Traditionally, a severely resorbed maxilla with sinus pneumatization would need multiple surgeries including sinus augmentation/lifts and bone grafts to rebuild enough bone mass to create a sufficient foundation for traditional dental implant placement. In severely resorbed cases, zygomatic implants are the only possibility to rehabilitate the patient immediately. Zygomatic implants have been an evidence-based surgical and prosthetic solution since 1999. With the development of the zygomatic implant, the placement of Brånemark System® Zygoma implants has been simplified, which has eliminated the need for bone grafting altogether. Zygomatic implants are developed for the graftless approach in which the implant is directly loaded into the zygomatic bone bilaterally, combined with two to four conventional anterior implants loaded within the alveolar bone, allowing for immediate load and function of a fixed implant-supported prosthesis. Zygomatic implants have revolutionized traditional dental implant techniques and considerations for the severely atrophic patient minimizing surgeries, healing, and overall treatment time. This presentation will discuss critical factors from work-up and pretreatment planning to important considerations for providing an immediate fixed implant-supported restoration. Learning Outcomes: - Understand pretreatment planning, including considerations for the provisional prosthesis. – Be able to review anatomical and biological considerations of the maxilla and zygomatic bone. – Become familiar with and understand the three basic techniques for zygoma implant placement: inter-sinus, extrasinus, and extra-maxillary. – Go over recorded surgical video with live Q&A for detailed understanding. – Discuss management of complications and maintenance of zygomatic implants. – Be familiar with prosthetic solutions for zygomatic implants.