10/01/2026
Russian 🇷🇺 below ⬇️
Around the transnasal implant placement technique, I still observe various myths and misconceptions regarding long-term outcomes, the risk of nasolacrimal duct perforation, excessively palatal positioning, and so on. For me—and for many clinicians worldwide—this technique has long ceased to be an alternative to quad zygoma and has instead become the first-line treatment option.
Let us proceed step by step.
💠Long-term follow-up data are available from many clinicians, including Dr. Vanderlim and myself. 💠Perforation of the nasolacrimal duct can occur only in one situation—when the surgeon does not fully understand the anatomy and the procedure being performed. 💠Following the same line of reasoning, quad zygoma placement may also carry a risk of orbital perforation during medial zygomatic implant insertion. 💠Fundamentally, however, this is an issue of inadequate training in zygomatic, transnasal, and pterygoid implantology.
The quad zygoma technique is not a panacea and cannot be applied in every clinical scenario. A significant number of patients, for example, do not present with sufficient anatomical conditions for placement of four zygomatic implants due to limited zygomatic bone volume. Palatal positioning is another frequent concern raised by colleagues; however, in cases of severe maxillary atrophy, even zygomatic implants may be positioned excessively palatally, necessitating the use of titanium bars and removable prosthetic designs during rehabilitation.
This represents only a small portion of the issues I commonly encounter. I will continue this discussion in future publications.
