Before

What are the causes of maxillary atrophy?

Maxillary atrophy usually occurs after tooth extractions, either due to dental infections and tooth decay, fractures or periodontal infections around the teeth, such as periodontitis or pyorrhea. Shrinkage of the maxillary bone can also be caused by losing dental implants or by bone graft failure. When sinus grafts fail, it is normal for maxillary atrophy to manifest more severely in the posterior areas of the mouth. Hormonal factors can also influence maxillary bone loss and is therefore common in middle-aged women. Finally, maxillary bone loss can be the result of resective neoplasm treatment, which affects the craniofacial bones.

Zygomatic Diagnostic
3D view of the patient CT

What is severe maxillary atrophy and how is it treated today?

In certain situations, the bone of the upper jaw can “shrink” and become significantly smaller to the point that sometimes, it can literally disappear. This is what is known as “bone loss”. The result of this is an upper maxillary bone made up of a very pneumatized sinus that contains a lot of air and is separated from the mouth by a thin bone septum, only a few millimeters thick. Colloquially, this is also known as “jawbone loss,” a situation where there is not enough bone material for conventional implants to be placed. Currently, our process involves using the cheekbone, or zygomatic bone, to anchor implants and place fixed teeth in 24 hours.

Zygomatic Implants Indications

What types of cases are zygomatic implants recommended for?

Zygomatic implants are used as a last resource for people with bone loss in order to avoid the use of bone grafts, which are more aggressive and less predictable. When your ZZC surgeon uses the ZAGA method to place your zygomatic implants, you will benefit from having fixed teeth in just one day that are more aesthetic and similar in appearance to your original teeth. In addition to providing a better long-term prognosis, this procedure is less invasive, is specifically designed to adjust to your personal anatomical characteristics and the method makes patients less likely to encounter the complications of other zygomatic implants.

Zygomatic Diagnostic

What diagnostic testing is needed?

In addition to an intraoral examination, a panoramic X-ray is generally needed as well as an X-ray computed tomography, such as a Cone Beam CT. These tests do not eliminate the need for other medical tests.

Zygomatic Treatment Length

How long does it take to complete the treatment?

After the zygomatic implants are placed, and generally within 24 hours of the procedure, patients will receive a fixed denture called an “immediate prosthesis.” The final prosthesis is created after a 4-month period of using the provisional fixed teeth, during which time a soft diet is recommended. Throughout these first few months, it is normal for the inflammation in the gums to reduce; this creates gaps between the prosthesis and the gums that get bigger over time. The final prosthesis will fill these gaps and correct other technical and aesthetic aspects.

During

ZAGA Book

What is the ZAGA method for zygomatic implants?

The placement of zygomatic implants with the ZAGA method uses a minimally invasive osteotomy by following an individualized route for each patient that often passes through part of the maxillary sinus until it is anchored in the zygomatic (malar) bone. Zygomatic implants are used to attach fixed teeth to atrophic maxillary bones by avoiding the need for and the complications of bone grafts in the maxillary sinus, nose or alveolar ridge. Zygomatic implants are therefore the preferred option for restoring the missing teeth of people who cannot receive regular implants due to maxillary bone loss.

ZAGA Zygomatic Implants

What are zygomatic implants?

Zygomatic implants are longer than conventional implants. Starting at the residual maxillary bone, they are anchored to the zygomatic bone, malar bone or cheekbone. One of the distinguishing characteristics of the zygomatic bone is that, unlike the maxillary bone, tooth loss does not cause it to atrophy. Zygomatic implants are used to secure fixed teeth in atrophic maxillary bones and help prevent complications that derive from the use of bone grafts in the maxillary sinus, nose or the alveolar ridge. Zygomatic implants are therefore the preferred option for treating tooth loss in patients who cannot have regular implants because of a lack of enough maxillary bone.

ZAGA Zygomatic Implants

Are all zygomatic implants the same?

There are differences among the zygomatic implants that are currently available on the market. It is worth pointing out that, in addition to the surgical procedure, the design and composition of the implant to be used is also important in order to maximize the long-term success of the treatment. For this reason, results and potential complications vary widely depending on the materials and methodology used.

The ZAGA platform not only advocates for adapting the technique to each individual patient, but for adapting the implant’s design to the patient. Some of the benefits to ZAGA zygomatic implants are that their dimensions can adapt to the very complex cases of people who have severe atrophy, such as with female patients, and that placing these implants requires a less invasive procedure. ZAGA Centers give preferential access to implant procedures and other ZAGA designs.

ZAGA Centers

How long does it take to complete the treatment?

After the zygomatic implants are placed, and generally within 24 hours of the procedure, patients will receive a fixed denture called an “immediate prosthesis.” The final prosthesis is created after a 4-month period of using the provisional fixed teeth, during which time a soft diet is recommended. Throughout these first few months, it is normal for the inflammation in the gums to reduce; this creates gaps between the prosthesis and the gums that get bigger over time. The final prosthesis will fill these gaps and correct other technical and aesthetic aspects.

ZAGA Collaboration
Dr Costa Nicolopoulos (Dubai) and Dr Aparicio (Barcelona) sharing opinions on a Patient’s treatment

Why is a ZAGA center the best place to get zygomatic implants?

Zygoma Zaga Centers bring in both regional and local patients with severe maxillary atrophy, making them the real experts on maxillary atrophy (bone loss in the mouth). ZZCs have the capacity to treat more patients and therefore have the experience to handle your case successfully. They also have established the protocols for achieving superior long-term results and have access to state-of-the-art technology such as the ZAGA model for zygomatic implants that are specifically designed to adapt to the anatomy of each person. For the ZZC team, the patient is the center of our treatment. The seasoned professionals of the ZAGA method understand and empathize with the patient’s suffering, in whatever form this may present. As leading experts in treating advanced bone atrophy, your ZZC will adapt the treatment and the zygomatic implants to your specific anatomy, and not the other way around. In other words, ZZCs promote the ZAGA philosophy of providing therapy that is specific to each patient (patient-specific therapy), a philosophy that is commonly used in medicine today to maximize the duration of successful treatment.

After

ZAGA Approach

What is the success rate of this procedure?

At 92%, treating tooth loss with fixed prosthesis anchored on zygomatic implants has a very high 10-year success rate. With new developments such as the ZAGA method, these implants now improve patients’ prognosis by reducing the number of related complications.

Zygomatic Implant Success
A surgery taking place in the ZAGA Center Barcelona, Spain

What can be done if an implant is not successful?

There are few options to deal with the unsuccessful placement of a zygomatic implant. It is our firm belief that in the great majority of cases, patients who lose their teeth and have severe atrophy in their maxilla have only ONE opportunity to treat this tooth loss with fixed teeth, so the process has to be performed right on the first try. This is why it is best to rely on a center that is highly specialized in the restoration of extreme maxillary atrophy with zygomatic implants.

3d Model Zygomatic Implant
Personalized 3D Model used to prevent complications

Can there be complications?

As with all surgeries, there is always a potential for complications, so you should ask about your specific case in order to be informed of these in detail. Generally, however, the ZAGA method prevents oro-antral communication-related complications, which are common with other methods. Compared to traditional zygomatic implant techniques, the dental prosthesis used in the ZAGA method takes up a natural space in the mouth, as its dimensions are very similar to those of original teeth, which helps improve aesthetic aspects, maintenance and hygiene.

Implante cigomatico

What type of teeth will I have after the procedure?

After the zygomatic implants are placed, and generally within 24 hours of the procedure, patients will receive a fixed denture called an “immediate prosthesis.” The process of permanently screwing-on teeth to the implants immediately after the operation for implant placement is called “immediate loading.” With this process, patients must have an understanding of the biological process of bone tissue repair, along with the technical aspects that must be considered for this immediate prosthesis. The general recommendation is for patients to maintain a soft diet and not smoke for approximately four months.