Fig. 4

a Oblique CBCT cut illustrating the planned implant path in a ZAGA Type 3 anatomy, starting from the lateral incisor/canine area until reaching the zygomatic bone. Note that the antrostomy zone (AZ) is planned far from the zone where the implant meets the alveolar bone or Zygomatic Implant Critical Zone (ZICZ). b Clinical picture illustrating a Straumann ZAGA-Round implant being screwed into the osteotomy planned in a. The tapered implant tip has a rough surface, whereas its body has a turned one. c The oblique cut of the DTX Studio Implant software (Nobel Biocare AB) is showing 3-D and 2-D images of the Straumann ZAGA-Round zygomatic implant one year after its placement. Sinus transparency is facilitated by the maintenance of sinus lining integrity at the level of the ZICZ and the placement of the AZ is located far from the ZICZ. Note that remains of alveolar bone have been maintained buccally to the implant neck to facilitate soft tissue fibers attachment preventing dehiscences. d Occlusal image of the patient represented in a–d taken 24 months after the surgery. Soft tissue maintenance is facilitated by several factors like adequate incision design, the use of site-specific implants, respect for alveolar bony remains maintenance, and correct placement of the ZICZ. (In collaboration with Drs. Pedro Guitian and Elena López ZAGA Center Vigo Spain and Drs. Edmon Bedrossian and Sepehr Zarrine.)