361-365. DOI: 10.7518/gjkq.2016.03.024.
[28] Wang F, Bornstein MM, Hung K, et al.Application of real-time surgical navigation for zygomatic implant insertion in patients with severely atrophic maxilla[J]. J Oral Maxillofac Surg, 2018,76(1):80-87. DOI: 10.1016/j.joms.2017.08.021.
[29] Polido WD, Machado-Fernandez A, Lin WS, et al.Indications for zygomatic implants: a systematic review[J]. Int J Implant Dent, 2023,9(1):17. DOI: 10.1186/s40729-023-00480-4.
[30] Al-Nawas B, Aghaloo T, Aparicio C, et al.ITI consensus report on zygomatic implants: indications, evaluation of surgical techniques and long-term treatment outcomes[J]. Int J Implant Dent, 2023,9(1):28. DOI: 10.1186/s40729-023-00489-9.
[31] Chow J, Wat P, Hui E, et al.A new method to eliminate the risk of maxillary sinusitis with zygomatic implants[J]. Int J Oral Maxillofac Implants, 2010,25(6):1233-1240.
[32] Miyasawa EM, Vianna CP, Rocha RS, et al.Incidence of sinusitis after surgery for zygomatic implant placement in patients with atrophic maxilla: a systematic review[J].J Oral Maxillofac Sur Med, Pathol, 2023, 35(2): 103-108. DOI:10.1016/j.ajoms.2022.07.007.
[33] D'Agostino A, Lombardo G, Favero V, et al. Complications related to zygomatic implants placement: a retrospective evaluation with 5 years follow-up[J].J Craniomaxillofac Surg, 2021,49(7):620-627. DOI: 10.1016/j.jcms.2021.01.020.
[34] Aparicio C, Ouazzani W, Garcia R, et al.A prospective clinical study on titanium implants in the zygomatic arch for prosthetic rehabilitation of the atrophic edentulous maxilla with a follow-up of 6 months to 5 years[J]. Clin Implant Dent Relat Res, 2006,8(3):114-122. DOI: 10.1111/j.1708-8208.2006.00009.x.
[35] Romeed SA, Malik R, Dunne SM.Zygomatic implants: the impact of zygoma bone support on biomechanics[J]. J Oral Implantol, 2014,40(3):231-237. DOI: 10.1563/AAID-JOI-D-11-00245.
[36] Fan X, Feng Y, Tao B, et al.A hybrid robotic system for zygomatic implant placement based on mixed reality navigation[J]. Comput Methods Programs Biomed, 2024, 249:108156. DOI: 10.1016/j.cmpb.2024.108156.
[37] Ramezanzade S, Keyhan SO, Tuminelli FJ, et al.Dynamic-assisted navigational system in zygomatic implant surgery: a qualitative and quantitative systematic review of current clinical and cadaver studies[J]. J Oral Maxillofac Surg, 2021,79(4):799-812. DOI: 10.1016/j.joms.2020.10.009.
[38] Bhalerao A, Marimuthu M, Wahab A, et al.Flapless placement of zygomatic implants using dynamic navigation: an innovative technical note[J]. Br J Oral Maxillofac Surg, 2023,61(2):136-140. DOI: 10.1016/j.bjoms.2022.11.282.
[39] Bhalerao A, Marimuthu M, Wahab A, et al.Dynamic navigation for zygomatic implant placement: a randomized clinical study comparing the flapless versus the conventional approach[J]. J Dent, 2023,130:104436. DOI: 10.1016/j.jdent.2023.104436.
[40] 任宇飞, 刘琳. 口腔种植体表面处理方法及其促进骨结合的研究进展[J].现代口腔医学杂志, 2024,38(6):455-459.
Ren YF, Liu L.Research progress on surface treatment methods of oral implants and their promotion of bone integration[J].J Mod Stomatol, 2024,38(6):455-459.
[41] 张晨秋, 王柏翔,王慧明. 种植体表面抗菌技术的分类与研究进展[J]. 口腔医学, 2020, 40(3): 258-261. DOI: 10.13591/j.cnki.kqyx.2020.03.014.
Zhang CQ,Wang BX,Wang HM.Classification and research progress of surface treatment of dental implant against bacteria[J]. Stomatoligy, 2020, 40(3): 258-261. DOI: 10.13591/j.cnki.kqyx.2020.03.014.
[42] 陶宝鑫, 汪文颖, 吴轶群. 颧种植手术机器人的研发及应用进展[J].中国口腔种植学杂志, 2023,28(3):193-197. DOI: 10.12337/zgkqzzxzz.2023.06.011.
Tao BX,Wang WY, Wu YQ .Research and application progress of surgical robot system for zygomatic implant placement[J].Chin J Oral Implantol,2023,28(3):193-197. DOI: 10.12337/zgkqzzxzz.2023.06.011.
[43] Wu Y, Tao B, Lan K, et al.Reliability and accuracy of dynamic navigation for zygomatic implant placement[J]. Clin Oral Implants Res, 2022,33(4):362-376. DOI: 10.1111/clr.13897.