When patients come to us after being told by multiple dental clinics that fixed implant teeth are "not possible," we understand their frustration. Extreme bone loss can seem like an insurmountable barrier. But with advanced techniques like zygomatic implants, we can often help patients who were previously considered untreatable.
Today, I want to share a remarkable case that demonstrates what's possible with specialized training and the right approach.
What Are Zygomatic Implants?
Zygomatic implants are specifically designed for patients with extreme upper jaw bone loss—cases where conventional All-on-4 or All-on-6 implants simply won't work.
Key Differences from Regular Implants
| Feature | Conventional Implants | Zygomatic Implants | |---------|----------------------|-------------------| | Length | 10-15mm | 35-55mm | | Anchoring location | Jawbone | Cheekbone (zygoma) | | Bone grafting needed | Often yes | Usually no | | Healing time | 3-6 months | Immediate loading possible | | Specialist required | Recommended | Essential |
These long implants anchor into the cheekbone (zygomatic bone), bypassing the deteriorated maxillary bone entirely. This allows us to provide fixed teeth to patients who would otherwise be limited to removable dentures.
The Case: Patient Told "It Can't Be Done"
Patient Background
A gentleman traveled from Los Angeles to our Roseville, California clinic after being rejected by multiple dental offices. His situation was complex:
- Complete upper jaw resorption: No bone remained for conventional implants
- Failed previous implants: Earlier attempts had not succeeded
- Facial trauma history: A fall from a roof years prior had fractured his right cheekbone
- Existing hardware: Metal plates from the fracture repair
- Severe lower arch issues: Extreme tooth extrusion and periodontal disease
He had been told repeatedly that a fixed bridge retained by implants was "not an option" for either jaw.
Our Evaluation
Using advanced 3D CBCT imaging, we conducted a thorough evaluation:
Upper Jaw Assessment:
- Conventional implant sites: No usable bone
- Cheekbone quality: Good bone on both sides
- Complication: Right cheekbone had prior fracture with exposed sinus and metal plate
Lower Jaw Assessment:
- Adequate bone for 4-5 conventional implants
- Severe tooth extrusion due to lack of upper teeth
- Collapsed bite with aged facial appearance
Our Conclusion: Despite the complexity, we determined that implant-supported fixed teeth were possible—using a combination of zygomatic and pterygoid implants for the upper arch.
The Surgical Plan
Upper Arch: Quad Zygoma + Pterygoid
We developed a plan using five implants in the upper jaw:
- Four zygomatic implants (two on each side, varying lengths)
- One pterygoid implant (anchoring in the pterygoid region behind the maxilla)
This "quad zygoma" approach provides excellent anterior-posterior spread—support from the front to the back of the arch—essential for a stable, functional prosthesis.
Lower Arch: Conventional Implants
The lower jaw received five conventional implants placed in available bone.
Additional Procedures
- Metal plate removal from the previous facial trauma
- Sinus management for the exposed sinus area
- Extractions of remaining hopeless teeth
Surgery Day and Results
The Procedure
Both arches were treated in a staged approach:
- Lower arch first: Implant placement with immediate temporary teeth
- Facial scanning and planning: Digital measurements for upper arch
- Upper arch surgery: Zygomatic and pterygoid implant placement with simultaneous plate removal
- Same-day teeth: 3D-printed provisional prosthesis delivered
The Transformation
The before and after results speak for themselves:
Before:
- Collapsed bite
- Aged facial appearance
- Severely extruded lower teeth
- Gum disease visible
- Unable to smile with confidence
After:
- Restored vertical dimension
- Youthful facial support
- Natural-looking smile
- Proper lip and airway support
- Full chewing function
Why Zygomatic Implants Require Specialized Training
This type of case requires:
- Advanced surgical training in zygomatic techniques
- Pterygoid implant expertise
- Complex case planning with digital workflows
- In-house lab capabilities for same-day teeth
- Experience managing complications like prior facial trauma
Not every dental office offers these advanced procedures. If you've been told you're not a candidate for dental implants, seeking a second opinion from a full-arch specialist is essential.
Who Benefits from Zygomatic Implants?
Zygomatic implants may be right for you if:
- You have severe upper jaw bone loss
- You've been told you need extensive bone grafting (and want to avoid it)
- Previous implants have failed due to bone issues
- You have a history of sinus problems affecting traditional implant placement
- You want fixed teeth without months of bone grafting
The Fusion Dental Difference
At Fusion Dental Implants, we specialize in complex full-arch cases that other offices may decline. Our advantages include:
- Dr. Antipov's specialized training in zygomatic and pterygoid techniques
- In-house dental laboratory for same-day teeth
- Advanced 3D planning for precise implant placement
- Full sedation options for patient comfort
- Experience with trauma and revision cases
Take the First Step
If you've been told dental implants aren't possible for you, don't give up. Advanced techniques like zygomatic implants have helped countless patients who were previously considered untreatable.
Schedule a consultation at our Roseville clinic to find out if zygomatic implants could work for you:
- Phone: (916) 292-9998
- Online: Request a consultation
We welcome patients from throughout Northern California, including Sacramento, El Dorado Hills, Folsom, and beyond—as well as those traveling from out of state for specialized care.
Dr. Alexander Antipov is a full-arch implant specialist at Fusion Dental Implants, with advanced training in zygomatic and pterygoid implant techniques. The clinic serves Sacramento, Roseville, and Northern California.