By Oral & Maxillofacial Surgeon Dr Ali Direnç Ulaşan – Milim Dental, Bursa, Turkey’s first Health Tourism Authorized boutique dental center

If you are reading this, there is a good chance you’ve already heard at least one of these sentences:

1. “Your upper jaw bone is too thin, implants are impossible.”
2. “Sinus surgery failed – now only a removable denture is possible.”
3. “All-on-4 cannot be done because you have no bone left.”
4. “You are not a candidate for dental implants.”

For many patients, this is the moment they start searching for “zygomatic implants Turkey”, “zygomatic implants for no bone”, or “full mouth implants with no bone”.

You may have seen impressive before–after photos and dramatic social media promises – but also completely contradictory information.

As an Oral & Maxillofacial Surgeon who treats advanced cases every week,

I wrote this article for patients like you – people who have been told “it cannot be done” and are now searching for real, medically solid options, not just another flashy Instagram ad.

At Milim Dental in Bursa, we are:

1. Turkey’s first Health Tourism Authorized boutique dental center
2. A multidisciplinary team (oral & maxillofacial surgery, prosthodontics, orthodontics, endodontics, periodontics, pediatric dentistry)
3. Focused on complex, treatment-oriented dentistry – not high-volume “factory” dentistry

We treat many patients referred from other clinics because of severe bone loss, multiple failed implants, or complicated sinus problems.

In this article, I’ll explain – in clear language – how zygomatic implants and All-on-4 / All-on-X protocols can be used to restore a full fixed smile even when you have been told you don’t have enough bone for implants.

This is not a promise of miracles.

It is a realistic guide to what is and is not possible.

1. Why Are You Being Told “You Don’t Have Enough Bone”?

Before talking about zygomatic implants or All-on-4 in Turkey, we need to understand why so many patients are told they “have no bone”.

Common reasons:

1. Teeth were extracted many years ago
2. After extractions, the jawbone gradually shrinks (resorption).
3. In the upper jaw, this is made worse by the maxillary sinus expanding downward.
4. Over time, the bone where implants should go becomes thin, low, and fragile.
5. Long-term removable dentures
6. Wearing a full denture for years can accelerate bone loss, especially in the upper jaw.
7. The denture presses on the bone, and because the bone no longer carries teeth, it shrinks faster.
8. Failed implant and sinus surgeries
9. Failed sinus lifts, repeated bone grafts, or poorly placed implants can damage and further reduce the bone.
10. Some patients come to us after 2–3 unsuccessful attempts in other clinics.
11. Periodontal (gum) disease and infections
12. Chronic advanced gum disease can destroy the bone that supports teeth and potential implants.

When your dentist looks at a regular panoramic x-ray and sees only a thin strip of bone between your mouth and the sinus cavities, they may say:

“Implants are impossible. You can only use a removable denture.”

Sometimes this is true with standard techniques.

But with zygomatic implants and advanced All-on-X concepts, “impossible” can change to “possible with the right team”.

2. What Are Zygomatic Implants?

In a healthy upper jaw, traditional dental implants are placed into the maxillary bone (the normal jawbone that used to hold your teeth).

But if this bone is very thin, very short, or almost gone, we need a different anchorage.

This is where zygomatic implants come in.

2.1. Zygoma = Cheekbone Support

The zygoma is your cheekbone – a dense, strong bone located higher and further back than your upper jaw bone.

Zygomatic implants are extra-long implants designed to anchor into this cheekbone instead of the resorbed upper jaw.

So instead of trying to place implants in the thin, fragile alveolar bone, we use:

The strong cheekbone (zygomatic bone) as a deep anchor

– and then connect a full arch bridge to these implants.

2.2. When Are Zygomatic Implants Considered?

Zygomatic implants are often considered when:

1. There is severe upper jaw bone loss
2. Multiple bone grafts or sinus lift surgeries have failed or are not advisable
3. You have been told you’re not a candidate for implants and must wear a removable denture
4. Long-term denture use has led to an extremely thin upper jaw

Many of our international patients (from Europe, the Middle East, the US, and beyond) find us by searching for:

1. “zygoma implants Turkey”
2. “zygomatic implants for no bone Bursa”
3. “fixed teeth with no upper jaw bone”

Zygomatic implants are a highly specialized procedure. They must be planned and placed by a surgeon with:

1. Advanced anatomical knowledge
2. Experience in 3D imaging, sinus surgery, and complex implantology
3. A close working relationship with a prosthodontic team to design a stable, functional full arch bridge

This is part of why a boutique, specialist-led center (rather than a high-volume chain) is so important for these cases.

3. What Is All-on-4 / All-on-X – and How Does It Relate to “No Bone”?

You have probably seen the term All-on-4 on social media or in ads like:

“Full mouth implants in 24 hours – All-on-4 in Turkey”.

In simple terms:

1. All-on-4 means a full arch of fixed teeth supported by 4 implants.
2. All-on-X is a more general term – it can be 4, 5, 6 or more implants, depending on your anatomy.

The concept is:

1. Place implants in strategic positions (often tilted)
2. Connect them with a rigid full arch bridge
3. Distribute chewing forces efficiently, even when bone volume is limited

3.1. What If There Is Almost No Bone?

In moderate bone loss, All-on-4 / All-on-6 can often be done without zygomatic implants, sometimes with minor bone grafts or sinus lifts.

But in severe bone loss cases, a purely standard All-on-4 may not be safe or stable.

This is where we sometimes combine:

1. Zygomatic implants (anchored in the cheekbone)
2. With additional conventional implants if possible

to create a hybrid All-on-X solution such as:

1. 2 zygomatic implants + 2–4 regular implants
2. 4 zygomatic implants in the most extreme cases

The bridge is still “All-on-X” – a full arch fixed on a limited number of implants –

but the anchorage points are much stronger because we are using the cheekbone.

4. When You’ve Been Told “It’s Not Possible”: What We Actually Look At

At Milim Dental, when a patient comes saying:

“Three clinics told me implant is impossible. Can you check?”

we do not rely only on a quick panoramic x-ray and a 2-minute conversation.

Instead, our workflow is:

4.1. Detailed Clinical & Medical Evaluation

1. Overall health (diabetes, heart disease, osteoporosis, medications like bisphosphonates or blood thinners)
2. History of sinus surgery, bone grafts, previous implants
3. Your expectations:
4. Do you want fixed teeth only?
5. Are you willing to accept staged treatment (healing periods)?
6. What is your tolerance for surgery, travel, and time?

4.2. 3D CBCT (Cone Beam Computed Tomography)

This is non-negotiable for zygomatic and All-on-X planning.

On CBCT we measure:

1. Bone height and width in every relevant area
2. The exact shape and volume of your maxillary sinuses
3. The position and quality of your zygomatic bones
4. The relationship with vital structures (nerves, nasal floor, other sinuses)

4.3. Digital Surgical & Prosthetic Planning

In our boutique setting, your case is discussed in a team meeting:

1. Oral & maxillofacial surgeon (me, Dr Ali Direnç Ulaşan)
2. Prosthodontist / restorative dentist
3. Sometimes orthodontist and periodontist if needed

We simulate:

1. How many implants are needed (4, 6, with or without zygoma)
2. Their length and angulation
3. How the final bridge will be designed – teeth length, smile line, bite, lip support

Only after this do we tell you honestly:

1. What is realistically possible
2. How many stages it will take
3. What the risks and limitations are

No “Hollywood smile in 24 hours whatever your situation”.

If we can do it, we explain how.

If we cannot, we say so clearly – and suggest the safest alternative.

5. What Does Zygomatic / All-on-X Treatment Involve?

Every case is unique, but a typical zygoma + All-on-X treatment pathway looks like this:

5.1. Step 1 – Consultation & Diagnosis (1–2 days)

1. Clinical exam + full photography
2. Panoramic x-ray + CBCT scan
3. Medical history review
4. Discussion of expectations, timeline, and travel if you are coming from abroad

After evaluation, we create a written treatment plan with:

1. Surgical steps (zygomatic implants, any remaining extractions, possible sinus surgery)
2. Whether immediate loading (same-day or next-day temporary fixed teeth) is possible
3. Estimated healing periods and final prosthesis timing

5.2. Step 2 – Surgery (Usually Under Sedation or General Anesthesia)

Because zygomatic implants are advanced surgery, many patients prefer:

1. Conscious sedation or
2. General anesthesia in a controlled medical environment

During surgery, we may:

1. Extract remaining hopeless teeth
2. Place zygomatic implants (2 or 4, depending on the case)
3. Place additional conventional implants in the front upper jaw if there is enough bone
4. In full mouth cases, also treat the lower jaw (All-on-4 / All-on-6 or conventional implants)

Our goal is to achieve strong primary stability of the implants – enough for them to support a temporary fixed bridge if your case allows.

5.3. Step 3 – Immediate or Early Provisional Teeth

In many zygoma + All-on-X cases, patients can receive:

1. A fixed provisional bridge screwed onto the implants
2. on the same day or within 24–72 hours.

This is often called:

1. “Teeth in a day”
2. “Immediate loading”

However – and this is important in the era of social media marketing –

not every case is suitable for same-day full loading.

We decide this based on:

1. Implant stability (torque values)
2. Bone quality
3. Your bite forces (strong clenching, bruxism, etc.)
4. The distribution of implants

If immediate loading is not safe, we may recommend:

1. A shorter healing phase
2. A temporary removable solution
3. And then a fixed bridge as soon as clinically predictable

Our promise is not “everyone gets fixed teeth in 24 hours”,

but “we load implants when it is biologically safe for you”.

5.4. Step 4 – Healing Phase (3–6 Months)

During this period:

1. The bone grows around the implants (osseointegration).
2. Soft tissues heal and stabilize.
3. We monitor healing with clinical checks and sometimes x-rays.

You use the provisional teeth for normal speaking and eating (with some dietary precautions).

We guide you on:

1. What you can and cannot eat
2. Oral hygiene techniques around your new bridge
3. Any necessary adjustments

5.5. Step 5 – Final Bridge Design & Delivery

After healing:

1. We take digital scans or precision impressions.
2. We design the final full arch bridge:
3. Zirconia, metal-ceramic, or high-end hybrid materials
4. Adjusting bite, phonetics, lip support and aesthetics
5. We test the framework first, then the aesthetics,
6. and finally screw the definitive bridge into place.

The result:

1. A fixed, screw-retained full arch of teeth
2. Supported by zygomatic and conventional implants
3. Designed not just to look good in photos,
4. but to last and function daily.

6. What About Pain, Risks and Recovery?

6.1. Is the Surgery Very Painful?

With modern anesthesia and sedation techniques,

patients typically describe:

1. Pressure and swelling, but
2. Less pain than they expected

Post-op, we prescribe:

1. Appropriate pain medication
2. Antibiotics when indicated
3. Nasal sprays (for sinus comfort) if needed

Most patients can:

1. Go back to light daily activities within a few days
2. Fly home after a short recovery (depending on the complexity and your general health)

6.2. Potential Risks and Complications

Any surgery – especially advanced procedures like zygomatic implants – carries risks. These may include:

1. Swelling and bruising (especially around the cheeks and under the eyes)
2. Sinus-related symptoms (pressure, congestion)
3. Infection
4. Implant failure (rare but possible)
5. Changes in sensation (very rare with zygoma, more relevant in lower jaw surgeries)

The key to minimizing risk is:

1. Proper case selection
2. 3D planning
3. A surgeon and team experienced in zygomatic implantology
4. Clear pre- and post-operative instructions (no smoking, sinus care, etc.)

At Milim Dental we prefer to sit down with you and explain risks honestly, rather than pretending advanced surgery is “as simple as a filling”.

7. Zygomatic Implants vs. Endless Bone Grafts: Which Makes Sense for You?

Many patients come after hearing this plan:

1. 1st surgery: sinus lifting + bone grafts
2. Wait 6–12 months
3. 2nd surgery: implants
4. Wait again
5. 3rd step: fixed bridge

In patients with very severe bone loss, repeated grafting procedures may:

1. Be expensive
2. Take years
3. Still fail to provide a stable foundation

In these cases, zygomatic implants often offer:

1. A more direct, structurally strong anchor
2. The possibility of immediate or early fixed teeth
3. Fewer overall surgeries

That does not mean zygoma is always better than grafts.

But if you have already had:

1. Failed sinus lifts
2. Failed implants
3. Severe bone atrophy

then zygomatic implants may be the more logical and predictable solution.

This is why each case must be individually evaluated – we don’t use a one-size-fits-all protocol.

8. Why Choose a Boutique Clinic for Zygomatic & All-on-X Treatment?

You will find many clinics in Google searches for:

1. “All-on-4 Turkey cheap”
2. “Full mouth implants in 3 days”
3. “Hollywood smile package”

The problem is:

1. Many are volume-driven: high numbers of patients per day,
2. limited time for planning and communication.
3. Zygomatic implants and complex All-on-X cases are not simple;
4. they cannot be treated with the same workflow as routine single implants.

At Milim Dental in Bursa, our structure is different:

1. We are a boutique clinic, not a chain.
2. We intentionally see fewer patients per day,
3. especially for surgical and complex rehab cases.
4. Every advanced case is evaluated in a multidisciplinary meeting.
5. We are Health Tourism Authorized by the Turkish Ministry of Health –
6. which means we meet strict standards for international patient care.

Our focus is not to show the biggest number of “smiles per month”,

but to build long-term trust and predictable outcomes.

We spend time:

1. Explaining your options,
2. Showing you your CBCT images,
3. Discussing realistic expectations (function, aesthetics, longevity).

Our promise:

We don’t sell miracle smiles in 24 hours to everyone.

We design stable, medically sound rehabilitation that respects your biology.

9. FAQ – Questions Patients Ask About Zygomatic Implants & All-on-4 in Turkey

1. Am I a candidate for zygomatic implants if several clinics told me “no bone”?

You might be – but the only way to know is through a 3D CBCT scan and a detailed consultation.

Panoramic x-rays alone are not enough.

We have treated many patients who were previously told “impossible”,

but also some for whom zygoma was not suitable and we recommended safer alternatives.

2. Can I really get fixed teeth if I have almost no upper jaw bone?

In many severe cases, yes – using zygomatic implants (cheekbone support) combined with All-on-X concepts.

But not everyone is safe for immediate loading or full arch prostheses;

your general health, bone quality and expectations all matter.

3. Will I go back home with fixed teeth on my first trip?

Often, yes – especially if immediate loading criteria are met.

However, in some complex or medically sensitive cases we may advise:

1. Staged treatment
2. Short temporary solutions
3. Final bridge at a second visit

We prefer to be honest rather than guarantee “fixed teeth for everyone in 24 hours”.

4. Are zygomatic implants only for older patients?

No. Age is less important than bone condition and health.

We have treated relatively young patients (40s–50s) with severe bone loss caused by:

1. Long-standing periodontal disease
2. Multiple failed implants
3. Genetic bone patterns

5. How long do zygomatic implants last?

Clinical studies and long-term follow-ups show high survival rates when:

1. The surgery is properly performed
2. The prosthesis is well designed
3. The patient maintains good oral hygiene
4. Regular check-ups are done

Like any implant solution, zygomatic implants require maintenance and follow-up.

6. Is Milim Dental a good option if I’m traveling from abroad for zygoma / All-on-X?

If you are looking for:

1. A specialist-led clinic
2. A boutique setting with more time per patient
3. A team comfortable with complex, “impossible” cases
4. A structure that is officially Health Tourism Authorized

then yes, Milim Dental is aligned with that profile.

We regularly treat international patients and build treatment schedules around travel logistics.

10. Final Thoughts: Between Social Media Promises and Real Medicine

If you have:

1. Severe upper jaw bone loss,
2. A history of failed implants or sinus surgeries,
3. Or have been told you can only wear a removable denture,

you are exactly the kind of patient this article is written for.

On one side, you see:

1. Aggressive marketing,
2. Guaranteed “perfect smiles in 24 hours for everyone”,
3. Prices that seem too good to be true.

On the other side, you may have dentists saying:

1. “Nothing can be done”,
2. “You are not a candidate for implants”,
3. “Just accept your denture.”

The reality is usually somewhere in between.

At Milim Dental in Bursa, our philosophy is simple:

1. Complex treatment – clear communication.
2. Fewer patients – more time per person.
3. Boutique structure – big surgical capability.

Every zygomatic or All-on-X case is personally evaluated by Oral & Maxillofacial Surgeon Dr Ali Direnç Ulaşan and our multidisciplinary team.

If you feel lost between social media promises and pessimistic answers,

the next logical step is not to believe the loudest ad –

but to seek a thorough, honest evaluation.

We cannot promise that every case will be possible.

What we can promise is to tell you the truth,

to show you your anatomy in 3D,

and to design a plan that respects your health and long-term stability.

If you are considering zygomatic implants or All-on-4 in Turkey,

and want a clinic that treats you as a person – not a number –

our team at Milim Dental will be happy to review your scans and guide you step by step.