Zygomatic and Pterygoid Implants in Sydney CBD
Advanced implant solutions for severe upper jaw bone loss, potentially avoiding the need for conventional bone grafting.
Zygomatic and pterygoid implants are specialised dental implants designed for patients with severe bone loss in the upper jaw. Rather than relying solely on the weakened upper jawbone, zygomatic implants anchor into the cheekbone (zygoma), while pterygoid implants engage the dense pterygoid region behind the upper jaw. In appropriately selected patients, these techniques can support fixed upper teeth without conventional bone grafting or sinus augmentation.
Here at Pitt Street Dental Centre in Sydney CBD, Dr Michael Cai works with an oral and maxillofacial surgeon to plan and restore these complex cases. Surgery is performed in a private hospital under general anaesthesia. Dr Cai has placed over 3,000 implants across more than 18 years and manages the restorative planning and prosthetic rehabilitation, while the surgeon performs the specialised surgical placement.
Depending on your anatomy, implant configuration and implant stability, the two types may be combined to support a full upper arch. In suitable cases, a fixed provisional prosthesis may be fitted on the day of surgery.
Have You Been Told You Do Not Have Enough Bone for Implants?
You may have been told that dental implants are not possible because there is not enough bone in your upper jaw. Perhaps you were advised to have extensive bone grafting or a sinus lift first. You may have had a graft that did not succeed, or spent years relying on an upper denture that moves when you eat or speak.
For patients with severe upper jaw bone loss, conventional implant treatment is not always the only option. Zygomatic and pterygoid implants use different areas of available bone to support fixed teeth, and may offer an alternative to conventional grafting, depending on your anatomy and clinical circumstances.
These procedures require advanced surgical training, hospital facilities and a team that works together on complex cases. Here at Pitt Street Dental Centre, Dr Michael Cai works with an oral and maxillofacial surgeon to assess these cases, and we will tell you honestly whether this approach is right for your situation.
What Are Zygomatic and Pterygoid Implants and How Do They Work?
After teeth are lost, the upper jawbone gradually thins and resorbs, particularly with long-term denture wear. By the time many patients seek implants, there is not enough bone for standard placement. These two techniques bypass the weakened jawbone and anchor into denser bone nearby.
Zygomatic implants are longer than conventional dental implants and are anchored in the dense zygomatic bone (cheekbone). This lets the surgeon use available bone beyond the severely resorbed upper jaw, potentially avoiding conventional bone grafting and sinus augmentation. They are particularly relevant when there is substantial bone loss across the upper jaw. The concept was developed by Professor Per-Ingvar Branemark, who also pioneered modern dental implants, and has been in clinical use for over 30 years.
Pterygoid implants are angled backwards to engage the dense pterygoid region of the sphenoid bone, located behind the upper jaw. They provide support towards the back of the upper jaw, where conventional implants can be difficult because of limited bone and the position of the maxillary sinus.
In many full-arch cases, the two are combined to support fixed teeth across the entire upper arch, often without conventional bone grafting. The two techniques are related, but they are not interchangeable.
We place these implants in a private hospital under general anaesthesia, in collaboration with an oral and maxillofacial surgeon. Dr Cai handles the restorative planning and prosthetic design, and the surgeon manages the surgical placement.
Who Should Consider Zygomatic or Pterygoid Implants?
If any of these describe your situation, these implants may be a suitable option:
“I have been told I do not have enough bone for standard implants in my upper jaw”
“I had a bone graft that failed, and I do not want to go through that again”
“I have worn a full upper denture for years and the fit keeps getting worse”
“I was told I need a sinus lift first, but I want to avoid the extra surgery”
“I want fixed upper teeth without waiting months for grafts to heal”
“I have been to multiple dentists and been turned away each time”
Patients who have experienced extensive tooth loss, long-standing denture use or previous unsuccessful implant treatment may benefit from an assessment to determine whether these techniques are appropriate. These are specialised solutions for a specific clinical problem. If you have enough upper jaw bone for conventional implants, that is the simpler approach. Dr Cai will assess your 3D scans and recommend the least invasive option suited to your situation.
What Does the Zygomatic and Pterygoid Implant Process Look Like?
01
Consultation with Dr Cai (60 minutes)
Your first appointment is at our practice. Dr Cai uses 3D imaging, such as a CBCT scan where appropriate, to assess bone volume and density in your upper jaw, your cheekbones and your sinuses. He will review your history, including any previous implant attempts or grafts, and explain whether zygomatic implants, pterygoid implants or a combination suits you.
02
Collaborative Treatment Planning
Dr Cai and the oral and maxillofacial surgeon plan the case together using your 3D scans, assessing sinus anatomy, available bone and implant positioning. Implant positions, angles and lengths are mapped before surgery. You receive a complete treatment plan and a written cost estimate.
03
Surgery in Hospital Theatre (under general anaesthesia)
Surgery takes place at a private hospital. The oral and maxillofacial surgeon performs the implant placement, and Dr Cai is responsible for the restorative plan and the teeth fitted to the implants. In suitable cases, where implant stability allows, a fixed provisional prosthesis may be fitted on the same day.
04
Recovery and Integration
Most patients need a few days of rest, with swelling and discomfort managed with prescribed medication. Implant integration takes place over the following months. Your surgeon and Dr Cai will monitor healing at regular follow-up appointments and determine when the permanent prosthesis can be fitted.
05
Final Prosthesis
Once integration is complete, Dr Cai designs and fits your permanent full-arch prosthesis, with the material selected according to your clinical needs and treatment plan, such as high-strength zirconia. You care for it like natural teeth: brushing, flossing and regular check-ups.
Zygomatic vs Pterygoid vs Bone Grafting vs Dentures: Your Options for Severe Bone Loss
Zygomatic Implants
Pterygoid Implants
Bone Grafting + Conventional Implants
Upper Denture
Anchors into
Anchors intoCheekbone (zygoma)
Anchors intoPterygoid region behind the upper jaw
Anchors intoUpper jawbone, including grafted bone
Anchors intoRests on the gums
Conventional bone grafting
Conventional bone graftingOften avoided
Conventional bone graftingOften avoided
Conventional bone graftingUsually required in this pathway
Conventional bone graftingNot required
Sinus augmentation
Sinus augmentationOften avoided
Sinus augmentationOften avoided
Sinus augmentationMay be required
Sinus augmentationNot required
Surgical complexity
Surgical complexityAdvanced
Surgical complexityAdvanced
Surgical complexityVaries
Surgical complexityNo implant surgery
Fixed teeth
Fixed teethPossible, including same-day provisional teeth in suitable cases
Fixed teethPossible, including same-day provisional teeth in suitable cases
Fixed teethAfter appropriate healing and implant placement
Fixed teethNo (removable)
Potential application
Potential applicationSevere upper jaw bone loss
Potential applicationBone loss at the back of the upper jaw
Potential applicationPatients needing additional bone volume
Potential applicationPatients seeking a removable option
The most appropriate treatment depends on bone availability, anatomy, general health and individual clinical circumstances. Dr Cai will recommend the least invasive approach suited to your situation, which may combine zygomatic and pterygoid implants.
What Are the Risks of Zygomatic and Pterygoid Implants? What Should I Expect During Recovery?
Zygomatic and pterygoid implants are complex surgical procedures involving anatomical structures beyond those encountered in conventional implant placement. Although they can provide an alternative for patients with severe upper jaw bone loss, they carry specific surgical and restorative risks. Your oral and maxillofacial surgeon will discuss the potential complications, expected recovery and long-term maintenance requirements with you before treatment.
Possible risks:
Surgical considerations:
- Infection and delayed healing
- Swelling and bruising in the cheeks, jaw and around the eyes, typically settling within one to two weeks
- Sinusitis and other sinus complications, as zygomatic implants are placed close to or through the maxillary sinus
- Temporary difficulty opening the mouth fully (trismus), which settles as the surrounding muscles heal
- Numbness, tingling or altered sensation in the cheek or upper lip
- Oroantral communication (an opening between the mouth and sinus), which may need further treatment
- Bleeding and injury to nearby anatomical structures
Longer-term considerations:
- Failure of the implants to integrate with the bone
- Peri-implantitis (inflammation of the gum and bone around implants) and soft-tissue inflammation
- Prosthetic complications, such as loosening or fracture
- Difficulty keeping the area around the prosthesis clean
Recovery considerations:
- Rest for several days after hospital surgery, as advised by your surgical team
- Swelling typically peaks on days two to three, then gradually subsides
- Prescribed pain medication, antibiotics and anti-inflammatory support
- Liquid diet for the first week, progressing to soft foods over weeks two and three
- Avoid blowing your nose forcefully for two to three weeks
- Sleep with your head elevated for the first few nights
- Avoid strenuous activity for one to two weeks
- Implant integration takes place over several months and is monitored at follow-up appointments
Our team is available throughout your recovery. If you have any concerns, call us on +61 2 8000 1832.
Transparent pricing, no surprises
Zygomatic and pterygoid implant treatment is individually planned according to the surgical requirements, number of implants, hospital fees and final prosthesis. Download our general dental implant price list and arrange a consultation for an individualised treatment estimate.
Frequently Asked Questions About Zygomatic and Pterygoid Implants
What is the difference between zygomatic and pterygoid implants?
Zygomatic implants anchor into the cheekbone, while pterygoid implants engage the pterygoid region behind the upper jaw. Both bypass the weakened upper jawbone. In many complex full-arch cases, Dr Cai and the surgeon combine them to support a complete fixed bridge without conventional bone grafting.
Am I a candidate for zygomatic or pterygoid implants?
If you have significant upper jaw bone loss, have been told you are not a candidate for standard implants, or have had a failed bone graft, you may be a candidate. Dr Cai will assess your anatomy with a 3D CBCT scan and discuss all available options during your consultation.
How much do zygomatic and pterygoid implants cost in Sydney?
Pricing depends on the number and type of implants required, hospital and anaesthesia fees, and the type of final prosthesis. After your consultation, you will receive a detailed written quote covering everything. Download our general dental implant price list from this page, and arrange a consultation for an individualised estimate.
How long do these implants last?
Zygomatic and pterygoid implants are designed to provide long-term support for fixed teeth. Published research on zygomatic implants has shown encouraging long-term survival rates, although outcomes vary according to your anatomy, general health, surgical factors and ongoing maintenance. The life of the final prosthesis also depends on bite forces, oral hygiene, material selection and regular professional maintenance.
Is the procedure painful?
The procedure is performed under general anaesthesia, so you will not be conscious during the surgery. Post-operative discomfort, swelling and bruising are expected to varying degrees and are managed with medication and instructions from your surgical team. The initial recovery period is generally the most uncomfortable, with symptoms gradually improving as healing progresses.
Who performs zygomatic and pterygoid implant surgery?
Zygomatic and pterygoid implant placement involves complex surgical planning and detailed knowledge of the anatomy of the upper jaw, cheekbone and surrounding structures. These procedures are generally performed by oral and maxillofacial surgeons with experience in advanced implant surgery. At Pitt Street Dental Centre, Dr Michael Cai works with an oral and maxillofacial surgeon. Dr Cai manages the restorative planning and prosthetic rehabilitation, while the surgeon performs the specialised surgical placement.
Payment Plans
Why Choose Pitt Street Dental Centre for Zygomatic & Pterygoid Implants in the Sydney CBD?
A collaborative team built for complex cases
Zygomatic and pterygoid implants require more than surgical placement. Successful treatment also depends on careful prosthetic planning, appropriate implant positioning and restoring the implants into functional, maintainable fixed teeth. Dr Michael Cai works with an oral and maxillofacial surgeon to coordinate the surgical and restorative sides of treatment, so you receive coordinated care from your first assessment through to your final prosthesis.
Hospital-grade surgical environment
Surgery is performed at a private hospital under general anaesthesia, with full monitoring, a dedicated surgical team and the safety infrastructure complex procedures require.
Over 3,000 implants of personal experience
Dr Cai has placed and restored over 3,000 dental implants across 18+ years, including complex cases involving severe bone loss, failed grafts and long-term denture wear.
Same-day teeth in suitable cases
In suitable cases, where implant stability allows, a fixed provisional prosthesis can be fitted on the day of surgery.
Honest assessments and second opinions
Not every patient needs these implants, and we will recommend a simpler approach where it will achieve a suitable result. If you have been told elsewhere that implants are not an option, we welcome you to come in for an independent assessment.
Author Attribution:
Medically reviewed by Dr Michael Cai, BDSc (Hons) WA MRACDS (GDP) – July 2026
Medical Disclaimer:
The information on this page is intended for general educational purposes only and should not be considered a substitute for professional dental advice. Treatment outcomes vary between individuals. All surgical procedures carry risks. Please consult Dr Michael Cai or one of our qualified dentists at Pitt Street Dental Centre for personalised advice about your dental health.
