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Zygomatic Lip and Face Support – Ramsey Amin DDS

This patient I treated in Burbank, CA has no bone on the upper jaw.  You can see that she was unable to wear a denture.  Her face would cave in right to the bottom of the nose!

Lip and face support considerations for implant zygomatic bridge

I placed four zygomatic implants (quad zygoma) with a fixed bridge that she does not need to remove…ever.  NO BONE GRAFTING WAS DONE!

  I commonly focus on the profile trying to get the teeth into a vertical orientation.  This helps decrease wrinkles and creases in the upper lip.  If the teeth slant in, they don’t look normal.  This creates certain cantilever forces that connecting (splinting) the implants together helps protect the bone.

Replacing your teeth when there is this amount of extreme bone loss  requires a lot of testing with a temporary.  These are made of PMMA.  I often leave these in for 1-3 months to allow the patient to assess not only the teeth, but rather lip and face support.

Lip and face support considerations are really important for all on 4, Prettau, hybrid type full replacements.  Keep in mind that these teeth are not just a tooth replacement, but they are replacing teeth, the gum, and bone.

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

6 thoughts on “Zygomatic Lip and Face Support – Ramsey Amin DDS

  1. I have a front bridge (6count) which doesn’t show at all. My front looks sunken and added years of appearance to my actual age. My bottom teeth is what shows the most. On top of it I have a lip support a removable gum to make appearance a little bit okay. I have been dealing with this for such a long time and I always smile with close mouth because it looks weird, it is so flat. This article gave hope and reading about 24 hr treatment is even better to get to work faster. Any idea on the price point? Thank u.

  2. This is El again. I also want to say I have learned more from reading you’re site then anywhere. I’m impressed with the zygomatic implants and the information on zygomatic arch and lip support information. This has never been mentioned to me at all but thinking about all the facial changes it makes sense. Again, I’m not sure at all now of the best route. I was even thinking of flying to Europe to get implants. The extreme boneless and grafting that would need to be done and time to heal which I was planning to get done here, and then spend the summer in Europe with family and getting the implants done there, which now seems a little more complicated than I imagined. I know either way the cost would been the thousands, however I also want a procedure thats not only cost effective but also one that I can resume my life as fast as possible. Again any advice would be greatly appreciated. There’s so much that I had not thought about because again no one has mentioned the facial changes and what can be done about that. If I’m going to pay thousands I’d at least want the best outcome in appearance. Thanks again.

    1. I’m not really sure what question you are asking. I would be happy to treat you as well. I have many patients to travel to see me if Southern California is more acceptable. Thank you for your kind words. Facial changes and lip support are extremely important!

  3. I am 43 and had all my bottom removed three years ago which left me with extreme boneless. Recently I went to a dentist who said he needed to remove most of my upper teeth leaving the 4 back intact. He said could make a denture on the top which I wrongly assumed meant it would be similar to a bridge connected to my upper back teeth. That was not the case. Its virtually a full denture which I can not because I gag and sometimes even dry heave or vomite. The bottom denture does not fit at all he said it was because I had no bone its absolutely flat worse than that. I asked him about the fit secondary to the boneless and he said well u will just need extra glue. It was a waste of time I feel like ‘m wearing 2 sports mouth guards, I can’t talk right and furthermore I can’t chew because it hurts and bite alignment is so bad. He now says well u need to get a few implants. Well, prior to seeing this dentist I had been told that I was a perfect candidate for full mouth reconstruction which was at that time not affordable. At this time I am able to afford for something to be done. Can bone grafting still be done and do I need to have it done to have implants or at least something done so I can smile and chew effectively. I cannot have something on the top of my mouth like a top denture has I can’t tolerate that plastic that sits on the top of my mouth, if that makes sense. I need something done fast. I’m a physical therapist and can not work. I won’t even leave my house now. My lips seem to have already sunken in and has caused me to feel extremely depressed. I now have money to do something but I don’t want it to take an entire year either to accomplish because I would love to go back to work or even out with friends. what do you recommend? I’m just reading so many things every where for implants and with my severe bone loss it could take forever it seems. Please advise me…Thank You

    1. “I need something done fast. I’m a physical therapist and can not work. I won’t even leave my house now. My lips seem to have already sunken in and has caused me to feel extremely depressed.”

      it sounds like you need same day treatment but she has a very difficult upper jaw. You might be a good candidate for a zygomatic procedure. Literally 95% of the patients that I treat even with very extreme bone loss are able to leave within 24 hours with teeth that are nonremovable and do not cover the palate

      This is a concept of utilizing the good bone that you have rather than trying to build up the bone that you’ve lost. Both are options that I use on a very regular basis and are very much patient/case dependent

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About Ramsey A. Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.