ZAGA is more than just a method, it is a philosophy of how we work with patient well-being as one of its core principles. Each patient’s individual characteristics and needs are the main elements considered when designing a treatment plan and deciding what materials or implants will be used.
By anchoring the dental prosthesis to zygomatic implants, the ZAGA philosophy aims to achieve long-term success in treating severe maxillary atrophy. In addition to maximizing success, the ZAGA philosophy seeks to prevent complications instead of treating them. To obtain these objectives through a standardized process, the ZAGA philosophy develops and uses individual, contrasted, and systemized action protocols.
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INCISION AND FLAP DESIGN IN ZYGOMATIC IMPLANT SURGERY: A ZAGA-BASED DECISION TREE
October 2025
In the International Journal of Periodontics & Restorative Dentistry
Carlos Aparicio, MD, DDS, MSc, MSc, DLT, PhD
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COMPARATIVE FINITE ELEMENT ANALYSIS OF THREE ZYGOMATIC IMPLANT APPROACHES USING REAL-LIFE ANATOMIC MODELS
October 2025
In Journal of Prosthetic Dentistry
Carlos Aparicio, MD, DDS, MSc, MSc, DLT, PhD, Adi Lorean, OMFS, DMD, and David Pastorino, Mat.Sci.Eng., MEng, MASt, PhD
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IMPLANT DESIGNS AND THE EDENTULOUS PATIENT
September 2025
In Managing Fully Edentulous Patients
Bilal Al-Nawas, Prof, Dr, Dr, Carlos Aparicio, MD, DDS, MSc, MSc, DLT, PhD
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ZAGA PROTOCOL FOR QUADRUPLE ZYGOMA IMPLANT INSTALLATION
July 2025
Carlos Aparicio, MD, DDS, MSc, MSc, DLT, PhD, Antoine Chehade, BSc, MS, David Wei-Kai Hsu, DDS , Guy McLellan, DDS, MS
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ROUND AND FLAT ZYGOMATIC IMPLANTS: EFFECTIVENESS AFTER A 3‑YEAR FOLLOW‑UP NON‑INTERVENTIONAL STUDY
June 2024
Carlos Aparicio, Waldemar D Polido, Antoine Chehade, Marc Shenouda, Madalina Simon, Peter Simon, Bilal Al-Nawas
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ZAGA DOUBLE PEDICLE PALATAL FLAP FOR SOFT TISSUE MANAGEMENT IN ZYGOMATIC SURGERY
February 2024
Carlos Aparicio, Arnau Aparicio
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SURGICAL–ANATOMICAL AND PROSTHETIC–BIOMECHANICAL ZAGA CRITERIA TO DETERMINE THE ZYGOMATIC IMPLANT TRAJECTORY
July 2023
Carlos Aparicio, Arnau Aparicio and John Brunski
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THE ZYGOMA ANATOMY-GUIDED APPROACH (ZAGA) FOR PREVENTING COMPLICATIONS USING ZYGOMATIC IMPLANTS
July 2023
Carlos Aparicio
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ADVANCED ZYGOMATIC IMPLANTS: THE ZAGA CONCEPT
July 2023
A Book by Dr. Carlos Aparicio
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A MODIFIED DELPHI CONSENSUS FOR REHABILITATIONS ANCHORED TO ZYGOMATIC IMPLANTS
September 2023
Carlos Aparicio, David Pastorino
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ZYGOMATIC IMPLANTS. THE ZAGA CONCEPT
March 2023
C. Aparicio, A. Dawood and C. Ucer
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THE ZAGA CONCEPT: A MULTIFACETED APPROACH TO ZYGOMA IMPLANT REHABILITATION
March 2023
In Zygoma Implants. Step by Step by Arun K. Garg
Co-authors: Carlos Aparicio -
SUCCESS RATES OF ZYGOMATIC IMPLANTS FOR THE REHABILITATION OF SEVERELY ATROPHIC MAXILLA: A SYSTEMATIC REVIEW
August 2022
Aleix Solà Pérez, David Pastorino, Carlos Aparicio, Marta Pegueroles Neyra, Rabia Sannam Khan, Simon Wright and Cemal Ucer
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ROUND AND FLAT ZYGOMATIC IMPLANTS: EFFECTIVENESS AFTER A 1-YEAR FOLLOW-UP NON-INTERVENTIONAL STUDY
April 2022
Aparicio C, Polido WD, Chow J, Davó R, Al-Nawas B. Int J Implant Dent. 2022 Apr 1;8(1):13. doi: 10.1186/s40729-022-00412-8.
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THE ZYGOMA ANATOMY-GUIDED APPROACH (ZAGA) FOR REHABILITATION OF THE ATROPHIC MAXILLA.
February 2022
Carlos Aparicio, Antonio Olivo, Victor de Paz, Daniel Kraus, Manuel Martin Luque, Eduardo Crooke, Peter Simon, Madalina Simon, Jose Ferreira, Andre Sakima Serrano, Jan Peter Ilg, Arturo Bilbao, Alberto Fernandez, Pedro Guitián, Jay Neugarten
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PREOPERATIVE EVALUATION AND TREATMENT PLANNING. ZYGOMATIC IMPLANT CRITICAL ZONE (ZICZ) LOCATION
September 2021
Carlos Aparicio, Roberto López-Píriz, Miguel Peñarrocha
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THE ZYGOMA ANATOMY-GUIDED APPROACH FOR PLACEMENT OF ZYGOMATIC IMPLANTS
September 2021
Carlos Aparicio, Waldemar D. Polido, Hooman M. Zarrinkelk, Atlas of the Oral and Maxillofacial Surgery Clinics
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IDENTIFICATION OF THE PATHWAY AND APPROPRIATE USE OF FOUR ZYGOMATIC IMPLANTS IN THE ATROPHIC MAXILLA: A CROSS-SECTIONAL STUDY
August 2021
Carlos Aparicio, Waldemar D Polido, James Chow, Lesley David, Rubén Davo, Eduardo Jose De Moraes, Alex Fibishenko, Masami Ando, Guy Mclellan, Costa Nicolopoulos, Michael A Pikos, Hooman Zarrinkelk, Thomas J Balshi, Miguel Peñarrocha
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PREVALENCE OF MAXILLARY SINUS ALTERATIONS AFTER ZYGOMATIC SURGERY. A COMPARATIVE STUDY BETWEEN INTRA-SINUS AND ZAGA APPROACHES
May 2021
Carlos Aparicio, Pedro Clarós, Natalia Końska, P. Clarós-Pujol, D. Clarós-Pujol, M. Peñarrocha-Diago
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ORIS CRITERIA OF SUCCESS FOR THE ZYGOMA-RELATED REHABILITATION: THE (REVISITED) ZYGOMA SUCCESS CODE
April 2020
Carlos Aparicio, MD, DDS, MsC, MsC, DLT, PhD/Roberto López-Piriz, MD, DDS, PhD/Tomas Albrektsson, MD, PhD, RCPSG
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ZYGOMA ANATOMY-GUIDED APPROACH "SCARF GRAFT" FOR PREVENTION OF SOFT TISSUE DEHISCENCE AROUND ZYGOMATIC IMPLANTS: TECHNICAL NOTE
April 2020
Carlos Aparicio, Sanz Antonio
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BONE REGENERATION AND SOFT TISSUE ENHANCEMENT AROUND ZYGOMATIC IMPLANTS: RETROSPECTIVE CASE SERIES
March 2020
Miguel Peñarrocha-Diago , Juan Carlos Bernabeu-Mira, Alberto Fernández-Ruíz, Carlos Aparicio and David Peñarrocha-Oltra
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THE ZYGOMA ANATOMY-GUIDED APPROACH (ZAGA) — A PATIENT-SPECIFIC THERAPY CONCEPT FOR THE REHABILITATION OF THE ATROPHIC MAXILLA
2020
In: James Chow (Ed.), Zygomatic Implants: Optimization and Innovation, March 2020, pp. 63–85
Carlos Aparicio -
COMPUTER-GUIDED APPLICATIONS FOR DENTAL IMPLANTS, BONE GRAFTING, AND RECONSTRUCTIVE SURGERY
by Marco Rinaldi, Scott Ganz, and Angelo Mottola
2015
Featured chapter: Carlos Aparicio
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ZYGOMATIC IMPLANTS: INDICATIONS, TECHNIQUES AND OUTCOMES, AND THE ZYGOMATIC SUCCESS CODE
October 2014
Carlos Aparicio, Carolina Manresa, Karen Francisco, Pedro Claros
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ZYGOMATIC IMPLANTS PLACED USING THE ZYGOMATIC ANATOMY-GUIDED APPROACH VERSUS THE CLASSICAL TECHNIQUE: A PROPOSED SYSTEM TO REPORT RHINOSINUSITIS DIAGNOSIS
October 2014
Carlos Aparicio, Carolina Manresa, Karen Francisco, Arnau Aparicio, Jonas Nunes, Pedro Claros, Josep M Potau.
Clin Implant Dent Relat Res. 2014 Oct;16(5):627-42. doi: 10.1111/cid.12047. Epub 2013 Mar 6. PMID: 23464749.
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THE LONG-TERM USE OF ZYGOMATIC IMPLANTS: A 10-YEAR CLINICAL AND RADIOGRAPHIC REPORT.
October 2012
Carlos Aparicio, Carolina Manresa, Karen Francisco, Wafaa Ouazzani, Pedro Claros, Josep M Potau, Arnau Aparicio
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ZYGOMATIC IMPLANTS. THE ANATOMY-GUIDED APPROACH
August 2012
Carlos Aparicio
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IMMEDIATE/EARLY LOADING OF ZYGOMATIC IMPLANTS: CLINICAL EXPERIENCES AFTER 2 TO 5 YEARS OF FOLLOW-UP
May 2010
Carlos Aparicio, Wafaa Ouazzani, Arnau Aparicio, Vanessa Fortes, Rosa Muela, Andres Pascual, Maria Codesal, Natalia Barluenga, Monica Franch
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EXTRASINUS ZYGOMATIC IMPLANTS: THREE YEAR EXPERIENCE FROM A NEW SURGICAL APPROACH FOR PATIENTS WITH PRONOUNCED BUCCAL CONCAVITIES IN THE EDENTULOUS MAXILLA
Clin Implant Dent Relat Res 2010;12:55-61. E-Pub 2008.
Aparicio C, Ouazzani W, Aparicio A, Fortes V, Muela R, Pascual A et al.
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THE USE OF ZYGOMATIC IMPLANTS FOR PROSTHETIC REHABILITATION OF THE SEVERELY RESORBED MAXILLA.
April 2008
Carlos Aparicio, Wafaa Ouazzani, Naoki Hatano
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¿QUÉ INDICACIONES TIENEN Y QUÉ RESULTADOS NOS OFRECEN LOS IMPLANTES CIGOMÁTICOS?
April 2008
Aparicio, C., & Soto-Yarritu Quintana, R.
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IMMEDIATE/EARLY LOADING OF DENTAL IMPLANTS: A REPORT FROM THE SOCIEDAD ESPANOLA DE IMPLANTES WORLD CONGRESS CONSENSUS MEETING IN BARCELONA, SPAIN, 2002
October 2006
Carlos Aparicio, Bo Rangert, Lars Sennerby
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VALIDITY AND CLINICAL SIGNIFICANCE OF BIOMECHANICAL TESTING OF IMPLANT/BONE INTERFACE
September 2006
Carlos Aparicio, Niklaus P Lang, Bo Rangert
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A PROSPECTIVE CLINICAL STUDY ON TITANIUM IMPLANTS IN THE ZYGOMATIC ARCH FOR PROSTHETIC REHABILITATION OF THE ATROPHIC EDENTULOUS MAXILLA WITH A FOLLOW-UP OF 6 MONTHS TO 5 YEARS
August 2006
Carlos Aparicio, Wafaa Ouazzani, Roberto Garcia, Xabier Arevalo, Rosa Muela, Vanessa Fortes
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ZYGOMATIC IMPLANTS. A NEW SURGICAL APPROACH.
J Clin Perio 2006: 33: supplement (second part) 128
Ouazzani W, Arevalo J, Sennerby L, Lundgren S, Aparicio C.
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ZYGOMATIC IMPLANTS. A NEW SURGICAL APPROACH.
2006-2010
The group led by Dr. Carlos Aparicio published in 2006 a first report summarizing their initial one-year experience with the extra-maxillary technique (Ouazzani W, Arevalo J, Sennerby L, Lundgren S, Aparicio C. Zygomatic implants. A new surgical approach. J Clin Perio. 2006;33: supplement [second part]:128). Subsequently, in 2008, as a continuation of that prospective study, the same group reported the three-year follow-up (Aparicio C, Ouazzani W, Aparicio A, Fortes V, Muela R, Pascual A, Codesal M, Barluenga N, Manresa C, Franch M. Extra sinus zygomatic implants: three-year experience from a new surgical approach for patients with pronounced buccal concavities in the edentulous maxilla. Clin Implant Dent Relat Res. 2010;12(1):55-61. doi:10.1111/j.1708-8208.2008.00130.x. Epub 2008 Dec 3. PMID: 19076181).
It is also noteworthy that, in 2006, the group of Dr. Reginaldo Migliorança published in Portuguese, in a non-indexed Brazilian journal, their experience placing zygomatic implants using an exteriorized technique (Migliorança et al. Exteriorização de fixações zigomáticas em relação ao seio maxilar: uma nova abordagem cirúrgica. Implant News. 2006;3(1):30).
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EL IMPLANTE TRANS-ZIGOMÁTICO
1999
C Aparicio
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A NEW METHOD FOR ACHIEVING PASSIVE FIT OF AN INTERIM RESTORATION SUPPORTED BY BRÅNEMARK IMPLANTS: A TECHNICAL NOTE
September-October 1995
C Aparicio
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RECONSTRUCTION OF THE PREMAXILLA WITH AUTOGENOUS LLIAC BONE IN COMBINATION WITH OSSEOINTEGRATED IMPLANTS
February 1993
Carlos Aparicio, Per-lngvar Brånemark, Eugene E. Keller, Jordi Olivé
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COMPARATIVE SURFACE MICROANALYSIS OF FAILED BRÅNEMARK IMPLANTS
1992
Aparicio C, Olivé J.
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PERIOTEST METHOD AS A MEASURE OF OSSEOINTEGRATED ORAL IMPLANT STABILITY
1990
Olivé J, Aparicio C.
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