Dr. Perez-Rosich Completes Advanced Zygomatic Implant Training

From September 9 to 12, 2026, Dr. Ramon Perez-Rosich attended a four-day live course titled "Full Spectrum Zygomatic and Pterygoid Implant Therapy Demystified." This course provided 28 hours of continuing education and was held at the Pikos Institute in the Tampa Bay area of Florida. The Pikos Institute is a dedicated implant education center founded by oral and maxillofacial surgeon Dr. Michael A. Pikos. Its faculty includes oral and maxillofacial surgeons, prosthodontists, and periodontists, and it is well regarded among implant surgeons.

Dr. Perez-Rosich pursued this training because many patients come to our practice after being told they do not have enough bone for dental implants, or after a bone graft did not work. He wanted to be able to offer these patients a fixed-teeth option in-house, planned and placed by the same surgeon.

What the advanced training covered

The course format included lectures, hands-on model workshops, and a hands-on cadaver lab on the final day. This structure ensured that the clinical theory was matched with physical practice. The curriculum covered several key technical and planning topics:

• Anatomy: the anatomy of the zygoma (cheekbone), the maxilla (upper jaw), and the sinus.
• Surgical techniques: zygomatic implant techniques and the use of pterygoid implants, which are another way to anchor implants in the back of the upper jaw without grafting.
• Planning: diagnosis, treatment planning, and digital and guided planning.
• The restorative process: the workflow for the final teeth, as well as hygiene and long-term maintenance.
• Risk management: preventing and managing complications and reviewing clinical cases.
• Immediate function: the history and application of full-arch immediate function.

The stated goals of the course were to build a patient-specific surgical decision process based on evidence and to ensure proficiency with digitally guided workflows. A major focus was prosthetically driven planning, which means the surgeon plans the final teeth first, and then plans the implants to support them.

Insights from the cadaver lab and planning

For Dr. Perez-Rosich, the most important part of the training was the emphasis on what happens before the surgery ever begins. He noted that a successful zygomatic case is largely decided during the planning phase. The 3D scan, the anatomy of the sinus and cheekbone, and the planning of the final teeth first drive every decision.

The cadaver lab was also a vital part of the experience. Dr. Perez-Rosich found that working on real anatomy, rather than models, shows how the implant path relates to the sinus and the eye socket in a way that lectures cannot.

Additionally, the course gave equal weight to long-term maintenance and the management of complications. In this approach, hygiene and follow-up are treated as essential parts of the treatment rather than afterthoughts.

What are zygomatic implants?

Zygomatic implants are extra-long implants that are anchored in the zygomatic (cheek) bone instead of the upper jawbone. This is a helpful alternative because the cheekbone typically stays dense even when the upper jaw has lost a significant amount of bone.

These implants are used only in the upper jaw and are almost always part of a fixed full-arch bridge. Depending on the patient's needs, this may involve:

• Two zygomatic implants: these are combined with regular implants in the front of the mouth.
• Quad zygoma: four zygomatic implants are used when bone is limited everywhere in the upper jaw.

Because these implants anchor in the cheekbone, they often allow for a fixed temporary bridge the same day or within days, provided the stability allows for it.

Who can benefit from this procedure?

Zygomatic implants are an option for patients who have been told they are not candidates for traditional implants. They are typically recommended for:

• Severe bone loss: patients who have lost too much upper-jaw bone to support standard implants.
• Failed previous treatments: patients who have had bone grafts or sinus lifts that did not succeed.
• Graft avoidance: patients who want to avoid large grafts and the months of bone graft healing that those procedures require.

As with any advanced procedure, safety depends on careful 3D planning and the experience of the oral and maxillofacial surgeon. Published systematic reviews report implant survival rates between 95 and 100 percent in most studies, though results are lower for patients who have had part of the upper jaw surgically removed. The most commonly reported complication is sinus inflammation or infection.

What this means for our patients

By completing this training, Dr. Perez-Rosich can now offer zygomatic implants in-house at OMS Associates. This means the same surgeon who performs your initial consultation and 3D imaging will also plan the surgery, place the implants, and handle your follow-up. We can also discuss IV sedation to help you remain comfortable during the procedure.

For many patients who previously felt they had no options, this often provides a way to achieve a stable, fixed restoration without extensive bone grafting.

Frequently asked questions

Do I need a bone graft before getting zygomatic implants?

The primary purpose of zygomatic implants is to avoid the need for large bone grafts. Because these implants are anchored in the cheekbone, which remains dense, they can often be placed even when the upper-jaw bone is severely depleted.

How long does it take to get my teeth?

In many cases, a fixed temporary bridge can be placed the same day as the surgery or a few days later, depending on the stability of the implants. The final restorative workflow is planned from the start to ensure the best fit and function.

How do I find out if I am a candidate for this procedure?

The first step is a consultation that includes 3D imaging. This allows Dr. Perez-Rosich to evaluate the anatomy of your sinus and cheekbone to determine if zygomatic implants are a safe and effective option for your specific needs.

What are the risks involved?

While survival rates are high in most studies, complications can occur. The most common issue reported is inflammation or infection of the sinus. We manage these risks through precise 3D planning and a thorough surgical process.

Schedule a consultation

If you have been told you do not have enough bone for implants, we can help you determine if zygomatic implants are a viable option for you. Our consultations include 3D imaging to accurately assess your anatomy.

You can reach us at our Southwest Ranches office at 954-693-0026 or our Kendall and Doral offices at 786-210-6160.