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Dental Implants: The Pros and Cons of Endosteal, Subperiosteal, and Zygomatic Procedures

Dental implants are a popular and effective tooth replacement option for people missing one or more of their natural teeth. Implants serve as artificial tooth roots and provide a stable, secure foundation for fixed or removable replacement teeth. There are three main types of dental implants: endosteal, subperiosteal, and zygomatic, each with their own advantages and disadvantages.

Endosteal Implants - The Most Common Dental Implant Type

Endosteal implants, also known as dental implants, are the most frequently used type of implant, accounting for more than 90% of all implant procedures. As the name suggests, they are embedded directly into the jawbone (endosteum).

The basic parts of an endosteal implant include the implant body (the artificial root), an abutment (the connector), and a crown (the visible tooth portion).

Endosteal implants have the highest long-term success rate at over 95%. They work very well when a person has healthy jawbone with sufficient width and density.

Advantages of Endosteal Dental Implants:

  • Very good long-term prognosis
  • Less costly compared to other options
  • Shorter healing time
  • Suitable for most candidates

Disadvantages of Endosteal Dental Implants:

  • Require a healthy jawbone
  • Higher failure rates for smokers
  • More complicated procedure

With proper care, endosteal dental implants can last over 20 years.

Subperiosteal Implants - An Alternative When Bone Grafting isn't Possible

Subperiosteal dental implants consist of a metal frame placed under the gum and above the jawbone. As the name indicates, the structure lies below the periosteum (the membrane covering the bone). They were designed specifically for patients who do not qualify for endosteal implants due to severe bone loss in the upper jaw.

The custom-made metal framework fits over the bone to ensure stability. After placement, the gums heal around these implants to hold them firmly in place. Artificial teeth are then mounted to posts extending above the gums.

Advantages of Subperiosteal Dental Implants:

  • Useful alternative when bone grafting isn't an option
  • Less invasive procedure
  • Shorter recovery period

Disadvantages of Subperiosteal Dental Implants:

  • Higher long-term failure rate
  • More difficult to clean properly leading to peri-implantitis
  • Can only be used in the upper jaw

While not used as commonly today due to advanced bone grafting techniques, subperiosteal implants still serve an important purpose for select patients and represent roughly 5% of all implant procedures.

Zygomatic Implants - For Patients With Severe Bone Atrophy

Zygomatic implants, also known as zygoma implants, were specifically designed for patients with severe bone atrophy in the upper jaw. “Zygoma” refers to the cheekbone region, and these exceptionally long implants anchor into and through this dense facial bone for stability.

A zygomatic implant emerges from the maxillary posterior region (upper jaw) and extends into the zygomatic bone (cheekbone). The threaded tip then returns back into the maxillary bone for strength. Traditional implants placed into site extensions just wouldn’t be stable enough.

Advantages of Zygomatic Dental Implants:

  • Solution for patients with severe maxillary/upper jaw bone loss
  • High success rates of approximately 94%
  • Immediate function and loading possible

Disadvantages of Zygomatic Dental Implants:

  • Complex surgical procedure
  • Higher risk of facial swelling
  • Requires CBCT scan for precision
  • More difficult to retrieve if replacement needed

For patients with severe bone deterioration in the upper jaw, zygomatic dental implants can provide a life-changing solution when other options fail.

Dental Implant Success Relies on Several Key Factors

While technological advances have greatly improved the long-term prognosis of all three main dental implant types, success ultimately relies on various patient, procedural, and restoration factors.

Some considerations influencing outcomes include:

  • General health conditions like diabetes or autoimmune disorders
  • Oral hygiene habits
  • Tobacco use
  • Quality and quantity of jawbone
  • Implant design, materials and placement
  • Skill and precision of the surgical team
  • Ongoing professional cleanings and exams

Careful treatment planning, excellent oral health and hygiene habits, regular dental visits and following all post-procedure instructions help to ensure many years of a healthy, happy smile.

Dental Implants - A Permanent Solution for Missing Teeth

For patients struggling with missing teeth, dental implants offer an effective and predictable permanent solution. The three main options - endosteal, subperiosteal and zygomatic implants - all have excellent long-term prognosis when properly placed and cared for.

Factors like the location and amount of bone loss and overall health conditions play important roles in selecting the best type to meet individual needs. With ongoing professional care and good oral home care, dental implants provide an excellent way to restore form, function and smile confidence.