Peri‐zygomatic complications on zygomatic implants with or without penetrating the external surface of zygoma: A 2‐year retrospective study

Objectives The main purpose of this retrospective study was to assess the difference in the incidence of peri‐zygomatic complications (PZCs) when zygomatic implants (ZIs) penetrate or do not penetrate the external surface of zygoma. Materials and Methods This study included 32 patients with edentulous maxillae or potentially edentulous maxillae undergo zygomatic implantation. The patients were divided into the penetration group (P‐group) and the non‐penetration group (N‐group) according to whether the apex of implants penetrated the external surface of zygoma in postoperative CBCT. The extension length, the penetration section of the implants, and the skin thickness at the corresponding position were simultaneously measured. Clinical follow‐up was conducted regularly until 2 years after surgery. The occurrence of PZCs (including peri‐zygomatic infection, skin numbness, non‐infectious pain, and foreign body sensation) was recorded. A mixed effect logistic model was used to compare the difference of complication rate between the P‐group and the N‐group, and odds ratio (OR) was calculated. Then identify the impact of the extension length, penetration section and skin thickness in P‐group with the same model. Results A total of 71 ZIs were implanted in 32 patients, including 37 implants in the P‐group and 34 implants in the N‐group. During the 2‐year follow‐up, a total of 13 implants occurred PZCs, with an overall complication rate of 18.3%. Thereinto, the incidence rate was 29.7% in the P‐group, and 5.9% in the N‐group (OR = 6.77). In P‐group, there was a significant difference in complication rate of different extension lengths, while the penetration section and skin thickness had no statistical significance on the complication rate. Conclusion Under the limitation of this study, to minimize the risk of PZCs, ZI should be placed in a manner that avoids the apex penetrating the external surface of the zygoma.