A protocol to perform a prosthetically driven minimally invasive zygomatic osteotomy, named zygoma anatomy-guided approach (ZAGA) is introduced. The ZAGA method aims at promoting a patient-specific therapy by adapting the osteotomy type to the patient’s anatomy. In most cases, this method avoids the opening of a window or slot into the lateral wall of the maxillary sinus before implant placement. Instead, a mucoperiosteal flap, including the posterior maxillary wall and the superior zygomatic rim, is raised to allow visual control of the complete surgical field. The surgical management of the implant site is guided by the anatomy of the patient according to specific prosthetic, biomechanic, and anatomic criteria. The ZAGA Concept represents the logical evolution of the extra-sinus technique and ZAGA classification previously described. The results of using the combination of the ZAGA Concept together with the new ZAGA implant designs consistently show less traumatic osteotomy; better implant stability; improved bone to implant contact, and bone sealing around the implant neck. Additionally, the rate of late complications such as oral–sinus communication or soft tissue recession dramatically decreases when compared to the original technique.
André Sakima Serrano is a zygomatic implant expert and oral and maxillofacial surgeon. He is one of the owners and leading surgeons at ZAGA Center São Paulo. Also, he works in the leading hospitals in São Paulo city and has experience in Orthognatic Surgery, TMJ Surgery, Implantology (All-on-4 and Zygomatic implants), facial trauma and wisdom teeth. To this day he has 18 years of experience in the rehabilitation of atrophic maxilla.
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