Basal Implants
Basal implantology comes from the type of dental implant called “basal” or “cortical” which is the hardest bone in the jawbone.
The basal implant is the dental implant solution to be used in the most severe cases of missing bone and for complete dental reconstruction of the jaw.
What is basal implantology?
Basal implantology is one of the implant solutions to be used in the most severe cases of missing bone. However, we will also see that other techniques should be considered before basal implantology, which should only be used as a last resort and in very specific cases.
It is only after having assessed the risks of the various possible solutions that the surgeon will choose basal implantology.
The cortical bone
The adjective basal (basic) is used to differentiate the basal dental implant from the classic implant in the sense that it is inserted deep into the base of the bone.
The base of the bone into which this type of implant fits deeply is called the cortical bone. A classic implant is inserted into the alveolar bone which is more on the surface.
Basal implantology: Different types
“Cortical” basal implant
The principle of the basal implant is based on its mode of retention. When a traditional implant requires osseointegration (healing of the bone) in the spongy part of the bone, the basal implant is fixed like a screw in the hard and mineral part of the bone. This part of the bone does not osseointegrate. The basal dental implant must therefore be loaded immediately so that the prosthesis acts as a link between each basal implant and can guarantee the correct distribution of masticatory forces over the entire jaw.
The basal implant has been known and practiced for many years, its name comes from the part of the bone in which it is implanted, the basal part, also called cortical bone. It is the most mineralized part of the bone, the hardest. Conversely, the traditional implant is implanted in the spongy part of the bone which requires osseointegration and therefore a long treatment time.
2 types of basal implant. Disc implants (BOI implant) which are the first generation of basal implants, and the latest generation basal implant BAx.
Basal implantology: Things to know!
Contrary to what some people think, basal implantology is not intended to provide a one-step implantation treatment with an immediate permanent fixed dental prosthesis. An immediate fixed prosthesis is permitted but it must be temporary.
This technique is sometimes controversial, sometimes presented as a miracle treatment or as the future of implantology.
If you think you need basal implantology, this article allows you to sort things out with explanations and visual examples.
Who is the basal implants for?
Basal implantology is intended for people with very little bone in the upper jaw and who generally need to reconstruct the entire complete jaw on implants. It is possible to place a basal implant in a patient who only needs to redo a part of the jaw, but in general this applies rather to the complete jaw. See the patient’s case.
Bone thickness
When a patient has less than 5 mm of bone, the basal implant is an option.
Between 5 and 8 mm of bone, short implants will be preferable because they are both less invasive, just as strong and durable, without requiring a bone graft.
Between 8 and 12 mm of bone, it will be rather recommended to use a small bone graft or sinus lift in order to be able to put classic implants or short implants without a graft.
From 12 mm of bone, in general, conventional implants can be placed.
Of course, these rules are not absolute. The complete analysis of the dental and bone situation can lead to other recommendations if this is justified for the well-being of the patient.
The different types of basal implant
Cortical Basal Implantology
The simple basal implant is a long and straight implant.
It is generally used instead of conventional implants when there is a lack of bone, to avoid grafting. To allow the patient to receive a fixed crown or bridge directly after implant placement. Even with basal implantology, you have to wait a few months for the gums to heal to make a 100% suitable dental prosthesis, so a second step is necessary.
This option with temporary fixed teeth is much more comfortable than wearing removable dentures. The temporary teeth are replaced by permanent teeth in metal-ceramic or Zirconia-Ceramic 4 to 6 months after the first intervention. This healing period allows the gums to stabilize after surgery to produce new permanent teeth that are perfectly adapted.
Advantages of the basal implant
Avoid bone grafting
The great advantage of the basal implant is to avoid heavy bone grafting.
People with chronic sinusitis can benefit from this technique so as not to risk complications.
Sometimes a bone graft requires the removal of autogenous bone, that is to say: from another bone of the same patient. This type of procedure has additional risks associated with this additional surgery. This also has a generally significant cost.
Time saving
This second advantage is a consequence of the first.
When a patient receives a large bone graft, it is not possible to place the implants during the same procedure. It is then necessary to wait at least 6 months for the graft to take before placing the implants. Then the period of osseointegration of the implants lasts another 6 months before being able to place the definitive prostheses. The total duration is then more than 12 months.
Strong initial stability
The third advantage is the initial stability of the basal implant. This is so deep that it very easily allows the immediate placement of a fixed prosthesis directly a few days after surgery.
Immediate but temporary fixed prosthesis
A fixed implant prosthesis placed immediately (a few days) after surgery should always be temporary. A permanent prosthesis should not be placed directly. The gums are swollen and will deflate in the following weeks.
By deflating, the gums leave an empty space between the teeth and the gum. It is therefore necessary to wait 4 to 6 months after the surgery for the gums to deflate and stabilize. Then a new dental impression which is used to create the definitive dental prosthesis (crown or bridge).
This applies equally to conventional implants as well as to the basal implant. As well as for cases of implant placement directly after extraction, such as the case where the patient has already waited 3 months after the extraction to place their implants.
Basal implantology price
The cortical basal implant treatment costs between 12,000 and 20,000 euros for the full mouth. The price depends mainly on the final material of the teeth (Ceramic or Zirconia).
The zygomatic basal implant is around the same price.
These prices are the prices I found abroad where my father went for treatment. Contact me for more information.
Placing a basal implant requires specific skills. A maxillofacial surgeon must perform the procedure.
This work is carried out in 2 stages of 8-10 days, with an interval of 4-6 months during which the patient wears his temporary fixed teeth before returning for the permanent teeth.
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