Interview ZAGA Course January 2020: Dr. Costa Nicolopoulos
“Hello, I’m Costa Nicolopoulos Specialist maxillofacial and oral surgeon with over 50 years of experience. I’m based in Athens for the last 20 years and in Dubai for the last 8 years. My clinical practice concentrates mainly on treating patients without teeth with dental implants and teeth on the same day. My training has been done in South Africa in the 1980s and time in the late 1980s.
A very special professor from Sweden by the name of Per-Ingvar Brånemark introduced dental implants to the world. And from the time he introduced them, I became extremely interested in this treatment option. It changes people’s lives, it provides people without teeth fixed teeth as well as give them the appropriate esthetics.”
02. Zygomatic Implants
“Now, Zygomatic implant treatment is a highly specialized dental implants treatment specifically for patients with severe atrophy of the upper jaw, the maxilla, so if the patient doesn’t have any bone in the upper jaw conventionally he needs to have extensive and time-consuming and expensive and painful bone grafting procedure in the maxillary sinuses.
On the other hand with the zygomatic treatment, we can avoid all this and place implants in the cheekbone zygomatic in the cheekbones so we can secure these implants in available bone and then we can give patients fixed teeth on the same day without having to undergo these extensive bone grafting procedures. So that is what zygomatic implants are all about.“
03. ZAGA Concept
“Traditionally, placement of zygomatic implants has had some significant complications in specific sinus complications and bulky prosthetic teeth making it difficult for the patient either to speak or to clean. Dr. Carlos Aparicio from Barcelona has developed the ZAGA Concept which is basically a classification for patients with different types of atrophy in the mid-face and a specific treatment protocol for the different classification of bone atrophy.
With the ZAGA Concept, the dental implant surgeon can avoid the complications which were traditionally associated with zygomatic implants. So for me and for my patients, it’s very important to be a ZAGA Center because we can treat the patients with the ZAGA protocol thereby avoiding complications.
04. ZAGA Center Dubai & Athens
“Besides the prestige of being a ZAGA center and the patient recognize my center as being a place where an expert in zygomatic implant treatments will treat the patient, there are many other colleagues that come to Barcelona the get trained on the ZAGA Concept and those colleagues even tho they don’t become ZAGA Centers they can benefit tremendously by learning how to perform the ZAGA protocol to avoid the traditional complications associated with zygomatic implants. I can definitely highly recommend dental colleagues, dentists, to get trained on the ZAGA protocol because they will have a much higher success rate for the zygomatic implants, they will be able to prevent rather than treat complications associated with zygomatic implants.
Prevention is better than cure and that’s what the ZAGA concept is all about. Preventing the complications and we are talking about relatively serious complications in particular sinus situs difficult complications to treat and teeth that are not user-friendly for the patient they are either too bulky on the pallet or the patient can’t clean or the patient can’t speak. With the ZAGA protocol, we don’t have these problems.”
05. Patient’s first visit
“So the first visit in a ZAGA clinic for a patient and particular in my clinic is that the patient arrives for a consultation at the time of consultation we do a physical intraoral and extraoral examination we do some radiographic assessments with x rays and in specific we also arrange for a CBCT which a cone beam scan for the patient it’s like a 3D top X Rays which takes the guess out of the game. So we can see exactly how much bone there is, what amount of atrophy there is, the size of the zygoma because not all patients are the same, some patients have different anatomy and not I mean that different patient has different degrees of atrophy and different type of anatomy, the one side can be very different of the other side so it’s very important for us to have a detailed clinical radiographic assessment of the patient.
Which we can do virtual planning on specialized software place the implant then we can also have a 3D model we can discuss all that with the patient we can show them how we are going to do the treatment and explain to the patient what they should expect post-operatively what degree if any discomfort swelling and of course we can discuss the finances with the patient. So the patients before they start the treatment they have all the answers they know what will be involved in, what it will cost and possible complications that will implicate.”
06. Common questions about zygomatic implants
“The patient is coming to us for teeth, they are not coming to us for zygomatic implants, of course, they’re going to get zygomatic implants if they need them but the main thing is teeth, when will I get teeth? And the nice thing with zygomatic implants the nice plus factor is that patients can get teeth the same day or within 24h.
And of course, a very important question is: how much will this cost? And some patients also ask they want to know about post-operative side effects and possible complications which we, of course, tell them even if they don’t ask us.”
07. Why be part of ZAGA Centers
“I’m a ZAGA center because I want to treat patients regarding zygomatic implants in the correct way. I don’t want to treat them in the traditional way which as some complications associated I want to treat them with the ZAGA concept which has minimal complications associated. Furthermore, I was one of the very first fortunate and honored clinics to be associated with Dr. Carlos Aparicio and as they were no ZAGA Center in my area in Athens and Dubai I was privileged and honored to become a ZAGA center.
And when a patient comes to our clinic and they see on the wall Zygoma ZAGA Centers because we get a dedicated plaque from ZAGA Centers they see that we are experts in this type of treatment modality and that creates a certain amount of confidence in the patient. So if you’re a ZAGA center that transfers confidence to the patient to get treatment by you because they recognize you as a specialist and expert in this field.”
08. Experience with zygomatic implants
“To give you a little background in terms of zygomatic implants in my 50 years of clinical experience in early 2000 I started placing zygomatic implants as per the original protocol. I placed them for 2-3 years and then I realized that this was not a good treatment modality for the patient because of the recurrent and common complications associated with the original protocol in other words sinus situs and prosthetic prosthesis that were very bulky, patients can’t speak well because the implant is going out too much towards the pallet.
Then I stopped placing zygomatic implants for close to 15 years and then I was in a very fortunate position to meet Dr. Carlos Aparicio and I read his book and I highly recommend his book to dentists to be informed of about ZAGA concept and once I read his book I then came to his course and now I’m treating patients with ZAGA concept and I’m not having the type of complication that I was seeing with the original protocol so I can highly recommend the ZAGA concept to dental specialist and dentists placing implants in order to avoid rather than treat complications.”