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Product Review: Straumann® Zygomatic Implant System

Healthcare | Apr, 2021

Once bone mass is gone, it cannot be reversed thus, rehabilitation of the teeth may be needed. If you do not replace the missing tooth with the replacement tooth, then dental occlusion and domino effect can cause a drastic change to the overall dynamic of your teeth and mouth. Generally, there are two surgical alternatives to achieve fixed rehabilitation for completely edentulous patients, such as grafting and graft-less solution. For patients with insufficient intra-oral donor sites, oral surgeons prefer graft-less solutions using zygomatic implants. Unlike conventional implants, zygomatic implants are safe and effective options for the management of severely resorbed edentulous maxillae and atrophic jaws. Reducing the time between surgery and fixed restoration, and offering a broad range of options for prosthetics, zygomatic implants allow a quick return to normal life and increases comfort and quality of life for the patients.


Straumann® zygomatic implant system stands as a breakthrough for the rapidly expanding field of zygomatic implant rehabilitation that incorporates unique design and features. The system consists of Straumann® Zygomatic Implant ZAGA™ Round and Straumann® Zygomatic Implant ZAGA™ Flat designs, which were born out of the collaboration of three surgeons and engineers. Each implant has been fabricated to suit the patient’s anatomical situation for maximum comfort and efficiency.


With unique design and straightforward prosthetic concept, Straumann® Zygomatic Implants provide versatile treatment options, which support clinicians to customize solutions as per patient’s requirements. The size of the Straumann® Zygomatic Implant makes it an excellent choice for enhancing patient safety, with 2.6 mm at the apex, 3-3.9 mm for the tapered and threaded apical portion.


Zygoma Anatomy-Guided Approach (ZAGA) is a concept used to place zygomatic implants in a prosthetically driven manner. Adapting the implant design according to the patient’s anatomy is the key to achieving clinical success as well as patient satisfaction. Combining the ZAGA technique with the ZAGA Flat and ZAGA Round zygomatic implants helps to prevent soft tissue complications, rhinosinusitis complications, and other pitfalls associated with the treatment of severe maxillary atrophy. Straumann® Zygomatic Implant ZAGA™ flat design has a semi-circumference section to overcome situations where circular/tunnel osteotomy cannot be performed. However, it is at the surgeon's discretion to use either a flat or round implant design based on the residual bone at the crestal/sinus floor level. The two ZAGA zygomatic implants are thin, resistant, easily adaptive to the anatomy of the patient, and are proven to be appreciated by oral surgeons.


Key features of Straumann® Zygomatic Implant System


Surface Type

Straumann® Zygomatic implants combine both rough and machined surfaces, each having its benefits in the implant design. During the crucial transition between initial mechanical stability and secondary biological stability, the sandblasted rough surface enhances bone apposition onto the titanium surface along with providing higher osseointegration values in shorter healing times. The machined surface prevents the proliferation of bacteria on the titanium implant surface, and ultimately reduces the risk of bone loss around the implant neck. Some of the zygomatic implants whose final apex is rounded, and threads are not as aggressive are IDC zygomatic implants, Noris Medical Zygomatic implants, Nobel Biocare, among others.



The oral surgeon needs to consider installing four zygomatic implants, and with anterior implants much larger than posterior implants for anatomical reasons, the space available for anchorage is not too large. The tip of the implant should not be set too low otherwise it can fracture the zygomatic bone, nor it should be set too high so as not to penetrate the infratemporal fossa. The length of the Straumann® zygomatic implants (available in a wide range of 30 -55 mm) is excellent for the surgical procedure as it does not risk the patient's safety. The size might seem like a minor detail to be taken into consideration, but length can become a decisive factor for the resolution of some cases in an ideal way. Other zygomatic companies that stand out in this regard are SIN Implant System with zygomatic implant length up to 62.5 mm, Nobel BioCare with maximum implant lengths of 52.5 mm. The ideal zygomatic implant system must cover a wide range of lengths to suit the varying needs of individuals.


Prosthetic Versatility

The 55o implant platform provides a higher angle and versatility, which also guarantees long-term mechanical behavior. An ideal prosthetic component optimizes the prosthetic screw's emergence as well as maintains a vertical position compatible with the soft tissue thickness. The greater the range of possibilities offered by the zygomatic implant system in terms of height and resolutions, the better are the outcomes of the surgical treatment. Although zygomatic implants with a 45o head promote good prosthetic resolution, an increase in angle to 55o provides a greater advantage. JDentalCare, Noris, NobelZygoma, IDC Implants, Titaniumfix, offer 0o head implants, which give the surgeon the flexibility to install implants without assemblers and minimize the chances of mechanical complications under high torque.



Just like lengths, there is a wide variation between the zygomatic implants' thickness among different brands. The zygomatic implant of inappropriate thickness could lead to fracture due to lack of support to implant head in the cervical region, lack of splinting, excess of the anterior cantilever, etc. Straumann® zygomatic implants have an optimal thickness of 3.4 mm, which does not lead to any kind of complications after the procedure. Southern implants are the unique zygomatic implant manufacturer company that offers different alternatives for implant thickness, 3.4 mm, and 4.1 mm.


Some of the other unique features of the Straumann® ’s implant design includes

·         Narrow 3.4 mm apex diameter and grade 4 titanium to increase fatigue strength

·         Rough tapered apex portion to improve primary stability and match ZAGA osteotomies

·         Turned machined implant platform for optimizing prosthetic versatility

·         Flat mid-portion to reduce soft tissues tension

·         Round mid-portion to fit tunnel type osteotomy

·         Transporter with the same outer diameter as an implant to preserve bone crest


Straumann® ’s zygomatic implant systems address the following concerns post-procedure such as

·         Gradual loss of volume in zygomatic bone, especially with quad surgeries

·         Breaking of the bony crest valuable for soft tissue maintenance

·         Interference of wide implant transporter with another implant in a compromised maxilla

·         Lack of stability in zygoma area

·         Difficult soft tissue anchoring at the crest level

·         High tension of soft tissue during placement of implant extra-maxillary in ZAGA types 2 and 4

·         Bacterial adhesion over implant surface

Other Zygomatic Implants

Nobel Biocare’s zygomatic implants

Designed to achieve high primary stability for immediate function, the Nobel Biocare's zygomatic implants allow patients to have a fixed provisional prosthesis fitted immediately after surgery, resulting in shorter treatment time. The precision-engineered Nobel Biocare component removes the risks associated with ill-fitted third-party abutments and eliminates the risks that unclean and non-biocompatible components encounter the soft tissue. The Nobel Biocare zygomatic implants have an unthreaded implant body designed to interface with the soft tissue, and for extra maxillary placement, the coronal part of the implant provides bone support. Without the Nobel BioCare Zygomatic implant, many people would have otherwise required invasive grafting procedures to establish adequate bone volume for conventional implant placement.

The Nobel Biocare zygomatic implants have benefits for both the patient and clinician. As the prosthesis is supported by the implants and not by the soft tissue as the surgical site, the patient feels more confident with the stability of the prosthesis. The immobility of prostheses allows for more confident speech and enhanced appreciation of foods due to lack of palatal coverage. Nobel Biocare's zygomatic implants, NobelZygoma 0̊ and NobelZygoma 45̊ implants provide an excellent alternative for the treatment of maxillary resorption. The straight implant head ensures greater flexibility during implant placement and the implant comes in a broad range of lengths, from 30 mm to 52.5 mm with all external hex connections.

Noris Medical Zygomatic implants

The Noris Medical Zygomatic implants provide an excellent solution for cases of the extreme atrophic maxilla as it consists of sharp threads at the apical part, specifically designed for extra maxillary technique. The implant enables easy and convenient restoration and is available in a variety of lengths, from 30 mm to 60 mm with 2.42mm internal hex connection. The zygomatic implants offer 45°, 52°, and 60° angle multi-unit abutments for providing the required angular correction and more appropriate positioning of the restoration.


Straumann zygomatic implants are among the finest quality dental implants that are made up of the finest materials and the latest technology. Delivering optimum standards of functionality, comfort, and aesthetics, Straumann implants cater to the needs of patients and provide the best possible results, making them suitable treatment for patients with any number of missing teeth.

According to TechSci research report on “Global Dental Implants Market By Material (Titanium v/s Zirconium) By Design (Tapered v/s Parallel-Walled) By Type (Root-Form v/s Plate-Form) By Connection Type (Internal, External, One-Piece) By Procedure (One-Stage & Two Stage Surgeries v/s Immediate Loading) By Price (Premium, Value, Discounted) By Application (Single Tooth Replacement v/s Multi-Tooth Bridge Securement) By End User (Hospitals & Clinics, Dental Laboratories, Others) By Region, Competition Forecast & Opportunities, 2026”, the global dental implants market is expected to grow at a significant CAGR, owing to the increasing demand for prosthetics and growing dental problems globally.

According to another TechSci research report on “Global Dental Bone Graft Substitute Market By Type (Synthetic Bone Graft, Xenograft, Allograft, Autograft, Alloplast, Others) By Material (Collagen, Human Cell Source, Animal Source, Others) By Mechanism (Osteoconduction, Osteoinduction, Osteopromotion, Osteogenesis) By Product (Bio OSS, Osteograf, Grafton) By Application (Socket Preservation, Ridge Augmentation, Periodontal Defect Regeneration, Implant Bone Regeneration, Sinus Lift) By End User (Hospitals & Clinics, Dental Laboratories, Others) By Region, Competition Forecast & Opportunities, 2026”, the global dental bone graft substitute market is expected to grow at an impressive CAGR during the forecast period on the account of increasing cases of dental disorders, and introduction of advanced dental restoration products by major key players in the market. 

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