Being told you do not have enough bone for upper implants is not always the end of the road to fixed teeth. In the most severe cases, longer implants can be anchored in the cheekbone, called the zygoma, instead of the thin bone left in the upper jaw. These zygomatic implants can often carry a fixed bridge soon after surgery, without the long wait that extensive bone grafting involves.
They are a specialised treatment for a narrow group of patients, so it helps to understand why they exist and how they compare with the alternatives.
The upper jaw loses bone in two directions
Once upper teeth are lost, the ridge of bone that held them slowly shrinks. At the back of the upper jaw there is a second problem: the sinus above the roots tends to enlarge downwards into the space. After years without teeth, after gum disease, failed implants, or surgery for trauma or tumours, the bone that remains may be too thin or too short to hold a standard implant.
At that point there are two broad routes. One is to rebuild the bone with grafting or a sinus lift and place standard implants once it has healed. The other is to bypass the missing bone altogether and anchor in the dense bone of the cheek.
How a zygomatic implant is held
A zygomatic implant is much longer than a standard implant. It enters the mouth where a back tooth would have been, runs upwards at an angle, and engages the cheekbone. Usually one or two are placed on each side, often together with standard implants at the front of the jaw where bone tends to be better preserved. All of them are then joined by a single fixed bridge.
The surgery is more involved than standard implant placement and is usually carried out under deep sedation or a general anaesthetic, often in a hospital. In many cases a fixed temporary bridge is attached within a few days, and the final bridge follows once healing has settled.
What the research shows
The long-term numbers are reassuring for this group of patients. A 2023 systematic review and meta-analysis in the International Journal of Implant Dentistry (Brennand Roper and colleagues) pooled 18 studies covering 1,349 zygomatic implants in 623 patients. Average implant survival was 96.2% at about six years, which the authors considered comparable to conventional implants, and the bridges they supported lasted similarly well.
The same review found that sinusitis was the most common biological complication, with a pooled prevalence of about 14% over an average of roughly five years of follow-up. That is one reason careful planning with 3D imaging, and follow-up with someone experienced in the technique, matters so much.
Zygomatic implants or bone grafting first?
Neither approach is better for everyone. The choice depends mostly on how much bone is left and how long you are willing to wait for fixed teeth.
| Zygomatic implants | Grafting, then standard implants | |
|---|---|---|
| Suited to | Severe bone loss in the upper jaw | Moderate bone loss that can be rebuilt |
| Fixed teeth | Often within days of surgery | Usually many months later |
| Surgeries | Usually one main operation | Often two or more stages |
| Main risks to discuss | Sinus problems, a more complex surgery | Graft not taking, longer overall treatment |
Most people who are short of some bone do not need zygomatic implants at all. Standard full-arch implants, sometimes angled to avoid the sinus, or a graft or sinus lift, solve many cases. Zygomatic implants are usually kept for situations where those options are not workable or have already failed.
Recovery and long-term care
Swelling and bruising around the cheeks are common for several days, and a soft diet is needed while the temporary bridge settles. Because the implants pass close to the sinus, you may be given specific instructions about nose blowing and sinus symptoms, and any congestion, discharge or facial pain should be reported.
Once healed, the bridge needs the same daily cleaning and professional maintenance as any implant work. Inflammation around implants can still develop, which our article on peri-implantitis treatment explains.
A guide to cost
Zygomatic treatment usually costs more than standard full-arch implants because the surgery is longer, often hospital-based, and uses specialised components. As a typical Australian market range, standard full-arch treatment is about $20,000 to $35,000 per arch, and zygomatic cases generally sit above that. These are general market figures, not Lumi fees; you will usually receive a written treatment plan with costs after a full assessment. Our guide to full-arch implant costs breaks down what affects the price.
Common questions
Will I be awake for the surgery?
Usually not fully. Zygomatic surgery is generally done under deep sedation or a general anaesthetic, and you can expect soreness and swelling for several days afterwards.
Can I have fixed teeth straight away?
Often, yes. A fixed temporary bridge is frequently attached within a few days, so many people avoid a long stretch with a removable denture. This depends on how stable the implants are at surgery.
Does Lumi place zygomatic implants?
We place standard implants and full-arch implant bridges. If a 3D scan shows that zygomatic implants are the best route for you, we can discuss referral to a surgeon experienced in the technique and explain how the rest of your care would fit around it.
If you have been told there is not enough bone for upper implants, a 3D scan and consult at our Melrose Park practice can show what options remain. Read about full-arch implants at Lumi and our dental implants page, or see the current deals page to book a free implant consult.
