What is the zygomatic implant?
The limitation of the original zygomatic implant protocol
When it was first introduced, the protocol involved placing two zygomatic implants, one on each side, together with four regular implants, making a total of six implants supporting a full arch fixed prosthesis. The limitation of this protocol is that in our Asian population, most of the fully edentulous patients do not have sufficient bone to support the four regular implants. Bone grafting was still needed to reconstruct the bone in the front to place those implants. What the zygomatic implant did was merely to replace the need for a sinus bone graft. With the need for bone grafting remaining, the advantage of zygomatic implants is largely negated. Dental implants in Singapore has largely been limited to the conventional ones.
The Quad Zygomatic Implant protocol
Studies in the last few years have shown that it is possible to placed two zygoma implants on each side, ie having four zygomatic implants to support a fixed prosthesis. The data showed that success for this protocol is similar to that of regular implants. It has the added advantage of immediate restoration with a functional prosthesis, thereby shortening the treatment duration.
Cost of bone grafting and regular implants
Cost of quad zygomatic implants
Using four zygomatic implants, the cost is significantly reduced. The surgery is usually done under general anesthesia but in a patient who is able to cooperate, it is possible to do this under local anesthesia with intravenous sedation in the clinic.h That will result in even greater cost-saving. When done in the clinic, cost of a full arch restoration supported by four zygoma implants ranges from $25000 to $30000. If general anesthesia is chosen, the hospital charges may add another $6000-8000 to the bill. This is a much lower cost compared with the traditional approach.
Disadvantages..
Is there still a role for the use of bone grafting and regular dental implants in rehabilitation of the atrophied maxilla? Definitely. While there are obvious advantages in the quad-zygomatic implant approach, it is not without its drawbacks. There is no contingency plan in this protocol. Should one implant fail, the whole prosthesis is compromised. Replacement of another zygomatic implant is more difficult due to limitation of the space available in the zygoma bone. The prosthesis also tends to be more bulky as the implant tends to emerge into the oral cavity through the palate.
The quad zygomatic implant method offers a more economical and time efficient way of converting a patient from a removable denture to a fixed prosthesis. While the traditional approach of bone grafting and implants has more contingencies built in, it costs more and requires a longer treatment duration.