Zygomatic implants in Turkey: fixed teeth when upper-jaw bone has gone

Zygomatic implants are much longer than standard dental implants. Instead of relying on the upper jawbone, they pass up through it and anchor in the zygoma, the cheekbone, which stays dense even when the jaw beneath has worn away. We consider zygomatic implants in Turkey for a small number of patients: people whose upper jaw has so little bone left that ordinary implants would not hold, and for whom grafting is not a good route. This page explains who that is, what the alternatives are, and the risks published research reports.

Why upper-jaw bone disappears

Bone in the jaw is kept in shape by the tooth roots inside it. When teeth are lost, the bone that held them slowly shrinks. In the upper jaw this happens from two directions: the ridge gets thinner from below, and the maxillary sinus, an air space above the back teeth, tends to expand downwards. After many years without teeth, or of wearing a full upper denture, there may be only a few millimetres of bone left. Advanced gum disease, old infections and failed implants can add to the loss.

A standard implant needs a certain height and width of bone around it to bond securely. When that is missing across most of the upper jaw, the choice is to rebuild the bone, to use the bone that remains in a clever way, or to anchor somewhere else.

Who zygomatic implants are for

We would only suggest them when the 3D scan shows:

• severe bone loss across the back of the upper jaw, and often the front as well
• too little bone for standard or tilted implants, even with a sinus lift
• grafting that would be very large, unlikely to succeed, or has already failed
• a patient who wants fixed upper teeth rather than a removable denture

Zygomatic implants are usually combined with a full upper bridge. Common designs use one zygomatic implant on each side with standard implants at the front, or two on each side when the front bone is also very thin. Lower-jaw bone loss is never treated this way.

They are not for you if you still have enough bone for standard implants, which is true of most people. They also need more caution, or may not be suitable, if you have chronic or untreated sinus disease, smoke heavily, have poorly controlled diabetes, take bone medicines such as bisphosphonates, or have had radiotherapy to the head and neck. Sinus problems must be checked and treated before surgery.

The alternatives to consider first

Sinus lifts have a long research record. A systematic review of sinus floor elevation found high survival for implants placed in grafted sinuses, which is why we treat it as the first choice when the bone loss is moderate. Zygomatic implants come into the picture when the loss is beyond what a lift and graft can reliably fix. You can read about full-arch plans on four or six implants on our full-mouth implants page.

How we plan and carry out the surgery

1. Images from home. Send a panoramic X-ray, or a CBCT scan if you have had one. A dentist gives you an early written opinion on whether zygomatic implants are even likely, and an itemised preliminary price.
2. 3D scan in Antalya. Our CBCT scan shows the remaining jawbone, the sinus and the cheekbone. The path of each zygomatic implant is planned on it. Your written plan states how many zygomatic and standard implants are proposed, which brand, and why.
3. Health and sinus check. We review your medical history and medicines, and look for signs of sinus disease on the scan. Anything that needs treatment first is dealt with before surgery.
4. Surgery. The implants are placed in one longer appointment. The anaesthetic approach is set out in your plan; sedation is available at our clinic.
5. Temporary teeth. Where the implants are stable enough, a fixed temporary bridge is usually attached within days. Published reviews found that studies using early loading of zygomatic implants did not show more failures, but the surgeon decides on the day.
6. Final bridge. On a second trip, after healing, the final zirconia bridge on a titanium bar is fitted. You receive your implant passport and copies of your scans.

Implant trips include 4 hotel nights on the first stay and 5 on the second, with transfers. Because zygomatic cases vary, your written plan confirms the exact length of each stay. Please wait for it before booking flights. Travel details are on your trip.

Risks, with the evidence

Zygomatic implants have been used for over two decades, and the published results are encouraging. A 2016 systematic review pooled 68 studies covering more than 4,500 zygomatic implants and estimated a cumulative survival of about 95% at 12 years, with most failures happening in the first six months. These are pooled research figures, not a promise for any one patient.

The same review, and later ones, describe the complications to know about:

• Sinus inflammation (sinusitis). The most common problem. Reported rates range from about 2% in one review to around 10% or more in others, depending on technique and how carefully it was recorded. It can appear years after surgery. The NHS page on sinusitis describes the symptoms.
• Soft tissue infection around the implant where it comes through the gum.
• Numbness or tingling of the cheek or lip, usually temporary.
• An opening between mouth and sinus (oroantral fistula), uncommon but sometimes needing a further procedure.
• Rare serious complications near the eye socket, because of how close the cheekbone is to it. This is why careful 3D planning matters.
• Repairs are more complex. If a zygomatic implant fails, replacing it is a bigger job than replacing a standard implant.

Swelling and bruising of the cheek are normal for a week or two. After surgery you will be told not to blow your nose hard, to sneeze with your mouth open, and to keep to soft food.

What zygomatic implants cost

Each zygomatic implant is £2,000. A full upper plan usually also includes standard implants at £300 each, the zirconia bridge on a titanium bar, and temporary teeth. Because the mix varies from patient to patient, the total is priced in your written plan after the 3D scan. Extractions are free and transfers are included; flights are not. Our prices page lists every item.

Guarantee and follow-up

Our written guarantee gives implants and abutments lifetime cover, with a failed implant replaced once free, and full-arch bridges 5 years. Conditions are in the written terms, and we will confirm in your plan how they apply to the zygomatic implants in your case. Guarantee work is done at our clinic in Antalya. See our guarantee page.

At home, keep up regular check-ups and daily cleaning under the bridge with a water flosser and interdental brushes. If you notice one-sided nasal blockage, discharge or pain in the cheek, contact us and see your GP or dentist.