Key points
- When the upper jaw has too little bone, implants can be anchored in the cheekbone (zygomatic implants) or far back behind the teeth (pterygoid implants), often instead of a bone graft.
- A review of 68 studies with 4,556 zygomatic implants found 95.2% still in place at 12 years. Most failures happened within the first six months.
- A 2024 review of 38 studies found a 10-year cumulative survival of 92.5% for pterygoid implants, with failures concentrated in the first year.
- These are specialised operations, done by surgeons trained in them.
Why they exist
An ordinary implant needs enough bone around it. In the back of the upper jaw, bone is often lost after teeth have been missing for years, and the sinus sits just above. The usual answer is to add bone first — a graft or sinus lift — and wait months before placing implants. Zygomatic and pterygoid implants take another route: they are anchored in denser bone further away, so a graft can often be avoided.
Zygomatic implants
These are long implants that pass from the mouth into the cheekbone (the zygoma). Chrcanovic and colleagues (2016) reviewed 68 studies covering 4,556 zygomatic implants in 2,161 patients. The cumulative survival at 12 years was 95.21%, and most failures were detected within the first six months after surgery. Studies that loaded the implants immediately reported fewer failures than studies that waited.
Pterygoid implants
These are anchored far back in the upper jaw, in the pterygoid region behind the last molars. Raouf and Chrcanovic (2024) reviewed 38 studies with 3,053 pterygoid implants. The 10-year cumulative survival was 92.5%, failures were concentrated in the first year, and few surgical complications were reported.
What this means in practice
Both techniques are well established but demanding. They are planned on a CT scan and carried out by surgeons who do them regularly. Whether you need one, and which, is decided only after imaging.
Worth knowing
- The most common complication of zygomatic implants is sinusitis, reported in about 2.4% of cases — and it can appear years after surgery.
- Other reported complications include soft-tissue infection (about 2%), numbness (about 1%) and an opening between mouth and sinus (about 0.4%). The reviewers note these are probably under-reported.
- Survival was lower in patients rebuilt after part of the upper jaw had been removed, for example after cancer surgery.
Sources
- Chrcanovic BR, Albrektsson T, Wennerberg A. Survival and complications of zygomatic implants: an updated systematic review. J Oral Maxillofac Surg. 2016;74(10):1949-1964.
- Raouf K, Chrcanovic BR. Clinical outcomes of pterygoid and maxillary tuberosity implants: a systematic review. J Clin Med. 2024;13(15):4544.
This summary is general information and no substitute for an examination and personal medical advice. The figures are averages from studies, not a promise of a result.