Zygomatic Implants
If you have been told that there is less bone in your upper jaw for dental implants, do not worry. The best solution for cases with severe bone resorption in the upper jaw is a pterygoid implant. Pterygoid implants are replacing zygomatic implants as the best solution for patients requiring dental implants for the upper jaw. Such patients were going for sinus lift or bone grafts as per old techniques. In a single procedure, we place a pterygoid implant and place the permanent crown in 3 days. As we use single piece implants the procedure is flapless and done under local anesthesia.
Zygomatic Implants Vs. Tuberopterygoid Implants
| PTERYGOID IMPLANT | ZYGOMATIC IMPLANT | |
| Type of implants | Single piece Implants is used. No screw loosening and no crestal bone loss. | Screw based implants used. Screw loosening is a problem |
| Cantilevers | No cantilevers placed | Molars if given are placed as cantilevers, which decrease the life of the bridge and cause screw loosening on the implant. |
| Criteria | No contraindications | Symptom free and pathologically free sinus |
| Relative risk of failure | Since sinus is not involved, no risk of sinusitis | Risk of sinus infection |
| Permanent bridge | Permanent ceramic bridge on 3rd day of implant placement, as the implant engages hard cortical bone. | Acrylic/plastic for first 4 months. Then cantilever permanent ceramic bridge given after 4 months. |
| CT scan | Not needed. | Compulsorily needed |
| Surgical guide | Not needed. | Compulsorily needed |
| Anaesthesia | Local anaesthesia with or without sedation | General anaesthesia |
| Cost of implant | Being regular sized single piece implant it is relatively cheap. | Zygomatic implants are very long manufactured specifically for the purpose, hence very expensive. Cost of the technique is more as CT scan and surgical guide is used. |
| No. of implants for full upper jaw | 8-10 for upper jaw. | 6 -10 for upper jaw |
| No. of teeth | 14 teeth are given. Teeth replaced till second molar | 10 teeth or 12 teeth given. 2nd molar is not given. |
| No. of trips | One trip, as permanent ceramic crown or bridge is placed in 3 days | Two trips. Permanent teeth fixed after 3 months of implant placement. |
| Warranty | Lifetime warranty on implant | No warranty |
When the patient requires fixed teeth on dental implants in upper jaw, then the options are:
Cantilever bridges:
Techniques have been devised to avoid the expensive and aggressive bone grafting by placing just 4 or 6 implants in the front part of the jaw and placing a set of just 10 or 12 teeth. As such 1st molar crowns are placed as cantilevers and 2nd molars are not replaced at all. Sometimes only 10 teeth are placed. Another disadvantage of cantilevers is that the permanent ceramic bridges are fixed after 3-6 months.
Sinus Lift:
Implants in anatomic buttress areas:
- Zygomatic implants
- Tubero-pterygoid implants
What are Tuberopterygoid implants
Pterygoid implants are implants located in the 2nd molar area of the upper jaw. They allow the prosthetic rehabilitation on dental implants in the upper jaw. The applied forces go to the pterygomaxillar buttress area allowing immediate loading of the implants.
Advantages of pterygoid implants
- Eliminates the need of sinus grafting.
- No cantilevers from front teeth or implants.
- Efficient chewing is possible as teeth up to second molars are replaced. In cantilevers and zygomatic implant cases 2nd molars are not replaced. If replaced then they are made as cantilevers which make the last implant weak and the bridge susceptible to fracture in the long run.
- Bone in pterygoid area is cortical in nature, and hence very strong and rigid allowing Immediate loading with a permanent crown in 3 days.
- Single piece implants are used which are strong in comparison to conventional dental implants.
- All patients who want dental implants in upper jaw are good candidates as bone is always available in pterygoid area.
- Flapless technique is used, as such patients have no swelling or bleeding and patients need not stop blood thinners, if they are taking any.
- Lifetime warranty given as strong single piece implants are being used in strong cortical bone.
- 100% success rate.