Clinical Case N° 17: Zygoma Quad, Zaga 4

Abstract

Cecilia’s case represents an excellent example of the treatment power and predictability of the sum of the ZAGA Concept and the use of the right tools, which in this case were our ZAGA Round and ZAGA Flat zygomatic implant designs. Cecilia had previously been treated with regular implants that failed. She presented an extreme resorption of the maxilla both at the level of the alveolar bone and the anterior wall which was so thin that it had a tendency to break when trying to cut it. However, the biggest challenge of her anatomy was represented by an extra-thin zygomatic bone that offered a doubtful anchorage power to place implants. Due to this bone fragility at the zygomatic level and the need to place two implants on each side, the risk of causing a fracture of the zygomatic bone was assessed. After an uneventful soft tissue detachment, we used the ZAGA technique of reverse drilling to cut without breaking the maxillary wall. Two channel-type osteotomies were created and two Straumann ZAGA Flat implants were placed in both posterior sectors classified as ZAGA type 4. In the anterior areas the ZICZ was placed at lateral canine tooth level. Both were classified as ZAGA type 2 and Straumann ZAGA Round zygomatic implants were used to seal the two osteotomies which, although incomplete, were classified as “tunnel” type.