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Table 1 Influence of implant design on ZAGA minimally invasive osteotomy goals

From: Round and flat zygomatic implants: effectiveness after a 1-year follow-up non-interventional study


Implant feature


Place the implant head at the optimal dental position using a prosthetically driven implant trajectory

Implant axis 55º correction

Easier ideal prosthetic positioning

Implant-to-abutment junction is not located at the zygomatic implant critical zone (ZICZ). This eliminates the possibility of bone resorption due to eventual bacterial leakage

Achieve optimal anterior–posterior distribution of the implants

Reduced apical diameter

The reduction of the apical diameter increases the possibility of divergent positioning of the implant shafts, thus improving the final AP distribution

Achieve maximal implant primary stability

Apical tapered self-cutting design

If a conservative osteotomy is performed, the difference between the diameter of the last drill and the progressive section of the implant achieves greater primary stability

Preserve as much bone as possible at the maxillary wall and alveolar bone

Threads and/or micro-threads are incorporated at the implant head/neck level

Threads, together with implant stability, facilitate osteointegration and bone stability

Maximize bone-to-implant contact (BIC) along the length of the whole implant. This includes alveolar, maxillary wall, and zygomatic bone

The tapered apical design experiences an increased diameter at the level of the implant neck. The drilling protocol shows a difference between implant diameter and last drill diameter (0,5 mm at the apical level increasing to 1,4 mm at the implant neck/head)

Increased BIC along the entire length of the implant

Achieve complete sealing of the osteotomy by the implant body

two types of implant section, round and flat

The clinician may decide which design would better adapt to the performed osteotomy

Protect sinus integrity at the implant head/neck level to prevent late sinus–oral communication

Implant-to-abutment connection is not located at the ZICZ

Threads and/or micro-threads at the head neck level

Machined surface at implant head and body

No bacterial leakage and subsequent bone resorption is expected at the ZICZ

Threads together with stability and alveolar bone contact will enhance the possibility of osseointegration

If a soft tissue recession occurs, machine-surfaced implants will maintain surrounding soft tissue health better than a rough-surfaced implant

Prevent soft tissue dehiscence

A design presenting a flat surface is available

By facing the flat surface against the soft tissue, any eventual compression of its vessels is diminished, thus decreasing the possibility for dehiscence