Zygomatic Implants Under Local Anaesthetic? The Risks of Untrained Hands
- Dr Samintharaj Kumar
- Feb 16
- 2 min read
Zygomatic implants are among the most advanced and technically demanding procedures in implant dentistry, designed for patients with severe maxillary bone loss. However, placing these implants under local anaesthesia without proper surgical protocols, monitoring, and specialist training poses significant risks to both the patient and the clinician.
Why Are Zygomatic Implants Technically Challenging?
Unlike conventional implants, zygomatic implants must be anchored into the zygomatic bone, requiring:
✔ Precise anatomical navigation – The implant trajectory passes near critical structures such as the infraorbital nerve, maxillary sinus, and orbital floor. Poor placement can lead to nerve damage, chronic pain, or orbital penetration.
✔ Intraoperative control and patient cooperation – Without sedation or general anaesthesia, patient movement during the procedure can compromise precision. Even minor movement at the wrong moment can lead to a misdirected drill path or trauma to surrounding structures.
✔ Monitoring and complication management – Performing this procedure without sedation monitoring (IV sedation or general anaesthesia) and without proper intraoperative imaging significantly increases the risk of hemorrhage, sinus perforation, and post-operative complications.
Dangers of Performing Zygomatic Implants Under Local Anaesthesia in an Untrained Environment
❌ Uncontrolled Patient Response
The psychological and physiological stress of undergoing such an invasive procedure under only local anaesthesia can lead to panic attacks, excessive movement, and an inability to tolerate the drilling into the zygomatic bone, ultimately affecting surgical accuracy and safety.
❌ Severe Bleeding Without Proper Management
The zygomatic region is highly vascularised, with risks of significant bleeding if the implant is placed incorrectly. Without advanced surgical experience and appropriate suction control, excessive bleeding can obstruct visibility, increasing the risk of misplacement and complications.
❌ Orbital and Neurological Risks
Incorrect placement without real-time monitoring can lead to implant trajectory misalignment, risking penetration into the orbit or damage to the infraorbital nerve, resulting in permanent facial numbness, chronic pain, or vision disturbances.
The Right Environment for Zygomatic Implant Surgery
🔹 Proper Sedation & Monitoring – IV sedation or general anaesthesia allows for better patient management, ensuring minimal movement and maximum precision.
🔹 CBCT-Guided Planning – Using detailed preoperative CT scans and intraoperative imaging ensures accurate placement and avoidance of critical structures.
🔹 Specialist Training – Zygomatic implants should only be placed by surgeons trained in full-arch rehabilitation with experience in zygomatic anatomy and emergency management.
At ZAGA Centre Singapore, we prioritise patient safety and surgical excellence, ensuring all zygomatic implant procedures are performed in a controlled, well-equipped surgical setting by certified specialists.
⚠ If your clinician suggests placing zygomatic implants under local anaesthesia without proper training or monitoring, reconsider your options. Your safety comes first.
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