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
Goal | Implant feature | Results |
|---|---|---|
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 |