Trans-sinus implants versus zygomatic implants in the atrophic maxilla: comparison of efficacy, safety, and clinical predictability
DOI:
https://doi.org/10.55892/jrg.v9i20.3248Keywords:
Zygomatic Implants; Atrophic Maxilla; Oral Rehabilitation; Trans-sinus Implants; Implant Survival.Abstract
The rehabilitation of the severely atrophic maxilla remains a significant clinical challenge in contemporary implant dentistry, mainly due to reduced bone volume and anatomical limitations in the posterior maxillary region. In this context, zygomatic implants and trans-sinus techniques have been proposed as alternatives to conventional reconstructive approaches. This study aimed to perform an integrative literature review based on articles published over the last ten years in recognized databases, in order to compare the efficacy, safety, and clinical predictability of these techniques. The search was conducted in PubMed/MEDLINE, Scopus, and LILACS, resulting in the inclusion of 12 studies that met the eligibility criteria. The findings demonstrated that zygomatic implants present high survival rates, frequently exceeding 95%, with long-term clinical stability. In contrast, trans-sinus techniques showed favorable short-term outcomes, including reduced sinus-related complications in certain approaches; however, they remain supported by a limited body of evidence and lack robust long-term follow-up data. It is concluded that zygomatic implants currently represent the most established and predictable option for the rehabilitation of the atrophic maxilla, supported by stronger scientific evidence, whereas trans-sinus techniques, although promising, still require validation through prospective and controlled studies with extended follow-up periods.
Downloads
References
AGLIARDI, Enrico Luigi et al. Clinical outcomes and biological and mechanical complications of immediate fixed prostheses supported by zygomatic implants: a retrospective analysis from a prospective clinical study with up to 11 years of follow-up. Clinical Implant Dentistry and Related Research, Hoboken, v. 23, n. 4, p. 511–523, 2021. DOI: https://doi.org/10.1111/cid.13017.
DAVÓ, Rubén et al. Long-term survival and complications of Quad Zygoma Protocol with Anatomy-Guided Approach in severely atrophic maxilla: a retrospective follow-up analysis of up to 17 years. Clinical Implant Dentistry and Related Research, Hoboken, v. 26, p. 343–355, 2024. DOI: https://doi.org/10.1111/cid.13296.
GOKER, Funda et al. Clinical outcome of 302 zygomatic implants in 110 patients with a follow-up between 6 months and 7 years. Clinical Implant Dentistry and Related Research, Hoboken, v. 22, n. 4, p. 1–9, 2020. DOI: https://doi.org/10.1111/cid.12909.
GRACHER, Ana Helena Pereira et al. Full arch rehabilitation in patients with atrophic upper jaws with zygomatic implants: a systematic review. International Journal of Implant Dentistry, Berlin, v. 7, n. 17, 2021. DOI: https://doi.org/10.1186/s40729-021-00297-z.
GRANDI, Tommaso et al. Psychosocial impact of Maxilla-for-All® treatment using standard and long implants (pterygoid, trans-sinus and zygomatic) on patients with severe maxillary atrophies: a 1-year prospective study with PIDAQ-23 and OHIP-14. Journal of Clinical Medicine, Basel, v. 14, n. 3544, 2025. DOI: https://doi.org/10.3390/jcm14103544.
KÄMMERER, Peer W. et al. Evaluation of surgical techniques in survival rate and complications of zygomatic implants for the rehabilitation of the atrophic edentulous maxilla: a systematic review. International Journal of Implant Dentistry, Berlin, v. 9, n. 11, 2023. DOI: https://doi.org/10.1186/s40729-023-00478-y.
KOPPAKA, Rahul; AHMED, Nabeel; ECHHPAL, Urvi R. Evaluation of the long-term success and patient-related outcomes of zygomatic implants in atrophic maxillary ridges. Cureus, Palo Alto, v. 16, n. 7, e64280, 2024. DOI: https://doi.org/10.7759/cureus.64280.
PATEL, Ruchi S.; METGUD, Renuka M. Surgical outcome of extra sinus zygomatic implants in comparison to conventional implants for the rehabilitation of atrophic maxilla: a systematic review and meta-analysis. International Journal of Community Medicine and Public Health, v. 11, n. 8, p. 3209–3219, 2024. DOI: https://doi.org/10.18203/2394-6040.ijcmph20242186.
PELLEGRINO, Gerardo et al. Computer-aided rehabilitation supported by zygomatic implants: a cohort study comparing atrophic with oncologic patients after five years of follow-up. Journal of Clinical Medicine, Basel, v. 9, n. 10, p. 3254, 2020. DOI: https://doi.org/10.3390/jcm9103254.
RAMEZANZADE, Shaqayeq et al. Zygomatic implants placed in atrophic maxilla: an overview of current systematic reviews and meta-analysis. Maxillofacial Plastic and Reconstructive Surgery, Heidelberg, v. 43, n. 1, 2021. DOI: https://doi.org/10.1186/s40902-020-00286-z.
REBELO, Helder Lima et al. Effectiveness of zygomatic implants using the externalized technique in the rehabilitation of atrophic maxillae: a systematic review with meta-analysis. Medicina Oral, Patología Oral y Cirugía Bucal, Valencia, v. 30, n. 6, p. e774–e786, 2025. DOI: https://doi.org/10.4317/medoral.27117.
SACCO, Roberto et al. The use of zygomatic implants in severe maxillary atrophy: a systematic and meta-analysis review of randomized clinical trials. International Journal of Morphology, Temuco, v. 41, n. 1, p. 35–44, 2023. DOI: https://doi.org/10.4067/S0717-95022023000100035.
WHITTEMORE, Robin; KNAFL, Kathleen. The integrative review: updated methodology. Journal of Advanced Nursing, Oxford, v. 52, n. 5, p. 546–553, 2005. DOI: https://doi.org/10.1111/j.1365-2648.2005.03621.x.
