In the interest of patients, this article will compare two zigomatic implantology techniques: Quad Zigomatic, performed by 95-100% of proposing doctors, against another lesser-known but highly performing zigomatic technique. This latter method is more complex and can be executed only by a few specialized studies, involving both doctors and dental prosthetic technicians. It is known as Pterygozigomatic. It is crucial that patients are aware of and understand the surgical, functional in terms of chewing, and consequently, aesthetic differences between these two approaches.
Zygomatic Quad Implantology
PterigoZygomatic Implantology
“PterigoZygomatic Implantology: The Alternative to QUAD”




Zygomatic QUAD implantology
Zygomatic QUAD implantology is an advanced procedure in the field of dentistry and dental implantology. This technique involves the use of zygomatic implants, which are anchored to the zygomatic bone, to provide support for a fixed dental prosthesis in the upper part of the jaw.
Here are some key points regarding Zygomatic QUAD implantology:
- Number of Implants: In Zygomatic QUAD implantology, four zygomatic implants are used. These implants are placed bilaterally, with two implants per zygoma, in the front part of the jaw.
- Implant Placement: Zygomatic implants are anchored to the zygomatic bone, which is a robust bony structure located in the lateral region of the jaw. This type of implant is designed to address bone loss in the posterior part of the jaw, allowing secure anchoring of the prosthesis.
- Procedure Objectives: Zygomatic QUAD implantology is suitable for patients with significant bone loss in the upper jaw, particularly in the posterior region where traditional dental implants may not be easily insertable.
- Fixed Dental Prosthesis: After the placement of zygomatic implants, a fixed dental prosthesis is anchored. This type of prosthesis offers greater stability compared to removable prostheses.
- Benefits: The Zygomatic QUAD technique overcomes challenges related to bone atrophy in the posterior part of the jaw, providing a solution for patients seeking a stable fixed dental prosthesis.
- Surgical Complexity: The procedure is considered complex and requires specialized skills. Detailed planning is essential to ensure the correct placement of zygomatic implants.
Zygomatic QUAD implantology offers an effective option for addressing bone loss in the upper jaw, providing a solid foundation for a fixed dental prosthesis. The choice of this technique depends on the specific conditions of the patient and should be evaluated in collaboration with the dental professional.
The dental prosthesis used in the QUAD zygomatic technique can vary depending on the specific needs of the patient and the preferences of the dental professional. However, often in QUAD zygomatic implant procedures, a fixed prosthesis anchored to the zygomatic implants is used. Some details regarding these prostheses may include:
- Type of Fixed Prosthesis: Commonly, a fixed dental prosthesis is used, meaning it is securely anchored to the zygomatic implants and provides greater stability compared to removable prostheses.
- Structure and Material: The fixed prosthesis can be made from various materials, including ceramics or metal alloy. The choice depends on the patient’s aesthetic preferences and other factors, such as the balance between aesthetics and strength.
- Number of Dental Elements: The prosthesis can consist of a variable number of dental elements depending on the patient’s needs. It can be a complete or partial dental prosthesis, depending on the clinical situation.
- Aesthetics: Given the potential complexity of the procedure and the presence of four zygomatic implants, attention is given to the aesthetic aspect of the prosthesis. Meticulous design aims to achieve a natural and harmonious result with the patient’s facial structure.
- Gum Shape: The prosthesis can be designed with a realistic gum shape to achieve a natural appearance. In some cases, a false gum may be used to cover any gaps and improve aesthetics.
- Maintenance and Hygiene: Attention is given to the prosthesis design to facilitate the patient’s daily cleaning and to prevent issues such as peri-implantitis. A proper home oral hygiene plan and regular visits to the dentist are essential to maintain the health of the implants and the prosthesis.
Ultimately, the specific choice of the dental prosthesis depends on the individual characteristics of the patient, the clinical assessment of the dental professional, and the desired aesthetic and functional goals.
“PterigoZygomatic Implantology: The Alternative to QUAD”
Pterygoid-Zygomatic Implantology is an advanced technique in the field of dental implantology that involves the combined use of zygomatic implants and pterygoid implants to provide support for a fixed dental prosthesis. This procedure is primarily indicated for patients with significant bone loss in the upper jaw, especially in the posterior area, where bone atrophy is more pronounced.
Here are the key features of Pterygoid-Zygomatic Implantology:
- Zygomatic Implants: Zygomatic implants are anchored to the zygomatic bone, a robust bony structure on the lateral side of the jaw. These implants provide stable anchorage in the anterior region.
- Pterygoid Implants: Pterygoid implants are placed in the
pterygoid process region, which is a bony structure in the posterior part of the jaw. These implants offer additional support in the posterior region, reaching the molar area.
- Purpose: The goal of this technique is to provide complete and stable anchorage for a fixed dental prosthesis, distributing chewing loads evenly across the entire dental arch.
- Wide Support: Thanks to the combination of zygomatic and pterygoid implants, this technique offers broader support compared to methods relying solely on zygomatic implants, which are predominantly frontal.
- Complete Chewing: The presence of implants in the posterior region allows for more comprehensive chewing, contributing to improved functionality.
- Surgical Complexity: The procedure is considered complex and requires meticulous planning by the dental surgeon.
Pterygoid-Zygomatic Implantology is recommended for patients with severe bone loss in the posterior area of the jaw, where traditional implants may not be sufficient. As with all implant procedures, the choice of this technique should be based on the specific clinical assessment of the patient and the guidance of the dental professional.
The type of prosthesis used in the pterygoid-zygomatic implantology technique can vary based on the specific needs of the patient and decisions made by the dental team involved in the procedure. However, generally, fixed dental prostheses anchored to zygomatic and pterygoid implants are commonly used in the pterygoid-zygomatic technique. Here are some common details about the prosthesis used in this technique:
- Fixed Dental Prosthesis: Typically, in the pterygoid-zygomatic technique, a fixed dental prosthesis is preferred. This type of prosthesis is securely anchored to the implants and provides greater stability compared to removable prostheses.
- Prosthesis Material: The fixed prosthesis can be made from various materials, including ceramics or metal alloys. The choice depends on the patient’s aesthetic preferences, required strength, and other clinical factors.
- Aesthetic Structure: The dental prosthesis will be designed to provide a natural and harmonious aesthetic appearance with the patient’s facial structure. The gum shape can be realistic to achieve an optimal aesthetic and functional result.
- Extension and Number of Dental Elements: The prosthesis can extend across the entire dental arch and may vary in the number of dental elements based on the patient’s clinical situation.
- Chewing Support: The presence of pterygoid implants in the pterygoid-zygomatic technique allows for a more comprehensive distribution of chewing loads, improving the functionality of the prosthesis compared to techniques relying solely on zygomatic implants.
- Ease of Hygiene: The prosthesis design should take into account ease of cleaning by the patient to prevent issues such as peri-implantitis. Proper at-home oral hygiene and regular visits to the dentist are important for maintaining the health of implants and the prosthesis.
In conclusion, the specific choice of dental prosthesis in the pterygoid-zygomatic implantology technique is a personalized process that depends on the individual characteristics of the patient, functional and aesthetic needs, and the clinical assessment of the dental professional.
Here is a comparison between QUAD zygomatic implantology and pterygoid-zygomatic implantology on the surgical side, focusing on the number of implants, their placement, and the surgical structure involved:
QUAD Zygomatic Implantology:
- Number of Implants: Utilizes four zygomatic implants. Two implants per zygoma, positioned in the anterior part of the upper jaw.
- Implant Placement: Implants are anchored in the zygomatic bones, located in the anterior part of the upper jaw.
- Area Involved: Predominantly anterior, with chewing support centered in the frontal region.
Pterygoid-Zygomatic Implantology:
- Number of Implants: Utilizes two frontal zygomatic implants and two posterior pterygoid implants. Zygomatic implants are placed in the anterior part, while pterygoid implants extend to the posterior region.
- Implant Placement: Zygomatic implants are anchored in the zygomatic bone, and pterygoid implants in the pterygoid process region at the posterior part of the upper jaw.
- Area Involved: Covers both the anterior and posterior regions of the upper jaw, providing more comprehensive chewing support.
Additional Considerations:
- Distribution of Chewing Load: Pterygoid-Zygomatic technique allows for a broader distribution of chewing loads as it involves both the anterior and posterior parts.
- Surgical Complexity: Both techniques are considered complex, but pterygoid-zygomatic implantology might require even greater expertise due to involvement of different regions of the upper jaw.
- Extent of Surgical Structure: In QUAD implantology, the surgical structure primarily focuses on the anterior region. In contrast, pterygoid-zygomatic implantology involves both the anterior and posterior regions of the upper jaw, requiring more detailed planning.
In conclusion, the choice between the two techniques depends on the specific conditions of the patient, the location of bone loss, and the preferences of the dental professional. Both techniques offer advanced solutions for addressing bone loss in the upper jaw, and the final decision should be based on a thorough evaluation by the medical team.


Dental Prosthesis in QUAD Zygomatic Implantology:
Design and Architecture: – Implant Placement: Four zygomatic implants are positioned bilaterally in the anterior part of the upper jaw. – Prosthesis Structure: The prosthesis is designed to cover the anterior area and may extend posteriorly, but the main chewing support is centered in the frontal part. – False Gum: Often, a Toronto Bridge prosthesis with an abundant false gum is used to cover any aesthetic gaps.
Chewing Support: – Load Zone: Chewing support is primarily concentrated in the frontal region of the upper jaw, as zygomatic implants are placed in this area. – Predominantly Frontal Chewing: Chewing is predominantly frontal, as there are no implants in the posterior region.
Functional and Aesthetic Benefits: – Reduced Chewing Function: Chewing may be reduced, especially in the molar areas, as implants are concentrated in the anterior region. – Aesthetics and Bulk: The abundant false gum may make the prosthesis more complex to clean, and the bulk of zygomatic implants can affect aesthetics, especially in the frontal area.
Dental Prosthesis in Pterygoid-Zygomatic Implantology:
Design and Architecture: – Implant Placement: Two frontal zygomatic implants and two posterior pterygoid implants provide complete anchorage from the anterior to the posterior part of the upper jaw. – Prosthesis Structure: The prosthesis can extend over the entire dental arch, benefiting from broader support both in the frontal and posterior parts. – Reduced False Gum: The prosthesis may have a reduced false gum, simplifying oral hygiene.
Chewing Support: – Load Zone: The presence of pterygoid implants in the posterior region allows for a more complete distribution of chewing loads across the entire dental arch. – Complete Chewing: Chewing is more complete, as pterygoid implants contribute to support in the posterior molar region.
Functional and Aesthetic Benefits: – Improved Chewing Function: The broader distribution of chewing loads allows for more complete and functional chewing. – Aesthetics and Lower Bulk: Designing with less false gum and fewer implants in the frontal area can lead to better aesthetics and ease of cleaning.
In conclusion, pterygoid-zygomatic implantology offers more comprehensive chewing support, better load distribution, and potentially improved aesthetic appearance compared to QUAD zygomatic implantology. However, the choice between the two techniques should be based on the specific conditions of the patient and the recommendations of the dental professional.
“Comparison of Prosthetics:


“Comparison of Prosthetics:


Zygomatic Implants: A Comprehensive Guide on Length and Positioning
The length of zygomatic implants can vary from approximately 35mm to a maximum of 55mm. This variation allows dental professionals to choose the most suitable length based on the patient’s anatomical conditions and specific clinical needs. The choice of implant length depends on the amount of available bone and the depth of the zygomatic bone in the region where the implants will be placed.
Anchoring Zygomatic Implants: Strategies and Considerations on Zygomatic Bone
The engagement of the tip of the zygomatic implant on the zygomatic bone is approximately 17 mm for men and 14 mm for women. This measurement takes into account individual anatomical variations, allowing for a more precise customization in selecting the length of zygomatic implants based on the patient’s gender.
Pterygoid Implants: Characteristics, Length, and Ideal Positioning
The length of a pterygoid implant is approximately 19 mm, but in some patients with notably different anatomies, it can be extended to 21 mm. This extension is necessary to reach the cortical pterygoid plates of the sphenoid, which can be particularly hard and resistant, belonging to category d1. These types of pterygoid plates do not show significant wear or resorption over time. The choice of pterygoid implant length is thus personalized based on the specific anatomical characteristics of the patient to ensure stable implant anchorage.
Basal Bones in the Skull: Types, Characteristics, and Role in Dental Implantology
Basal bones are fundamental parts of the skull that provide pillars of resistance when the alveolar bones of the maxilla and mandible undergo resorption over time. These cortical basal bones become crucial for maintaining the stability of the cranial bone structure. The main cortical basal bones are three: Zygomatic Bones, Canine Bones, and Pterygoid Bones. The uniqueness of these basal bones lies in their resistance and tendency not to undergo significant resorption over time, making them particularly suitable for anchoring dental implants in individuals with maxillary atrophy. The stability and load-bearing structure of these basal bones provide a solid foundation for supporting fixed dental prostheses, contributing to the success of implant procedures in patients with bone loss.