Comparison of Success Rate of Zygomatic Implant Placed in Atrophic Edentulous Maxilla To Bone Augmentation Followed By Conventional Implant Placement In The Same Region-A Systematic Review

Abstract Background: Rehabilitating the severely atrophic posterior maxilla is challenging due to bone resorption and sinus proximity. While conventional implants require bone augmentation, zygomatic implants (ZIs) offer a graftless alternative by anchoring in the zygomatic bone, allowing immediate loading and simplified protocols. Methods: This systematic review included studies from PubMed, Cochrane CENTRAL, and Google Scholar (2005–2021) comparing ZIs with conventional implants (CIs) placed after bone grafting. Inclusion criteria focused on in vivo human studies with ≥1-year follow-up. Primary outcomes were implant survival, prosthetic complications, and quality of life (OHIP-14). Results: Five studies involving 173 patients were included: 70 treated with ZIs and 72 with CIs. ZIs showed high survival rates (97–100%), while CIs ranged from 85–97%. Fewer prosthetic failures and complications were noted with ZIs. Use of techniques like ZAGA and extrasinus placement improved hygiene and prosthesis design. OHIP-14 scores were comparable between groups. Conclusion: Zygomatic implants provide a reliable, less invasive solution for atrophic maxillae, with high survival rates and reduced treatment time compared to conventional graft-based approaches. They should be considered a viable first-line option in appropriate cases.