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Perspectives on Zygomatic Implants: Overview, Controversies, and Future Directions

      The aging population of the United States is expected to continue to increase and reach the milestone of outnumbering children in 2035 as projected by the US census data. This generation of older adults is leading an active lifestyle, and quality of life is an important consideration. Although the dental field has been making a transition to a more preventative approach and maintenance of natural dentition, a significant proportion of this population has been managed in a less conservative fashion. Moreover, with age, the likelihood of developing a pathologic lesion requiring surgical resection also increases. While complete dentures and maxillary obturators were accepted as a gold standard prior to dental implant development, with the advent of implant-supported prostheses, few patients are content with the conventional dentures or ill-fitting obturators. In order to satisfy what undoubtedly is going to be an increasing demand for fixed prostheses, oral and maxillofacial surgeons should be well equipped with skills to offer comprehensive oral rehabilitation.
      Management of patients with severely atrophic maxilla has long been a treatment challenge for our specialty. The advent of zygomatic implants in 1988 by Branemark led to an alternative treatment modality for patients with maxillary defects and those with severely resorbed alveolar ridges. Over the past two decades, several implant and treatment advances have been made to improve treatment planning, placement, and restoration of the severely atrophic maxilla, making zygomatic implants a first-line treatment option in these situations.
      In the process of creating this issue of the Atlas of the Oral and Maxillofacial Surgery Clinics of North America, it became evident that there are parallel and opposing concepts and philosophies with respect to zygomatic implants. The objective of this issue evolved from simply providing the reader with the set of technical instructions on how to place zygomatic implants to allowing the reader to explore the various ideologies and adopt those that resonate most. Our world-renown authors and leaders in their field shared their expertise and experience in this collection of the articles. They illustrate the fascinating development of different schools of thought on techniques, utilization of computer-assisted surgical planning, and 3D and navigation technologies.
      We hope that through this text the reader is able to appreciate and obtain an understanding of different perspectives on zygomatic implant indications, placement, restoration, and recent technological advances.
      We would like to sincerely thank all the contributing authors for their time and effort spent on providing excellent articles for this issue of the Atlas of the Oral and Maxillofacial Surgery Clinics of North America “Perspectives on Zygomatic Implants.”