Am I a Candidate for Zygomatic Implants?
 If a dentist or oral surgeon in San Jose has told you that you don’t have enough bone for dental implants, you may still be a candidate for zygomatic implants at South Valley Oral and Facial Surgery – and this is the page that will tell you, in plain terms, whether the path is realistic for your situation.
Zygomatic implants are anchored in the dense cheekbone instead of the upper jawbone, which means severe upper jaw bone loss does not disqualify you. This is the procedure designed specifically for the patients who keep being told no everywhere else.
We see patients every month who arrive frustrated. They have already been told their bone is too thin, their sinus is too low, or that the only path forward is two years of bone grafting they aren’t willing to commit to. For many of these patients, zygomatic implants make a one-day full-arch reconstruction possible. Not for all of them, but for most. The point of a candidacy consultation is to find out, with certainty, which group you’re in.
Zygomatic implants are one specific path within a broader set of full-arch zygomatic implant options we offer, alongside All-on-4 dental implants and full mouth implants for patients whose anatomy allows traditional placement. The candidacy question helps us decide which path actually fits.
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What Are Zygomatic Implants?
 Zygomatic implants are longer dental implants anchored directly into the zygoma – the dense bone that forms your cheekbone. A traditional dental implant relies on the upper jawbone, the maxilla, for support. When that bone has resorbed from long-term denture wear, periodontal disease, or repeated tooth loss, there often isn’t enough vertical or horizontal bone left for traditional implants without significant grafting.
The zygomatic bone, by contrast, almost never shrinks. It is one of the densest, most structurally stable bones in the face. By placing implants that pass through the upper jaw and anchor into the zygoma, surgeons can support a full upper-arch fixed bridge in patients who have severe maxillary bone loss. Most zygomatic cases use either two zygomatic implants combined with two anterior traditional implants, or four zygomatic implants per arch (the quad-zygoma approach) for the most severe bone-loss cases.
Zygomatic Implants vs. Traditional Full-Arch Options
For patients with adequate upper jaw bone, All-on-4 and traditional full-mouth implants are typically the first-line options. Zygomatic implants become the recommended approach specifically when the upper jaw bone is too compromised to support those alternatives without years of grafting. The decision is not about preference; it is about anatomy. We will not recommend zygomatic implants if traditional implants work for you, because the simpler procedure is usually the better one when both are viable.
Your Zygomatic Implant Surgeons in San Jose
Zygomatic surgery is a procedure most oral surgeons do not perform. Both of our doctors perform it routinely.
Dr. Arian Chehrehsa, DDS, ABOMS, NDBA leads our full-arch and zygomatic implant program. He is dual board-certified in both Oral & Maxillofacial Surgery and Anesthesiology, completed his oral surgery residency at Montefiore Medical Center, and leads regional study clubs on full-arch implant surgery. Full background on Dr. Chehrehsa’s bio.
Dr. Joseph McMurray, DMD, MBA, FACOMS brings 35-plus years of oral and maxillofacial surgical experience to the team, including 11 years with the U.S. Navy. More on Dr. McMurray’s bio.
Having two surgeons who both perform zygomatic cases means we second-opinion each other during planning, which is uncommon in the Bay Area and adds a layer of safety that matters in advanced reconstruction.
How We Determine Whether You’re a Candidate
 A candidacy decision is not made on first impression. It requires imaging, an exam, and a structured conversation about your goals. Here is what the evaluation actually involves.
CBCT Scan and Imaging Review
We start with a 3D CBCT scan of your upper jaw, zygomatic bone, and sinus anatomy at our San Jose office. The scan tells us, with precision, how much usable maxillary bone you have, where the sinus floor sits, and whether the zygomatic bone has the volume and quality to anchor implants. This is the single most important diagnostic step. Without 3D imaging, no honest candidacy decision can be made.
Clinical Examination
We examine your remaining teeth, your soft tissue health, your bite, and the way your jaws relate to each other. When a candidacy case is complex, both of our surgeons review the imaging together before the consultation concludes – a two-surgeon review process that is uncommon in the Bay Area and adds a layer of safety in advanced reconstruction planning.
Medical History Review
Some medical conditions affect surgical candidacy or healing. Uncontrolled diabetes, certain bone-affecting medications, ongoing chemotherapy or radiation, and a few other systemic conditions need to be evaluated and sometimes managed alongside the surgical plan. Most patients with managed chronic conditions are still candidates. Because Dr. Chehrehsa is dual board-certified in anesthesiology, we also assess general anesthesia fitness in-house rather than referring out for a separate workup.
Goals and Expectations Conversation
We talk through what you want from treatment, what timeline fits your life, and what level of involvement feels right for you. A patient who wants fixed teeth in one day has different priorities than a patient who is willing to do a staged approach over a year. Both are valid; the right choice depends on your goals.
Treatment Plan and Estimate
By the end of the consultation, we tell you which approach actually fits – zygomatic implants, All-on-4, traditional implants with grafting, or in some cases a combination across the upper and lower arches. You leave with a clear estimate and a clear yes or no on zygomatic candidacy. We don’t make patients wait weeks for an answer that can be given in one visit.
Who Is and Isn’t a Candidate
The honest summary: most patients who have been told they aren’t candidates for traditional implants turn out to be candidates for zygomatic implants. But not every patient, and the specifics matter.
You May Be a Candidate If
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Severe upper jaw bone loss – You’ve been told you don’t have enough maxillary bone for traditional implants and would need major grafting first.
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Long-term denture wear – Years of wearing an upper denture have caused significant ridge resorption.
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Failed traditional implants – You’ve had implants that did not integrate, often due to inadequate bone, and need a different anchor strategy.
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Terminal upper dentition – Your remaining upper teeth are not salvageable and you want fixed replacement, not a removable denture.
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You want to avoid extended bone grafting – You qualify for staged grafting plus traditional implants but don’t want to commit to 12 to 24 months of staged procedures. |
You May Not Be a Candidate If
A small percentage of patients have anatomical or medical factors that make zygomatic implants impractical. The most common disqualifiers are active sinus disease that needs to be treated first (often this is a delay rather than a permanent disqualifier), zygomatic bone that is unusually thin or malformed (uncommon, but visible on CBCT), uncontrolled systemic conditions that make surgery unsafe, and active heavy tobacco use that significantly raises failure risk. Some of these factors can be managed; others mean a different approach is the right one.
For some patients, bone grafting or sinus lift surgery combined with traditional implants will be a better fit than zygomatic implants. We don’t push every bone-deficient patient toward the more advanced procedure; we recommend what fits.
Why Choose Our Team for Zygomatic Candidacy Evaluation
The single biggest reason patients come to us for this evaluation is that very few Bay Area offices have surgeons who actually perform zygomatic implants. A consultation with a surgeon who doesn’t perform the procedure will almost always recommend against it, even when it’s the right answer. A consultation with surgeons who do perform it gives you an honest comparison between zygomatic and the alternatives.
Both of our doctors have specific zygomatic training and active case experience. Dr. Chehrehsa focuses heavily on full-arch surgical work and is involved in regional teaching on the procedure. Dr. McMurray brings decades of complex oral and maxillofacial reconstruction experience. The two together cover both the technical execution and the case-planning judgment that this procedure rewards.
We also keep the entire case in-house. Surgery, anesthesia (Dr. Chehrehsa is dual board-certified in anesthesiology), same-day temporary teeth, healing follow-up, and the final restoration all happen at one office. For patients who’ve been bounced between specialists trying to find someone who can actually help, the single-office structure is itself a relief.
Cost and Financing for Zygomatic Implants
Cost is a fair question. Briefly: zygomatic implants cost more than traditional implants because the surgery is more involved, but they often cost less than the staged path of bone grafting plus traditional implants over 12 to 24 months. Our dedicated zygomatic implant cost page covers the line-item factors and financing options in detail.
Many dental insurance plans cover a portion of the components, and CareCredit and longer-term medical financing options are widely used by our patients. Our insurance and financing details cover accepted plans and financing partners. The candidacy consultation includes a detailed cost estimate so you can compare zygomatic against any other approach on the table.
Schedule Your Zygomatic Candidacy Consultation
If you’ve been told you can’t have dental implants, the candidacy evaluation is the next step. Call us at 408-479-9449 or request an appointment online. We’re at 5595 Winfield Blvd Suite 202 in San Jose, CA. We’ll make sure your visit gives you a clear answer.
Frequently Asked Questions
I’ve been told I can’t have implants. Is zygomatic really different?
Yes, fundamentally. Traditional implants need maxillary bone, which is often what bone-deficient patients have lost. Zygomatic implants are anchored in the cheekbone, which almost never resorbs and remains structurally available even after decades of upper jaw bone loss. Most patients who’ve been turned down for traditional implants are evaluated as candidates for zygomatic.
What if my CBCT scan shows I’m still not a candidate?
It happens with a small percentage of patients, usually because of unusual zygomatic anatomy, untreated sinus pathology, or systemic factors. When that’s the case, we explain what specifically rules zygomatic out and what alternatives remain on the table, including All-on-4 dental implants with limited grafting or a staged grafted approach with traditional implants. You leave with a real plan, not just a no.
Why didn’t my regular dentist offer zygomatic implants?
Because most general dentists and many oral surgeons do not perform zygomatic implant surgery. The procedure requires specific training in cheekbone anatomy and sinus structures that is not standard in dental school or general surgical residency. Bay Area dentists who don’t perform it typically refer cases out, and many simply recommend the procedures they do perform instead.
Is zygomatic implant surgery riskier than traditional implant placement?
Zygomatic surgery is more complex than standard implant placement, which is why it requires a surgeon with specific training. When performed by experienced surgeons with appropriate 3D imaging and planning, complication rates are low and the published long-term success rates are comparable to traditional implants. The technique is well-established and has been used for more than two decades for exactly this patient population.
What’s the difference between zygomatic implants and All-on-4?
All-on-4 uses four traditional implants placed in available maxillary bone, often at angles to maximize anchorage. Zygomatic implants extend further, into the cheekbone, and are reserved for patients whose maxillary bone won’t support All-on-4. The two are sometimes combined in a hybrid arrangement (two zygomatic plus two traditional anterior implants). Which approach fits depends on what your CBCT shows. Our overview of full mouth implants covers how these options sit alongside one another.
Will I be able to eat normally after zygomatic implants?
Yes, after healing. Most patients leave the surgical visit with a temporary fixed prosthesis and are advised to stick to a soft-food diet during the initial healing weeks. Once integration is confirmed and the final fixed prosthesis is delivered, patients eat a normal diet. The fixed-teeth result is one of the practical advantages over removable upper dentures, which restrict chewing on many foods.
What happens if a zygomatic implant fails?
Failure is uncommon when zygomatic implants are placed properly and the patient’s anatomy is suitable. If a single zygomatic implant does fail, the typical approach is to remove it, allow the site to heal, and either replace it with another zygomatic implant or adjust the prosthetic design to function on the remaining implants. The case is rarely a total loss. At South Valley Oral and Facial Surgery, we handle any salvage work in-house rather than referring it out.
How long is the consultation, and what should I bring?
Plan on about an hour for the initial consultation, including the CBCT scan, clinical exam, treatment planning conversation, and cost discussion. Bring any prior dental imaging you have, a list of current medications, your insurance card, and a list of questions. If a different dentist or surgeon has already told you you’re not a candidate for implants, bring their assessment if you have it; it helps us understand the picture you’re working from. |
