Kevser Pala, Jörg Neugebauer, Daniel Buser, Giulia Brunello, Krzysztof Chmielewski, Ramesh Chowdhary, Luca Cordaro, Ryuji Hosokawa, Ole T. Jensen, Ui-Won Jung, Ye Lin, Nikos Mardas, M. Aleksa, Nikos Mattheos, Eitan Mijiritsky, Iva Milinković, Leandro Soeiro de Souza Nunes, Waldemar D. Polido, Mariano Sanz, Frank Schwarz, Anton Sculean, Andreas Stavropoulos, Franz J Strauss, Takashi Sumi, Florian M Thieringer, Daniel S Thoma, Yuseung Yi, German O Gallucci
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.