Abstract
Introduction: In the dental implant scenario, the graft to treat severely reabsorbed jaws is currently the gold standard procedure, but there are flaws in this procedure from 10.0 to 30.0 % are reported in the literature. Zygomatic implants have shown, in many cases, improved clinical outcomes compared to bone graft and represent an essential alternative for compromised maxillary bone. Objective: It analyzed the main approaches and clinical optimizations of zygomatic implants through guided surgery. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2024 to January 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 195 articles were found, and 48 articles were evaluated in full and 36 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=91.7%>50%. It was concluded the zygomatic implant is revolutionizing the procedure of implants in the posterior atrophic maxilla, eliminating the complications of bone augmentation and sinus elevation, with delayed scarring. Zygomatic implants have in many cases shown better clinical results compared to bone grafts and represent a possible gold standard for dental implants. Robotic placement of zygomatic implants has the potential to produce excellent results.