Zygomatic Implant Planning -Ramsey Amin DDS -Burbank

Planning zygomatic implants in 3D is one of the most important parts of the diagnostic process.  In this video you can see how I placed  a quad zygoma… Meaning four zygomatic dental implants for an upper jaw that has literally no bone.  The implants are kind of laying on the side of the jaw near the base of the nose on this patient.

You can see that the bone has been lost underneath the nose.   I don’t even have room to do a nasal lift, which is different than a sinus lift.  This happens when you have lost all of your teeth and all the bone has melted away all the way until the “floor” of the nose and sinuses.

You can see on this video that the implants are placed partially in and partially out of the sinuses and into the meaty part of the cheekbone.  They are placed below the eye sockets, below the eye.  The bone of the eye socket is much larger than the actual eyeballs.

This 3-D software that I use is called anatomage.  I use for every single implant patient that I treat.  It allows me to do a virtual surgery prior to doing the actual procedure and/or create a surgical guide/template.  I sure this 3-D analysis with my patient at their second visit consultation appointment.  This allows me make sure that my patient understands the treatment.  One of the cool things about this process is that patients that were told they can’t have implants are almost always treatable!  In fact most of these patients get their teeth screwed in place the very next day or on the same day of the surgery eliminating the denture forever!

The 3-D planning also allows me to see not only how much bone we have (volume) but how hard or soft that bone is (density.)

Please comment and ask questions.  Thank you for taking a look.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
BURBANK, CALIFORNIA

10 thoughts on “Zygomatic Implant Planning -Ramsey Amin DDS -Burbank”

  1. Hello,
    I have lost some of my teeth due to periodontal disease. The major cause of this is radiation therapy for nasopharyngeal carcinoma which happened in 2007. My teeth are in a pretty bad shape now, and I am will to get implants. I saw someone here who told me I wasn’t a candidate because of the radiotherapy. Is there any hope for me?

    Reply
    • I have treated many patients with head and neck cancer with implants! There is hope! Reach out to my office if you need. Prayers that you will get through this difficult time! 🙏🙏🙏

      Reply
  2. I am from Michigan
    I emailed ur office I think
    If I wanted to fly to see you to get 4 extractions done (1 dead tooth) I have 2 open implants front teeth that are 15 years old that placed wrong and don’t make anymore and would give me bucked ugly teeth so I ended up w a partial and little by little lost all my upper teeth. my dentist said he could put extensions on them,, 7900 later after spending 10,000 the 1st time. 15 years ago.. ( idk if I can use these implants now.. but I’m scared and since COVID won’t leave the house
    What are the steps I need to do to come see u?? And have you do my work and also what are ur price ranges .. I have insurance covers the extractions .. I need a professional, please help
    46 year old from michigan

    Reply
    • I am very flattered that you might come and visit me. The best thing would be to speak to my staff. I have a lot of patients that travel.

      We just need to come up with a good plan and do something that will work the first time and last a really long time. That’s the only way I know how to do things 😊

      Reply
  3. Dear Dr Amin,

    I live in Australia and I have been wearing dentures for about 40 years now, and my case is an unfortunate one, because when I was 18 years old I went to a dentist with wisdom teeth pain and the dentist told me that my teeth would have to come out. I said take all the back teeth out, meaning the “wisdom teeth” and when I came out of the anaesthetic I had no back teeth at all. I asked him how was I supposed to eat? Blank look on his face said it all. I had beautiful teeth with no tooth decay, so I just wondered what sort of “DENTIST” he was to do that! Anyway, that is how I ended up with dentures.

    Now, I find that I don’t have much jaw bone on my bottom jaw, just a few millimetres thick (unable to post photos of cast of my jaw). My dentures are pressing on the nerve on the right side of my face and my face in going numb. My Oral & Maxillofacial Surgeon has said that I am unable to have posts implanted to hold my dentures because my jaw might break. He is going to make a plate to insert instead to hold my denture up from the nerve.

    My question is, do you have any advice on what I should/could have done other than a metal bar?

    Could I have implants of any kind at all?

    Would you advise any other treatment that he may be able to do?

    I have also been reading your article on Zygomatic dental implants and I find it very interesting. Would this be the sort of thing that I could have to fix the top jaw from shrinking before that also disappears?

    I would be grateful if you could give me some advice to help me make the right decision. Thank you.

    Looking forward to hearing from you and your professional advice.

    Reply
    • I recall seeing your photographs!

      Yes you certainly have a lot of bone loss. I am sure if your lower is that severe that your upper is just the same. If I were to place zygomatic implants on your upper jaw you would have teeth within 24 hours that were fixated and nonremovable. I often place pterygoid implants along with the zygomatic for increased stability.

      On your lower jaw even though it is very thin it is still possible to place a few implants without breaking your jaw. There are also options for what is called subperiosteal implants which very few people do. There are cases where I used these for patients but even in very thin lower jaws implants are still possible. It just requires a very specialized technique. I would suggest that you be treated by an expert not only for the surgery but for the prosthetic teeth making. There are not too many people that can do your case well.

      Good luck and stay safe during COVID 19

      Reply
  4. Hi Dr. Amin,

    My 65 year-old sister was advised by various Board Certified Oral Surgeons, Prosthodontists & Periodontists that she would need a full mouth restoration. It is because of having multiple loose & failed implants & severe cavities due to her previous general dentist’s sub-standard implant planning & placement.

    Recently my sister had consultations with a Board Certified Prosthodontist at a reputable implant center and he recommended using longer & wider implants one of which is 16 mm in length & the other one is little shorter and his surgeon would place 2 implants in a V shape in each side of the upper jaw. This implant method does not require bone grafts & sinus lifts and it will provide strong stability for the upper All On Four implants to last for a long time,

    Please advise if this recommended treatment plan will offer a long term solution for my sister. Also, please advise your consultation fee.

    Thank you!

    Elaine

    Reply
    • This is a fairly standard design of the all on x/all on 4 procedure. I routinely use implants that are 16 mm long and some that are shorter. In fact some of the zygomatic implants go from 30 mm to 60 mm long including placement into the pterygoid areapterygoid area which can allow for an excellent fixed prosthetic for the upper jaw with teeth that go further back also avoiding sinus lift bone grafting. This should work in most cases but there are so many more factors than just bone. You are welcome to call my office in Burbank California if you would like to have a consult. The phone number is 818-846-3203

      Reply
  5. Dr. Amin,
    After reading this article I was wondering why my impressions where taken with the gooey mold material. My thoughts are that it would have been less traumatic to use the digital workflow method.

    “This is how I take an impression for an implant. It can be one implant or it can be a whole mouth full of implants.
    This is a digital implant impression. This is far more accurate than messy gooey mold material.
    You may hear this called the digital workflow. This allows me to make the models and the implant crown/ Bridges/ prettau bridges digital from the start.
    This is not just simply replacing the material that a traditional impression would be taken with. It is a paradigm shift in design parameters. Your implant teeth will be far better done this way then in a traditional stone/plaster mold.”
    Thank You

    Reply
    • Hi Diana…thank you for your comment. I am glad I saw this! In the future please email me privately since you are a patient.

      Everything I have said here is exactly right. The difference is for some transitional/temporary appliances the analog workflow can be superior for capturing the palate anatomy. This is because the scanners love scanning teeth but sometimes have trouble scanning gums on the roof of the mouth.

      Often times I will digitize the analog mold and transition in and out of the analog/digital workflow along the way depending on each patient’s unique situation.

      The final teeth and Prototypes are almost always made through the digital workflow

      I hope this clarifies things for you.

      Looking forward to seeing you again 🤗

      Reply

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