Evaluating Zygomatic Implants in Orbital Floor Complications: A Clinical and Anatomical Study

Background: One of the most critical complications that can occur after placing zygomatic implants is the accidental penetration of the patient's eye socket by a drill or implant. This article aims to find some relationships between the anatomical features of the lower orbital wall, different configuration of zygomatic implants, and other factors when planning the placement of zygomatic implants. Methods: A total of 81 patients underwent zygomatic implant procedures, receiving different combinations of implants. These included four zygomatic implants along with one or two conventional implants (Group I), four zygomatic implants alone (Group II), two zygomatic implants paired with four conventional implants (Group III), or three zygomatic implants alongside one or two conventional implants (Group IV). The aim of the study was to describe the complications and clinical outcomes of treatment in 81 patients who received zygomatic implants. Results: The following parameters were statistically significant between all four groups of patients: height and distance of two zygomatic implants in the zygomatic bone; surgery type and duration; the distance between zygomatic implants in the zygomatic bone; and zygomatic orbital floor (ZOF) classification at the left side showed significant differences; intramaxillary insertion of zygomatic implants reduced the rupture of Schneiderian’s membrane; the average of zygomatic implants’ length in all groups was 42.8 mm. Conclusions: Not damaging the ZOF is profoundly important for preventing orbital damage during osteotomy for zygomatic implants and should be measured before every surgery.