Evaluation of Trabecular Bone Microarchitecture for Zygomatic Implants: A Cone Beam Computed Tomography Study

Abstract

Background/Objectives: Zygomatic implants are commonly used to rehabilitate atrophic maxillae and maxillary defects, offering quicker prosthesis placement than bone grafting, but their placement requires technical precision due to the complexity of the zygomatic region. Trabecular bone quality is a key determinant of implant stability, yet data on the zygomatic bone’s microarchitecture remain limited. This study aimed to evaluate and compare trabecular bone microarchitectural features of the zygomatic bone with three reference sites (first molar region, mandibular condyle, and angle of mandible) using cone beam computed tomography (CBCT). Methods: This retrospective cross-sectional study screened 847 archived CBCT scans from the Ankara University Faculty of Dentistry, of which 99 systemically healthy patients aged 20–30 years were included. Trabecular bone microstructural parameters, including tissue volume, bone volume, percent bone volume, trabecular thickness, trabecular number, trabecular separation, and fractal dimension, were assessed using CTAn software at the zygomatic bone, first molar region, mandibular condyle, and angle of mandible. Results: The zygomatic bone exhibited significantly higher tissue and bone volumes than the other regions but lower percent bone volume and trabecular number; trabecular thickness and separation were greatest in the zygomatic bone, while fractal dimension values were lowest. When pooled across the four regions, significant right–left differences were also observed, with higher tissue volume and pore space on the right side. Conclusions: These findings provide baseline reference data on the zygomatic bone’s trabecular structure in a young, systemically healthy population. Further clinical studies in patient groups more representative of typical zygomatic implant candidates, including both older individuals with age-related maxillary atrophy and younger patients with trauma- or pathology-related bone loss, are needed to confirm the relevance of these findings to implant predictability and safety.

The authors' abstract, as published at the source. Diagnostics, 2026 · DOI ↗