Why the cheekbone
Once upper teeth are lost, the bone that held them shrinks, and the sinus above often expands downwards into the space. After enough years, there’s simply too little bone for a regular implant. The traditional answer is a large bone graft or sinus lift, months of healing, and sometimes a second operation if the graft doesn’t take.
Zygomatic implants skip that. They’re long implants, angled from the back of the upper jaw into the zygomatic bone, the cheekbone, which keeps its density for life. Usually two zygomatic implants are combined with two to four regular implants at the front of the jaw. Where even the front has little bone, four zygomatic implants (a “quad zygoma”) can carry the whole upper bridge.
Who zygomatic implants suit
- People with an upper denture that no longer stays in, because the ridge has flattened.
- Anyone told they need a large graft before implants, who would rather avoid one.
- People whose earlier grafts or implants in the upper jaw have failed.
- Some patients after surgery to the upper jaw.
You need to be fit for a longer surgical procedure, and your sinuses are checked before treatment. If a less complex option works for your bone, such as conventional implants with a sinus lift, All-on-4 or All-on-6 or basal implants, we’ll tell you.
Your options for severe upper bone loss
| Bone graft, then implants | Zygomatic implants | |
|---|---|---|
| Operations | Usually two or more | Usually one |
| Time to fixed teeth | Often 6–12 months | Often within a few days |
| Main risks | Graft failure, longer healing | Sinus inflammation, gum irritation around the implants |
| Removable denture in between | Usually | Usually not |
What happens
- Assessment. A full examination and a CBCT scan of the jaws, sinuses and cheekbones. We check your general health and your sinuses, and plan the final teeth first.
- Digital plan. The angle and length of every implant is planned on the 3D scan. You get a written plan, timeline and itemised fee.
- Surgery. Our surgical team places the zygomatic and any regular implants. Your surgeon explains the anaesthesia used for your case beforehand.
- Fixed teeth. A fixed temporary bridge is usually fitted within a few days, so you leave with teeth rather than a gap or a denture.
- Final bridge. After several months of healing, Dr. Adish makes the final bridge, checks your bite and shows you how to clean underneath it.
Recovery
Swelling and bruising of the cheeks are common for the first week and settle with cold packs, painkillers and rest. Some people have a nosebleed or a blocked feeling in the sinus for a few days. A soft diet is needed while the implants heal. You’ll have regular reviews, and a professional clean around the bridge every few months.
Risks
Sinus inflammation is the commonest complication. Gum soreness around the implant heads, numbness of the cheek or lip, and loosening of an implant can happen. Rare but serious complications involving the eye socket or the sinus are the reason these cases are planned on a 3D scan and done by an experienced team. Your personal risks are explained at the consultation.
What affects the fee
The number of zygomatic and regular implants, extractions, the scans, the temporary and final bridges, and the material of the final teeth. You get an itemised written estimate before anything is booked.
Questions patients ask us
What are zygomatic implants?
They are much longer implants than usual, placed through the back of the upper jaw into the cheekbone (zygoma). The cheekbone is dense and doesn't shrink after tooth loss, so it can hold implants when the jaw bone can't.
Who needs zygomatic implants?
People with severe bone loss in the upper jaw, often after years of wearing a denture, gum disease, failed bone grafts or earlier surgery. If a sinus lift and regular implants are possible, those usually come first.
How successful are zygomatic implants?
A 2023 systematic review of 1,349 zygomatic implants in 623 patients found 96.2% survival at six years, comparable to conventional implants. Survival was higher when teeth were fitted straight away (98.1%).
What is the most common problem after zygomatic implants?
Sinus inflammation (sinusitis), reported in around 14% of patients in the same review. Most cases settle with treatment. Gum irritation around the implants can also happen, and rarer complications are why these cases need careful 3D planning.
Do I need a bone graft?
Usually not. Avoiding bone grafts and sinus lifts is the main reason zygomatic implants are used.
How long does it take to get teeth?
In most cases a fixed temporary bridge is fitted within a few days of surgery. The final bridge follows once the gums and implants have settled, usually after several months.
What is the difference between zygomatic and basal implants?
Basal implants grip the dense bone deep in the jaw itself. Zygomatic implants go further, into the cheekbone, for an upper jaw with very little bone left. Your 3D scan shows which is possible.
Sources
Brennand Roper et al., Long-term treatment outcomes with zygomatic implants: systematic review and meta-analysis, International Journal of Implant Dentistry, 2023 ↗ADA MouthHealthy: dental implants ↗Last updated 14 October 2026. This page explains options in general terms; your own plan comes from an examination.