The following pictures correspond to a heavy smoker patient with multiple failed implant procedures in her maxilla, treated in the ZAGA Center Barcelona, Hepler Bone Clinic. The surgery was performed by Dr Calos Aparicio with Dr Ophir Fromovich and Dr Guy Mclellan. Prosthetic work was performed by Dr Natalia Barluenga.

On the 3-D model we may appreciate extensive residual maxillary bony defects (fig.1). Righ side planning is sown in figs 2,3.  Left sinus included left osmium were mostly occupied. left side planning is shown in figs 4,5.A splinted flap was raised in both sides. Soft tissue closure of the sinus and nasal bony defects was maintained (fig 6&9). Fig. 7 illustrates osteotomy performed for implants in position of the right second premolar and canine. Right implants in position precisely closing the osteotomy (Fig.8).

Implant at second premolar position corresponds to the new ZAGA Flat design from Straumann AG Switzerland,  Implant at canine position corresponds to the new ZAGA Round design from Straumann AG Switzerland (Fig.8) Fig. 10  illustrates osteotomy performed for implants in position of the upper left second premolar and canine.Lateral view of left implants in position. Note the adaptation to the maxillary profile (Fig.11). Implant at second premolar position corresponds to a ZAGA Flat design from Straumann AG Switzerland,  Implant at canine position corresponds to a ZAGA Round design from Straumann AG Switzerland (Fig.11). Fig. 12 illustrates the final position and AP distribution of the implants.