Abstract
BACKGROUND: The objective of this work is to identify the effectiveness and summarize the scientific evidence of zygomatic implants using the externalized technique, as well as to evaluate the possible complications associated with this technique. MATERIAL AND METHODS: The study was registered in PROSPERO (CRD42022330060) and the searches were carried out in 6 databases (PubMed, Cochrane, LILACS, Scopus, Embase and Google Scholar), by two researchers individually. The aggregated data were subjected to statistical analysis using the MedCalc program for the variables: success rate and frequency of complications, using a 95% confidence interval. The risk of bias of the included studies was determined using the Newcastle-Ottawa Scale (NOS) tool. RESULTS: 912 articles were found in the initial search and 15 of them were included in this systematic review. A total of 1555 zygomatic implants and 1865 conventional implants were part of the study, with an overall success rate of 96.7% for zygomatic implants and 97.9% for conventional implants. There was no statistically significant difference between the survival of zygomatic implants using the externalized technique when compared with conventional implants (p=0.015). There was no significant heterogeneity between studies (p=0.89, I²=0%). Regarding complications, the most prevalent were sinusitis, which showed a proportion of 3.028% (CI95% = 1.053, 5.980%) and infections, which showed a proportion of 1.56% (CI95% = 0.358, 3.590%). Only three articles included presented a low risk of bias. CONCLUSIONS: Based on the present systematic review and with limited evidence, the use of zygomatic implants using the externalized technique proved to have a high implant success rate and few associated complications for the treatment of atrophic maxillae.