Radiologic and Clinical Anatomy of the Zygomatic Bone in Terms of Zygomatic Implant

The zygomatic bone is crucial in dental implantology, wherein zygomatic implants are increasingly used for patients with insufficient maxillary bone. A comprehensive understanding of the complex anatomy of the zygomatic bone is essential for minimizing surgical complications and optimizing implant success. This study aimed to provide morphometric data through cone-beam computed tomography (CBCT) and microcomputed tomography (μCT) to assist dental radiologists and surgeons in preoperative planning and implant placement. In addition, it seeks to provide physicians with comprehensive insights into the anatomy of the zygomatic bone and associated structures, enhancing the use of zygomatic implants in implantology. CBCT images from 3087 patients at Istanbul University, were scanned to examine the canals and foramina of the zygomatic bone. Their trajectories canals were assessed to identify their canal types (T-shaped or V-shaped). Forty-three dry bone samples were manually examined to classify zygomatic bone types, and μCT was utilized to observe the canal routes. The foramen zygomaticofacial, foramen zygomaticotemporale, and foramen zygomaticoorbitale revealed distinctive patterns. Most cases (n=414, 62%) had single zygomaticofacial canals, whereas 27 (4%) had double zygomaticofacial canals; 41 canals (6%) originated from the zygomaticotemporal canal, 174 (26%) had T-shaped canals, and 13 (1.9%) had V-shaped canals. Using μCT, their trajectories were observed by analyzing 43 dry bone samples. The 43 dry bone samples were scanned, and Y-shaped canal systems were observed in 6 of them. The canals entering from FZF exited FZO with a Y-shaped canal system. In 3 bones, the canals were straight. The zygomaticofacial canal entering from FZF exited FZO. The use of CBCT to map the zygomatic bone before zygomatic implant procedures provides valuable insights into routine dental imaging and enhances preoperative evaluations. This approach aids in scrutinizing anatomic variations and intrabone canals, ultimately reducing complications.