Consensus Report of Group 2 of the 1st Global Consensus for Clinical Guidelines for the Rehabilitation of the Edentulous Maxilla: Zygomatic, Standard-Length, and Short Implant-Supported Prostheses

Abstract

Objectives: The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an innovative, evidence-based approach to developing patient-centered and practical recommendations for the rehabilitation of the edentulous maxilla. Within this framework, Group 2 aimed to formulate clinical recommendations on the use of short, standard-length, and zygomatic implants in atrophic maxillae. Materials and methods: Group 2 followed the S2k-level guideline framework of the Association of the Scientific Medical Societies in Germany (AWMF), applying a structured nominal group technique. The evidence base included two systematic reviews synthesizing patient-reported outcomes (PROs), clinician-reported outcomes (ClinROs), and their respective measures, as well as single-round international surveys involving expert clinicians, patients, and cross-disciplinary experts. Draft recommendations were discussed during the in-person consensus meeting in Boston (June 16-18, 2025) and finalized through anonymous plenary voting. Consensus thresholds were predefined at >= 75% and <= 95% agreement for consensus and > 95% agreement for strong consensus. Results: The Group 2 participants formulated 6 clinical recommendations addressing the domains patient selection, surgical treatment options (short, standard-length, and zygomatic implants), and treatment planning. All 6 recommendations reached consensus. Conclusions: The Group 2 consensus provides practical guidance for the use of short, standard-length, and zygomatic implants in atrophic maxillae, balancing surgical complexity, prosthetic feasibility, and patient-centered care. Remaining evidence gaps-especially regarding standardized outcome sets, loading protocols, prosthetic strategies for zygomatic implants, the use of short implants for full-arch restorations and maintenance frameworks-should be prioritized in future research.