The zygoma anatomy-guided: The ZAGA approach for rehabilitation of the atrophic maxilla

We are thrilled to share with you our latest peer-reviewed publication “The zygoma anatomy-guided approach for rehabilitation of the atrophic maxilla” created by some of our brightest ZAGA members globally: Carlos Aparicio, Antonio Olivo, Victor de Paz, Daniel Kraus, Manuel Martín Luque, Eduardo Crooke, Peter Simon, Madalina Simon, José Ferreira, Andre Sakima Serrano, Jan Peter Ilg, Arturo Bilbao, Alberto Fernandez, Pedro Guitián & Jay Neugarten. This works represents an international collaboration between Barcelona (ES), Padova (IT), Madrid (ES), Mainz (DE), Canary islands (ES), Málaga (ES), Stutgart (DE), Braga (PT), Sao Paolo (BR), Ibiza (ES), Vigo (ES) and New York (US).

  1. ZAGA Center Barcelona, Director Zygomatic Unit at Hepler Bone Clinic, Roman Macaya 22-24, 08022, Barcelona, Spain
  2. ZAGA Center Triveneto – Medical Center Padova, Padua, Italy
  3. ZAGA Center Madrid – Instituto Maxilofacial IMA, Barcelona, Spain
  4. ZAGA Center Frankfurt Mainz – Dr. Kraus Zahnärzte & Implantatklinik, Mainz, Germany
  5. ZAGA Center Canary Islands – IOC Clínica Dental, Vecindario, Spain
  6. ZAGA Center Costa del Sol – Clínica Dental Crooke & Laguna, Marbella, Spain
  7. ZAGA Center Stuttgart – Zahnarztpraxis Dres. Simon, Stuttgart, Germany
  8. ZAGA Center Braga – DIMD- Diagnóstico Integrado em Medicina Dentária, Braga, Portugal
  9. ZAGA Center São Paulo – CA.SA Odontologia, São Paulo, Brazil
  10. ZAGA Center A Coruña y Lugo – AB Cirugía Oral y Maxilofacial, A Coruña, Spain
  11. ZAGA Center Ibiza – Clínica Fernández, Ibiza, Spain
  12. ZAGA Center Pontevedra & Orense – Clínica Guitián, Pontevedra, Spain
  13. ZAGA Center New York – The New York Center for Orthognathic and Maxillofacial Surgery, New York, USA

The zygoma anatomy-guided approach (ZAGA) for rehabilitation of the atrophic maxilla was published in Clinical Dentistry Reviewed, SpringerLink, and has open access to everyone who wants to dive deeper into the surgical performance of the zygoma implants, and especially the benefits of the ZAGA Concept.

As the article explains, the zygomatic procedure has evolved in time: “the management of a severely atrophic maxilla using zygomatic implants is different and more complicated than the placement of conventional endosseous implants from a surgical perspective. In most cases, patients with extreme maxillary atrophy have only one chance for oral prosthetic rehabilitation using zygomatic implants. The learning curve of the procedure may be long due to the reduced number of patients to be treated in a single office. Hence, the management of maxillary atrophy using zygomatic implants should preferably be performed by an experienced clinician”.

a) Tomographic section showing a straight maxillary ZAGA Type 0 wall. Bone height under the sinus is about 4 mm thick. Virtual placement of implant through a sinus floor as per the ZAGA Type 0 protocol. b) Tomographic section showing the post-operative implant status planned in (a) at the checkup.
c) Computed tomography shows a straight maxillary wall. Bone height under the sinus is about 1–2 mm thick. Preservation of bone crest integrity is mandatory to prevent later oro-antral communication. Accordingly, the implant was placed extra-sinus, buccal to the crest, converting the case into a ZAGA Type IV protocol. d) Tomographic section showing the post-operative implant status as planned in (c) at the checkup

Further, you can discover figures and indications regarding the type of implant, flat or round, to use as a function of the ZAGA classification. Explorer deeper into the anatomy of the zygomatic implant rehabilitation and understand the challenges linked with each of the three zones:

  • the “zygomatic implant critical zone”
  • the “zygomatic antrostomy zone”
  • the “zygomatic anchor zone”.

Finally, do you know the “ABC” of ZAGA? Discover it in the publication and follow it to plan your next zygomatic implant surgery:

  1. Determine the ideal position of the implant head at the coronal level.
  2. Select the entry point at the zygomatic bone
  3. Connect the two points.

For those who are interested in downloading the article, do it here.

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