Interview ZAGA Course January 2020: Dr. Lesley David

01. Presentation

“I’m Lesley David and I’m an oral maxillofacial surgeons practicing in Toronto Canada and have been in practice for (I hate to admit) 20 years. My practice is involved significantly in Implant Dentistry

I’ve been very fortunate to be doing implants since the beginning of my practices but zygomatic implants since early 2004 and it’s been really a game-changer in my practice in terms in how I treat patients and who I can treat with the Implant Dentistry and who I can rehabilitate using this technology and techniques. 

02. Zygomatic Implants

“The use of zygomatic implants really is a way to allows us to rehabilitate patients in a graft less solution. It essentially allows us to place implants in bone outside the maxillofacial we use the zygomatic bones of the cheekbone to anchor the implant. It allows us to bypass grafting so the traditional sort of concept of rebuilding surgery the maxilla using sinus lift and more advanced techniques, unlike grafting, vertical augmentation, 4 on one osteotomies with inter positional grafting.

All of those sort of fancy technique to surgically reconstruct the maxilla now really we don’t have to do in many scenarios it’s not all but many scenarios we can actually use the body of the zygoma or the cheekbone to anchor the implant and that allows us to then use a prosthesis for rehabilitation from a dental perspective.”

03. ZAGA Concept

“So the ZAGA Concept really allows us to tailor if you will the surgical placement of a zygomatic implant specific to each patient so it’s not just there is one technique to place zygomatic implants this is how we do it regardless of the patient and the patient anatomy so the ZAGA Concept really takes each individual patient, allows us to look at their anatomy diagnose the variations, we are all different, and we place that implant according to their anatomy.

In a position that is ideal from a prosthetic perspective ideal from a soft-tissue perspective to give us the best end result taking into account all the factors they’re important for survival and success of an implant.”


04.  Zygomatic implants, an less invasive option

“Some people wonder if the zygomatic treatment option is the only option for patients with severe atrophy. In fact, it’s not the only option because traditionally once upon a time we had more involved invasive techniques such as all-on-4 osteotomy with inter positional grafting you know major bone grafting surgical reconstruction of the maxilla and those techniques were much more involved less predictable.

So I can’t in fairness say it’s the only way to do it but certainly, we’ve come to a point in the rehabilitation of patients whereby this technique for the severely atrophy maxilla and we’re talking about placing 4 zygomatic implants (using Quad zygoma) this really is the most predictable and makes the most sense. I think it’s hard to justify now doing much more invasive surgery for a patient when we have a technique that is a lot less invasive requires a lot less time and actually allows us to rehabilitate the patient much more quickly.”



05. ZAGA Course

“I’ve actually been involved in many zygomatic implants courses certainly once upon a time taking this course to actually giving a course and it’s truly been my pleasure and honor to participate in the course. I can say that the sort of journey of you know patient presentation, explaining the rationale for the placement of implant, explaining the surgical technique, the prosthetic is really taught at an exceptional level. So one, there is the theory behind, the whole concept of the use of zygomatic implants and then it takes you to another level whereby there is not only the practical of placing implants on models. I think what is really unique in this course, is that these models are actually printed out of the cadaver that you’re then going to be placing implants on the next day.

So it truly takes it to the next level with regard to zygoma implant training it’s not just a stock maxilla and zygoma that you’re placing implants into it really makes you feel that this is your patient and placing the implant you know in a printed model that is a replication of the cadaver head that I’m then going to be using the next day. So it really makes you think a little bit different as to: this is my patient in a chair how I’m going to navigate this? I think it’s an exceptional hands-on experience.”

06.  ZAGA Centers

“The concept of the ZAGA Center to me is a way of standardizing in my opinion the manner in which a zygomatic implant is delivered. As I mentioned earlier their differents ways that zygoma implants can be placed and we’ve really evolved as to customizing the surgical technique according to each specific patient and how they present from an anatomic perspective. 

So I think the concept behind the ZAGA Centers is that were are insuring that the surgeons who are placing zygomatic implants are trained in a specific way to allow care that is really at the forefront of how we should be delivering treatment to patients and we’re looking at each patient individually and treating them accordingly. So within that sentence, this is the philosophy of ZAGA center and we’re ensuring that the care we deliver is the most optimized care possible.”



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