The ZAGA Concept — Zygoma Anatomy-Guided Approach — was developed by Dr. Carlos Aparicio, a Spanish oral surgeon and researcher who first published the protocol in 2011. His work introduced something the field had been missing: a reproducible classification system that maps each patient’s cheekbone anatomy before a single surgical decision is made.
Before the ZAGA Concept, zygomatic implant placement followed a standardised intra-sinus trajectory — the same technique applied to every patient regardless of their anatomy. This approach worked in some cases, but it was associated with a recurring pattern of complications: sinus inflammation, soft tissue breakdown, and prosthetic outcomes that were difficult to maintain long-term.
This protocol changed that. By identifying five distinct anatomical types, he gave surgeons a framework to adapt the implant path, the surgical technique, and the implant geometry to each individual patient, rather than adapting the patient to a fixed technique.