Z-classification: an anatomy-based ridge-sinus-zygoma classification and decision funnel for zygomatic implantology.

Authors

Sepehr Zarrine, Iva Ilic, Branislav Ilic, Marko Lazic, Aleksa Markovic

Published in

Clinical oral investigations. Volume 30. Issue 9. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

The rising demand for zygomatic implants (ZIs) in contemporary dental implantology underscores the need for an anatomy-based categorization system and a surgical decision-making panel that takes into account anatomical, biomechanical, and prosthetic factors to determine the final surgical strategy. This article proposes a new Z-Classification, the anatomical division of the maxillo-zygomatic complex.
The classification was developed from the authors' clinical experience of 882 ZIs placed in 234 patients across two centres over a ten-year period. According to anatomical presentations, 6 classes were described.
The classification is intended as a practical framework for preoperative assessment and treatment planning in ZI rehabilitation. It has not yet been validated against clinical outcomes. Additionally, a decision funnel for surgical strategy development and the structured checklists consisting of crucial clinical parameters for long-term success in ZI therapy were proposed.
The presented tools will potentially optimize a complex decision-making algorithm in zygomatic implantology.
The proposed Z-Classification and the decision funnel carry the potential to reduce the risk of complications associated with zygomatic surgery.

PMID:
42696158
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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