Fig. 3

a CBCT cut showing the chosen virtual planning for a zygomatic implant in a maxilla classified as ZAGA type 0. The finding of adequate alveolar dimensions together with a flat maxillary wall converts the intra-sinus implant path into the first election. b Clinical picture illustrating the “tunnel type” osteotomy entrance and the external pencil guideline that has been drawn previously to the osteotomy. c Occlusal clinical picture illustrating the final position of the Straumann ZAGA-Round implant head, totally closing the circular osteotomy. d CBCT cut after one year of implant placement. Implant stability together with implant neck osseointegration into adequate bone architecture is interpreted as the reason for long-term sinus transparency maintenance. e Occlusal clinical picture showing soft tissue stability at one-year follow-up. The chosen intra-sinus path in a maxilla presenting enough residual alveolar bone and a flat maxillary wall is not associated with soft tissue problems nor with non-anatomic prostheses. (Patient treated in collaboration with Drs. Peter and Madalina Simon, ZAGA Center Stuttgart, Germany.) f Occlusal view of the provisional prostheses. Note the favorable emergence of the prosthetic screws