The quad zygoma (QZ) concept, which uses 4 zygomatic implants (ZIs), is an excellent option in the rehabilitation of patients with extreme atrophy of the anterior and posterior maxilla. It negates the need for multiple staged procedures such as sinus lifts and bone grafting and allows immediate replacement of missing teeth. These advantages, combined with the high success rates reported in the literature, have made it a popular option for maxillary rehabilitation.1,2
One important factor often overlooked while planning for quad ZI surgeries is the position of the infraorbital foramen (IOF). The infraorbital nerve (ION), a branch of the maxillary nerve, emerges through the IOF to supply sensory innervation to the conjunctiva, lower eyelids, lateral nasal surface, and upper lip. While not life-threatening, damage to this nerve can be extremely distressing to patients.3 Given that the volume of the zygomatic bone is small, extreme variation in...
