ANALYSIS OF TECHNOLOGICAL ADVANCES IN ZYGOMATIC IMPLANTS FOR THE REHABILITATION OF ATROPHIC MAXILLA – A LITERATURE REVIEW

Abstract

Introduction: Despite bone grafting techniques are traditional, they increase morbidity and treatment time. In this scenario, zygomatic implants emerge as a robust solution, leveraging the density of the zygomatic bone for anchorage and primary stability. The evolution of techniques, from the intra-sinus to the extra-maxillary approach, combined with the transition to digital dentistry, has transformed the predictability of this surgical modality, allowing for immediate loading protocols even in critical bone conditions. Objective: To review and analyze the technological and technical advances in the evolution of zygomatic implants, identifying innovations in materials, implant designs, and digital workflows. It seeks to evaluate how these improvements impact the efficacy, longevity, and safety of treatments in patients with severe maxillary atrophy, in addition to comparing their benefits against other rehabilitative alternatives. Methodology: This is characterized as an integrative literature review, guided by the PICO strategy. Data collection was performed in the PubMed and VHL (LILACS and MEDLINE) databases between August and September 2024, using descriptors such as "zygomatic implant", "maxillary atrophy", and "digital planning". Experimental articles and reviews in Portuguese and English published between 2020 and 2026 were included and subjected to a qualitative analysis to synthesize evidence on clinical success and technological innovations. Results: The evidence shows that zygomatic implants have high survival rates (between 95% and 98%), overcoming the limitations of bone grafts in terms of time and comfort. The implementation of a full digital workflow, including cone-beam computed tomography, intraoral scanning, and personalized surgical guides, has drastically reduced positioning errors and the risk of damage to vital structures, such as the orbit and the infraorbital nerve. Discussion: The academic debate emphasizes that the extra-maxillary technique optimizes prosthetic emergence and reduces sinus complications. Despite the high cost and steep learning curve, guided surgery and digital navigation have democratized the safety of the procedure, promoting a significant improvement in the quality of life and self-esteem of rehabilitated patients. Conclusion: Zygomatic implants have evolved from a niche solution to a highly predictable alternative. The refinement of implant surfaces and the precision of virtual planning ensure superior aesthetic and functional results. It is concluded that technological integration is indispensable for contemporary dentistry, allowing high-performance rehabilitations that restore masticatory function and facial harmony quickly and safely.