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Updated: Sep 6, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Z-classification: an anatomy-based ridge-sinus-zygoma classification and decision funnel for zygomatic implantology
Sepehr Zarrine1,2, Iva Ilic3, Branislav Ilic3
1, Saint-Dié-Des-Vosges, France.
Objectives:
The rising demand for zygomatic implants (ZIs) in contemporary dental implantology underscores the need for an anatomy-based categorization system and a surgical decision-making panel that takes into account anatomical, biomechanical, and prosthetic factors to determine the final surgical strategy. This article proposes a new Z-Classification, the anatomical division of the maxillo-zygomatic complex.
Materials And Methods:
The classification was developed from the authors' clinical experience of 882 ZIs placed in 234 patients across two centres over a ten-year period. According to anatomical presentations, 6 classes were described.
Results:
The classification is intended as a practical framework for preoperative assessment and treatment planning in ZI rehabilitation. It has not yet been validated against clinical outcomes. Additionally, a decision funnel for surgical strategy development and the structured checklists consisting of crucial clinical parameters for long-term success in ZI therapy were proposed.
Conclusion:
The presented tools will potentially optimize a complex decision-making algorithm in zygomatic implantology.
Clinical Relevance:
The proposed Z-Classification and the decision funnel carry the potential to reduce the risk of complications associated with zygomatic surgery.
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