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All on X with zygomatic, transnasal and conventional implants

clinical case
Performed by Dr. Paulo Almeida, DDS, MS, PhD
Patient, a male, 65 years old with atrophic maxilla. 4 Noris Medical zygomatic implants were placed.
Due to the low torque of the right zygomatics (10 Ncm), 1 transnasal implant was installed on the right side (torque 45 Ncm) plus 1 conventional implant in the tuberosity region for subsequent rehabilitation of the patient (late loading).

Figure 1A: Initial computed tomography (3D)


Figure 1B: Initial computed tomography


Figure 2: atrophic maxilla (occlusal view)



Figure 3: marking of radiographic zones


Figure 4: marking of the entry points and paths of the zygomatic implants on the right side


Figure 5: access point performed with the ball drill


Figure 6: sinus membrane detachment


Figure 7: preparation of the 2 channels


Figure 8: channels made


Figure 9: sequence of drills performed (only up to drill number 2)


Figure 10: milling performed


Figure 11: right side zygomatic implants installed


Figure 12: quad zygoma


Figure 13: transnasal implant installed


Figure 14: final panoramic radiograph

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