Dr. Michael Pikos, ZAGA Center Tampa Bay
Episode summary
Dr. Michael Pikos, an oral and maxillofacial surgeon in Tampa Bay, Florida and founder of Coastal Jaw Surgery and the Pikos Institute, discusses zygomatic implant rehabilitation as the lead surgeon of the first ZAGA Center in North America. With 37 years in practice and more than 26,000 implants placed, he attributes rising demand to the aging baby-boomer generation presenting with terminal dentition and severe maxillary atrophy for whom bone grafting is impractical. He explains that the ZAGA Concept's anatomy-guided, customized classification aligns with his long-held view that one size does not fit all, and that it improves on the single-protocol trans-sinus approach by reducing prosthetic problems and morbidity. Pikos details a prosthetically driven digital workflow using cone-beam CT, stereolithographic model surgery, Simplant planning, the PIC system for 10-micron precision, and a nanoceramic provisional-to-final prosthesis. His central recommendation to clinicians is to commit fully, take multiple courses, and seek mentorship rather than dabble.
Key takeaways
- Dr. Michael Pikos has practiced oral and maxillofacial surgery in Tampa Bay, Florida since 1983 and has placed more than 26,000 implants over his career.
- Coastal Jaw Surgery is a multidisciplinary group practice of seven clinicians including four oral surgeons, two periodontists and a prosthodontist, and is the first ZAGA Center in North America.
- Rising demand for zygomatic implants is driven by the aging baby-boomer cohort (born 1946-1964, roughly 78 million in the United States) presenting with terminal dentition and severe maxillary atrophy.
- The ZAGA Concept applies an anatomy-guided, customized classification, in contrast to the older single-protocol approach in which the implant always passes through the sinus, thereby reducing palatal involvement and morbidity.
- Pikos's diagnostic workflow combines cone-beam CT, a stereolithographic model for model surgery, and Simplant software planning to rehearse the surgery before performing it in the mouth.
- The practice uses the PIC system to capture prosthesis position within 10 microns, enabling a passive-fitting nanoceramic prosthesis and a provisional-to-final transition in two appointments.
- Pikos declines to perform zygomatic cases on smokers and frames zygomatic therapy as a last-resort treatment that demands total commitment, multiple courses, cadaver training and mentorship.
What you'll learn
- Why demand for zygomatic implants is rising as the baby-boomer cohort presents with terminal dentition and severe maxillary atrophy
- How the ZAGA Concept's anatomy-guided, customized classification replaces the one-protocol sinus-slot approach and reduces morbidity
- A prosthetically driven digital diagnostic workflow: cone-beam CT, stereolithographic model surgery, Simplant planning and design-with-the-end-in-mind
- Using the PIC system for passive-fit prosthesis capture within 10 microns and a nanoceramic PMMA provisional-to-final path in two appointments
- The multidisciplinary, patient-centric team model and strict patient selection, including refusing zygomatic cases on smokers
- Why zygomatic therapy is a last-resort treatment demanding total commitment, multiple courses, cadaver training and mentorship
About the guest
Dr. Michael Pikos
Dr. Michael A. Pikos is an oral and maxillofacial surgeon practicing in the Tampa Bay, Florida area since 1983, and founder of the Coastal Jaw Surgery multidisciplinary group practice. He has focused exclusively on implant surgical reconstruction for the past 27 years and has placed more than 26,000 implants over his career. In 1990 he founded the Pikos Institute, through which he has taught more than 5,000 alumni across all 50 U.S. states and 43 countries. He was certified at ZAGA Center Tampa Bay, the first ZAGA Center in North America, after training directly with Dr. Carlos Aparicio in Barcelona.
Credentials: Oral and maxillofacial surgeon; founder of Coastal Jaw Surgery; founder and CEO of the Pikos Institute; ZAGA Center Tampa Bay, Florida (first ZAGA Center in North America)
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