BASAL IMPLANTOLOGY gupta.pptx

PRESENTED BY,
SWETHA M DAS
FINAL YEAR MDS
BASAL IMPLANTOLOGY
2

• INTRODUCTION
• HISTORY
• CLASSIFICATION
• PARTS OF BASAL IMPLANTS
• BASAL IMPLANTS V/S
CONVENTIONAL IMPLANTS
• INDICATIONS
• CONTRAINDICATIONS
• ADVANTAGES
• DISADVANTAGES
• CONTRAINDICATIONS
• PERIIMPLANT BONE HEALING
• METHODS TO CREATE PERMANENT
BONE-TO-IMPLANTCONTACT
• 16 RECOGNIZED AND CLINICALLY
PROVEN METHODS FOR PLACING
BASAL IMPLANTS
• IMMEDIATE LOADING DENTAL
IMPLANT SYSTEM
• PROSTHETIC PHASE
• COMPLICATIONS
• CONCLUSION
• REFERENCES
CONTENTS
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INTRODUCTION
• Basal implantology also termed bi-cortical implantology, cortical
implantology, and strategic implantology. Cortico-Basal
Implantology® is a modern innovative implantology system which
utilizes the basal cortical portion of the jaw bones for retention of
the dental implants, which are less prone to resorption and are
infection free.
4
GuptaAD, VermaA, Dubey T, Thakur S. Basal osseointegrated implants: Classification
and review. Int J Contemp Med Res 2017;4:2329-35.

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GuptaAD, VermaA, Dubey T, Thakur S. Basal osseointegrated implants: Classification and
review. Int J Contemp Med Res 2017;4:2329-35.

HISTORY
• Jean-Marc Julliet in 1972- developed and used the first single
piece implant
• Dr. Gerard Scortecci, 1980- invented an improved basal implant
system complete with matching cutting tools.- disk implants
• Germany (mid 1990)- lateral basal implants
• Dr. Stefan Ihde introduced bending areas in the vertical implant
shaft.
• 2005 – lateral basal implants were modified to screwable designs
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BABITA Y, CHOUDHARY N, NAZISH B, GAURAV T, PRANIT K. BASAL OSSEOINTEGRATED IMPLANTS. IJAHS. 2016;3:1

CLASSIFICATION
BASAL IMPLANT TYPES BASED ON MORPHOLOGY
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Both of the types can be further categorized into
SCREW FORM
• a. Compression Screw Design (KOS Implant)
• b. Bi-Cortical Screw Design (BCS Implant)
• c. Compression Screw + Bi-Cortical Screw Design
• (KOS Plus Implant)
II. DISK FORM
• Basal Osseointegrated Implant (BOI) / Trans-
Osseous
• Implant (TOI) / Lateral Implant
• b. ZSI Implant (Zygoma Screw).
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1) According to abutment connection
i. Single Piece Implant.
ii. External Threaded Connection.
iii. Internal Threaded Connection
a) External Hexagon.
b) External Octagon.
2) According to basal plate design
i. Basal disks with angled edges.
ii. Basal disks with flat edges also called as S-Type
Implant.
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3) According to number of disks
i. Single Disk.
ii. Double Disk.
iii. Triple Disk.
III. PLATE FORM
A. BOI-BAC implant.
B. BOI-BAC2 implant.
IV. OTHER FORMS
a. TPG Implant (Tuberopterygoid).
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IMPLANTS
• The basal implants are commonly single
piece implants
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a) Basal osseointegrated implant
b) Bi cortical screw implant
a) Kos with compression screws
b) Kos implant with compression and
bicortical screws

BOI(LATERAL BASAL IMPLANTS)
 These implants are placed
in the jaw bone from the
lateral aspect.
 The masticatory load
transmission is confined to
the cortical bone structures
and horizontal implant
segments
12
Babita Y, Choudhary N, Nazish B, Gaurav T, Pranit K. Basal Osseointegrated
Implants. IJAHS. 2016;3:1

• Flapless implants that are inserted
through the gingiva, without
giving a single cut inserted like a
conventional implant
• Bicortical screws (BCS) are also
considered basal implants, as they
transmit masticatory loads deep
into the bone, usually onto the
opposing cortical bone
BCS (SCREW BASAL
IMPLANT)
13
Babita Y, Choudhary N, Nazish B, Gaurav T, Pranit K. Basal Osseointegrated Implants.
IJAHS. 2016;3:1

• Used for single or multiple
unit restoration in adequate
bone tissue
• The formation of a direct
interface between an implant
and bone, without Intervening
soft tissue
• Delayed loading 3-6 months
• Used for multiple unit
restoration, mainly in
extraction socket
• Cortical anchorage of thin
screw Implants and excellent
primary stability can be
obtained along the vertical
surfaces of these implants.
• Immediate loading 72 hours
BASAL IMPLANTS V/S CONVENTIONAL IMPLANTS
14
Ihde S. Comparison of basal and crestal implants and their modus of
application. Smile Dental Journal 2009;4:36-46

• A wide range of sizes and
designs are available.
• Basal bone is more dense,
mineralized, and less prone
to bone resorption.
• The implant surgery kit is
very simple, with very few
instruments
• Limited range of size and
design are available.
• Crestal alveolar bone, bone
has less quality and is more
prone resorption.
• A wide range of devices are
required for the placement
of two-piece implants
15

• Single sitting surgical
procedure. Implant
procedures are less time-
consuming than those
required for bridgework
• No need for bone
augmentation.
• Simple procedure.
• More complex surgical
procedures are often
necessary, spread over 2
or 3 sittings in 3-6
months
• Most of the time
additional surgery is
required.
• Requires more complex
procedures and chairside
time.
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INDICATIONS
• Situations like several missing teeth or requiring
extracted
• Failure of 2-stage implant placement or bone
augmentation procedure
• All kinds of bone atrophies.
i e, - Very thin ridge (high knife ridge, where crestal
buccopalatal bone thickness is < 2 mm; pencil mandible). -
Insufficient bone height
17
Pathania, N., Singh Gill, H., Nagpal, A., Vaidya, S. and Lalmalsawmi Sailo, J., 2021.
Basal implants – A blessing for atrophied ridges. IP Annals of Prosthodontics and
Restorative Dentistry, 7(1), pp.16-21.

CONTRAINDICATIONS
1.Heavy bruxism, clenching, uncontrolled
malocclusion, and/or a history of fractured
teeth, especially when associated with
psychological problems.
2. High-dose IV bisphosphonates used in
the treatment of severe osteoporosis or
cancer (risk of osteonecrosis of the jaw).
3. Facial and trigeminal neuropathies.
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4) Severe heart disease, recent stroke, or heart attack (risk of
infective endocarditis), Uncontrolled diabetes , Untreated
renal insufficiency.
5) Ongoing radiotherapy for cancer (risk of osteoradionecrosis
of the jaw, especially after radiation of the head and neck
region
6)Cases where bilateral equal mastication cannot be arranged

7. Allergies or hypersensitivities to chemical ingredients of
material used: titanium alloy (Ti6Al4V6 )
8. An unbalanced relationship between the upper and lower
teeth and Poor hygiene of the mouth and teeth
9. Blood dyscrasias
10. Age less than 15 years
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11. Chronic or severe alcoholism
12. Heavy smoking habit (more than 20 cigarettes per day)
13.Severe hormone deficiency
14. Drug addiction
PATHANIA, N., SINGH GILL, H., NAGPAL, A., VAIDYA, S. AND LALMALSAWMI SAILO, J., 2021. BASAL
IMPLANTS – A BLESSING FOR ATROPHIED RIDGES. IP ANNALS OF PROSTHODONTICS AND RESTORATIVE
DENTISTRY, 7(1), PP.16-21.

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TOSIC BROCHURE 2022 ; INTERNATIONAL IMPLANT FOUNDATION;(IF)

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DISADVANTAGES OF BASAL IMPLANTS
1. Compromised aesthetics with single tooth replacement .
Narrow emergence profile.
2. Skilled surgeon with sound anatomic knowledge is
required to carry out successful surgery.
3. Overload osteolysis can be seen, if load distribution is not
done properly.
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DESCRIPTION OF METHODS TO CREATE PERMANENT
BONE-TO-IMPLANTCONTACT.
CLINICAL INDICATIONS AND MODALITIES FOR THESE
The
Osseointegration
Approach
The
“Compression of
Spongious Bone”
Approach
The Approach of
“Lateral Basal
Implants” and
“Blade Implants
4TH IF® CONSENSUS DOCUMENT FOR ORAL IMPLANTOLOGY: DESCRIPTION OF METHODS TO CREATE
PERMANENT BONE-TO-IMPLANT CONTACT. CLINICAL INDICATIONS AND MODALITIES FOR THESE METHODS
© 2022, INTERNATIONAL IMPLANT FOUNDATION, MUNICH/GERMANY 40

Image above illustrates an implant inserted to achieve
“osseointegration”. The crestal cortical bone and the spongious
bone will (must) develop now more bone on the implant’s surface.
A procedure that takes 3-6 or more months. To ensure that all the
necessary processes will happen, enough spongious bone must be
available between the endosseous surface of the implant and the
outer cortical to secure the constant supply of nutrients to the
repair site.
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PERMANENT BONE-TO-IMPLANT CONTACT. CLINICAL INDICATIONS AND MODALITIES FOR THESE METHODS
© 2022, INTERNATIONAL IMPLANT FOUNDATION, MUNICH/GERMANY

Image above illustrates the bone-implant contact region after a
vertical cortical bone contact has been established along the implant
body. The crestal and vertical cortical bones form one functional unit.
Osseointegration is considered complete, and the (2-stage) implant
can be effectively used/loaded.
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PERMANENT BONE-TO-IMPLANT CONTACT. CLINICAL INDICATIONS AND MODALITIES FOR THESE
METHODS © 2022, INTERNATIONAL IMPLANT FOUNDATION, MUNICH/GERMANY

II. The “Compression of Spongious Bone” Approach
• All endosseous implants with a conical shape design must
be considered as “compression screws” implants. The drill
hole into which the implant is inserted is under-
dimensioned, at least in width, compared to the implants
inserted later.
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PERMANENT BONE-TO-IMPLANT CONTACT. CLINICAL INDICATIONS AND MODALITIES FOR THESE
METHODS © 2022, INTERNATIONAL IMPLANT FOUNDATION, MUNICH/GERMANY

• An under-dimensioned conical drill removes a minimal amount
of bone, just enough to allow placement of the implant with
compression force up to approximately 80 Ncm.
• Subsequent to implant insertion, the spongious bone is
displaced laterally and compressed both laterally and at the
apex of the implant, forming a higher mineralization zone. This
process has been named “corticalisation of spongious bone”.
44
4TH IF® CONSENSUS DOCUMENT FOR ORAL IMPLANTOLOGY: DESCRIPTION OF METHODS TO
CREATE PERMANENT BONE-TO-IMPLANT CONTACT. CLINICAL INDICATIONS AND MODALITIES
FOR THESE METHODS © 2022, INTERNATIONAL IMPLANT FOUNDATION, MUNICH/GERMANY

3. The approach of “lateral basal implants” and
“blade implants”
• Both the “lateral basal implants” and “blade implants” are
hammered into thin slots in the bone. Implants in this
approach gain their primary stability by getting their plates
stuck between the corticals. After this, the bone slot is filled
with woven bone. Both implant designs (lateral basal
implants and blade implants) tend to fail, if the implants are
not in contact with cortical bone in the final position.
45
4TH IF® CONSENSUS DOCUMENT FOR ORAL IMPLANTOLOGY: DESCRIPTION OF METHODS TO
CREATE PERMANENT BONE-TO-IMPLANT CONTACT. CLINICAL INDICATIONS AND MODALITIES
FOR THESE METHODS © 2022, INTERNATIONAL IMPLANT FOUNDATION, MUNICH/GERMANY

PERI-IMPLANT HEALING (BOI AND BCS
IMPLANT)
• Implants have a unique design
their peri-implant healing is
also unique.
• According to philosophy of
basal implantology the
process of Osseoadaptation is
carried out by a “Bone
Multicellular Unit” (BMU).
PATHANIA N, GILL HS, NAGPAL A, VAIDYA S, SAILO JL.
BASAL IMPLANTS – A BLESSING FOR ATROPHIED RIDGES. IP ANN PROSTHODONT RESTOR DENT 2021;7(1):16-21.
46

• The formation of this BMU takes place when the BOI and
BCS implant are subject to immediate loading which leads
to remodeling of bone under functional stresses leading to
development of this unit, and thus initiates the healing
phase and leads to formation of a dense peri-implant bone.
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BASAL IMPLANTS – A BLESSING FOR ATROPHIED RIDGES. IP ANN PROSTHODONT RESTOR DENT
2021;7(1):16-21.

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CASCADE OF PROCESS
Activation
Phase
Resorption
Phase
Reversal
Phase
Progressive
Phase
Mineralization
Phase
Dormant
Phase
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2021;7(1):16-21.

Activation phase
• In this phase, lasting for three days, the precursor Cells/human
mesenchymal stem cells develop into osteoblasts and osteoclasts.
Resorption phase
• In this phase, osteoclastic activity begins and shows soft and
porous bone.
Reversal phase
• In this phase, the osteoblastic activity occurs, where the
Osteoblasts lay down new bone in the haversian canals at a rate
of 1-2micro metres /day.
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2021;7(1):16-21.

PROGRESSIVE PHASE
In this phase, the osteoblasts forms concentric lamella in haversian
canals, which leads to reduction in diameter of the canal and
increase in bone density. At this stage the diameter of the haversian
canal is 40-50 micro metres. Non-Mineralized Matrix Osteoid is
the newly formed bone and this phase lasts for 3 months.
MINERALIZATION PHASE
• This phase begins after ten days of osteoid formation.
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It should be noted that throughout these phases the implants are
under functional loads and because of which there is a continuous
stimulation of the BMU throughout the life of the implant, which
causes the peri-implant bone to become dense (which increases
throughout the implants life) and to adapt over the surface of the
implant, thus the term “Osseoadaptation”, and this is how
remodeling plays a key role and is called as the “4th Dimension”
52
PATHANIA N, GILL HS, NAGPAL A, VAIDYA S, SAILO JL. BASAL IMPLANTS – A BLESSING FOR
ATROPHIED RIDGES. IP ANN PROSTHODONT RESTOR DENT 2021;7(1):16-21.

DORMANT PHASE
During this phase, osteocytes develop from osteoblasts and
line the haversian canals and perform the
mechanical,metabolic and homeostatic functions.
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BASAL IMPLANTS – A BLESSING FOR ATROPHIED RIDGES. IP ANN PROSTHODONT RESTOR DENT 2021;7(1):16-
21.

16 RECOGNIZED AND CLINICALLY
PROVEN METHODS FOR PLACING BASAL
IMPLANTS
54

ANTONINA I, LAZAROV A, GAUR V, LYSENKO V, KONSTANTINOVIC V, GROMBKÖTÖ G, ET AL. CONSENSUS REGARDING 16
RECOGNIZED AND CLINICALLY PROVEN METHODS AND SUB-METHODS FOR PLACING CORTICOBASAL® ORAL IMPLANTS. ANN
MAXILLOFAC SURG 2020;10:457-62.
55
(a) Corticobasal® implant with an
apical cutting thread and a polished
shaft. This abutment head features
a multiunit design, and it is
designed for a screw connection to
prosthetics.
(b) Corticobasal® implant with an
apical cutting thread and a polished
shaft. This abutment head is
designed for cementing.
METHOD 1

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Converging placement of four Corticobasal® implants in the
interforaminal region of the mandible. This way of placement
ensures safety for the mental nerve, optimum utilization of the
corticalized bone.
METHOD 2

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METHOD 3
Placement of implant(s) in the gap between the root of the canine
and the mental nerve, with the implants reaching far deeper
(caudal) than the root of the canine.
ANTONINA I, LAZAROV A, GAUR V, LYSENKO V, KONSTANTINOVIC V, GROMBKÖTÖ G, ET AL. CONSENSUS
REGARDING 16 RECOGNIZED AND CLINICALLY PROVEN METHODS AND SUB-METHODS FOR PLACING
CORTICOBASAL® ORAL IMPLANTS. ANN MAXILLOFAC SURG 2020;10:457-62.

58
METHOD 4
Nerve bypass, on the lingual or vestibular side of the nerve.
With or without anchorage in the basal (2nd) cortical

59
METHOD 5
ANTONINA I, LAZAROV A, GAUR V, LYSENKO V, KONSTANTINOVIC V, GROMBKÖTÖ G, ET AL.
CONSENSUS REGARDING 16 RECOGNIZED AND CLINICALLY PROVEN METHODS AND SUB-METHODS
FOR PLACING CORTICOBASAL® ORAL IMPLANTS. ANN MAXILLOFAC SURG 2020;10:457-62.

METHOD 6:
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CONSENSUS REGARDING 16 RECOGNIZED AND CLINICALLY PROVEN METHODS AND SUB-
METHODS FOR PLACING CORTICOBASAL® ORAL IMPLANTS. ANN MAXILLOFAC SURG 2020;10:457-
62.
(a) The implant is engaged into the vestibular and lingual cortical of the maxilla,
without reaching the cortical of the floor of the maxillary sinus (as a 2nd cortical).
The method is used often if earlier implants fail and the 2nd cortical in the axial
direction is not available.
(b) This is often used in the anterior mandible and skeletal Class 2 cases. These
cases provide often a sand clock-shaped (anterior) mandible and the isthmus
provides additional possibility as well as vertical support

METHOD 7
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a) The implant in the area of the 1st upper molar engages into
the floor of the sinus as the 2nd cortical. (b) The implant in the
area of the 1st upper molar engages into an intrasinusal buttress
as the 2nd cortical.
METHOD 8

• In this two/three walls of the
sinus are sectioned to
facilitate placement of the
basal disk in the sinus
• The sole purpose of this
technique is to gain bi-
cortical support; also only
one implant can be placed
this way in each sinus.
SINUS SECTION TECHNIQUE
CORTICOBASAL® ORAL IMPLANTS. ANN MAXILLOFAC SURG 2020;10:457-62. 63

METHOD 9
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Canine bypass. The implant is inserted
in an oblique direction of the sphenoid
bone from the area of the 1st upper
premolar, it is bypassing the root of the
canine on the palatal side of the root,
and it reaches the floor of the nose
where it is anchored cortically.

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One or two implants are inserted through the distal maxilla into the
fusion zone between the distal maxilla and the pterygoid process
of the sphenoid bone
METHOD 10

• These implants are placed in
the pterygoid bone and aid in
providing additional support to
the prosthesis. These are used
in conjunct with Sinus Section
technique and are placed at 20º-
45º in the bone and the
angulation between BOI
implant and TPG screw should
not exceed 90º otherwise
prosthesis placement becomes
difficult
TUBEROPTERYGOID (TPG)
SCREWS
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Anchorage in the bone on the palatal side of the maxillary
sinus, without anchorage in the nasal floor or in the median
raphe of the maxilla.
METHOD 11
CONSENSUS REGARDING 16 RECOGNIZED AND CLINICALLY PROVEN METHODS AND SUB-
METHODS FOR PLACING CORTICOBASAL® ORAL IMPLANTS. ANN MAXILLOFAC SURG 2020;10:457-
62.

METHOD 12
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Anchorage of the implant in the body of the zygomatic bone:
Using a trans-sinusal procedure or inserting from caudal,
directly into the body of the zygomatic bone

These are zygomatic
implants that are placed in
the zygomatic bone and like
the BCS implant these also
have sharp edged cortical
screws that gain bicortical
support .
ZYGOMATIC SCREW IMPLANT (ZSI)
69
ANTONINA I, LAZAROV A, GAUR V, LYSENKO V, KONSTANTINOVIC V, GROMBKÖTÖ G, ET AL. CONSENSUS REGARDING
16 RECOGNIZED AND CLINICALLY PROVEN METHODS AND SUB-METHODS FOR PLACING CORTICOBASAL® ORAL
IMPLANTS. ANN MAXILLOFAC SURG 2020;10:457-62.

70
METHOD 13
Anchorage of the load-transmitting threads of the implants into the
cortical base of the mandible if knife-edge ridges are present,
which are larger than the implant. The vertical implant parts run
vertically and subperiosteally. Implant length and abutments are
placed with respect to a good possibility to provide prosthetic
equipment.

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Anchoring an implant in the fresh
extraction socket of the first or
second premolar with at least mesial
and distal cortical anchorage in the
bone of the extraction socket.
Utilizing the medial cortical of the
mandible increases the anchorage.
METHOD 14

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METHOD 15
Anchoring a larger diameter
implant into the fresh extraction
socket of the palatal root of the
upper first or second molar

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(a) Two implants are placed into the extraction socket of a two-rooted 1st upper
premolar. The implant on the palatal side is placed according to Method 9; the
vestibular implant is placed in the vestibular socket of the root. (b) Two implants are
replacing the 1st upper molar: the smaller implant inserts into the extraction socket of
the palatal extraction root (4.6 mm in diameter), whereas the vestibular socket is
equipped with a longer implant (3.6 mm in diameter)
METHOD 16

CORTICALLY FIXED @ ONCE.
• Introduced by Dr. Henri Diederich in 2013
• This is basically a plate form implant, which looks like mini plates
(used for fracture reduction) with an abutment platform, this
unique design allows them to be bent and adapt to any surface and
is anchored to bone using bone expanding mini screws .
74

IMMEDIATE LOADING DENTAL
IMPLANT SYSTEM
1.Use a DOS 1 or BCD 1 (yellow) drill for pre-drilling.
2.Use the shaping drill to the implant bed to full length. Use
an intermittent drilling technique and copious saline
irrigation.
3.The laboratory might insert guide sleeves (BFH) into the drill
holes to ensure that the drilling angle is exactly correct.
SIMPLADENT SINGLE PIECE SAP BROCHURE 75

In hard bone, if the full drilling depth is difficult to attain
with DOS 1, use the DS 2 cylinder drill (2 mm) to
achieve the correct depth
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SIMPLADENT SINGLE PIECE SAP BROCHURE

DRILLING /PREPARING
• DOS 2 / BCD 2
• Determine the correct direction and depth; alternatively, use BCD
1 “pathfinder” drill.
DS 2 pilot drill
• Use for hard bone, but only in the cortical area.
77

IMPLANT PACKAGING
• All KOC® implants are used as compression screws. In
order to acchieve a good bone condensation and implant
stability, the drilling should be carried out thinner than the
core diameter of the implant. The minimal diameter of the
drill depends on the bone density.
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• It is therefore not possible to advise drill-sequences which fit all
bone-qualities.
• Typically in the soft maxillary bone only small drill-diameters
are used (e.g. the usage of DOS1 only, for implants with 3.0 - 5.0
mm diameter), whereas in the highly mineralized lower jaw a
specific drill sequence with respect to the mineralisation of the
bone is necessary.
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REMOVE THE IMPLANT FROM ITS
PACKAGING
1.Open the lid.
2.The implant is fixed to the lid by a
break joint.
3.Remove the implant without touching
the inner wall of the tube.
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HANDLING
• Hold implant at the carrier,
and place the placement aid
on the implant head.
• Do not touch the endosseous
implant surface.Remove the
implant complete with the
plug and then remove the
plug at the break line.
81

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DEFINITIVE IMPLANT INSERTION
• Use the ratchet, torque wrench or angled handpiece to screw the
implant clockwise into the implant bed.
• The roughened endossous aspect of the implant must be completely
submerged in the bone.
• The polished implant head must be at the level of the mucosa. For
KOC, KOC Micro and BECES ex, TPG Uno and BECES N
• It is recommended to screw the implant so deep into the bone that 1
mm of the thin & polished implant shaft (above the thicker,
endosseous area) is below the level of the 1st cortical.
83

RECOMMENDED TORQUE LIMITATION
PROVIDED FOR THE BASAL IMPLANTS
1. Basal implant from diameter 3 .0 mm, via direct insertion -
Never exceed 117 Ncm
2. Basal implant from diameter 4.5 mm - 5.0 mm, via direct
insertion - Never exceed 238 Ncm
3. Basal implant from diameter 5.5 mm, via direct insertion -
Never exceed 298 Ncm
84

• Intraoperatively, rupture of palatine vessels while placing
pterygoid implants
• Nasal bleeding and breakage of drill while placing
implants anchoring floor of the nose
• Breakage of drill while drilling for pterygoid implants,
however, it could be easily retrieved.
COMPLICATIONS
89
PATEL K, MADAN S, MEHTA D, SHAH SP, TRIVEDI V, SETA H. BASAL IMPLANTS: AN ASSET FOR REHABILITATION OF
ATROPHIED RESORBED MAXILLARY AND MANDIBULAR JAW – A PROSPECTIVE STUDY. ANN MAXILLOFAC SURG
2021;11:64-9.

• Immediately postoperatively, ecchymosis intraorally as well as
extraorally could be seen which disappears in 1-2 weeks
• Sometimes reduced mouth opening after pterygoid implant
placement due to injury to muscle fibers which gradually
returns to normal.
• Postoperatively, ceramic chipping off from metal framework
and prosthesis loosening due to de-cementation can happen
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2021;11:64-9.

• Overload osteolysis around a single implant due to high
cuspal contact.
• The key for the long-term survival is proper case
selection, atraumatic extraction, achieving primary stability
and anchorage from second or third cortical, rigid
prosthesis fabrication with occlusion concept outlined by
Dr Ihde, achieving equal bilateral mastication and
lingualized occlusion, maintaining good oral hygiene, and
routine follow-up at regular intervals.
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2021;11:64-9.

Shahed et al. stated that basal implants may lead to
submucosal infection. This may result in infected vertical
parts if the implants are submerged below the mucosal level
over time, eliminating the necessary gateway for suppuration
as the area of penetration is closed with scar tissue. Any
inflammation of this type will spread just like a submucosal
abscess and is treated in the same way.
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2021;11:64-9.

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• Evolution of basal implants have given positive hope for
the patients with atrophied ridges which can be
rehabilitated not only by avoiding augmentation
procedures,time,cost but also by immediately loading of
prosthesis making them more confident and socialize
normally.
• Sometimes the best solutions are found in unconventional
• Also with respect to the accepted principle “primum nihil
nocere”, i.e. limiting treatment, basal implants are the
devices of first choice, whenever (unpredictable)
augmentations are part of an alternative treatment plan.
CONCLUSION

REFERENCES
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1) Yadav RS, Sangur R, Mahajan T, Rajanikant AV, Singh N, Singh R. An
alternative to conventional dental implants: Basal implants. Rama Univ J
Dent Sci 2015;2:22-8.
2) GuptaAD, VermaA, Dubey T, Thakur S. Basal osseointegrated implants:
Classification and review. Int J Contemp Med Res 2017;4:2329-35.
3) Nair C, Bharathi S, Jawade R, Jain M. Basal implants - a panacea for
atrophic ridges. Journal of dental sciences & oral rehabilitation, 2013; 1-4.
4) Patel K, Madan S, Mehta D, Shah SP, Trivedi V, Seta H. Basal implants:
An asset for rehabilitation of atrophied resorbed maxillary and mandibular
jaw – A prospective study. Ann Maxillofac Surg 2021;11:64-9.

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4) Niswade Grishmi, Mishra Mitul. Basal Implants- A Remedy for Resorbed
Ridges. WJPLS 2017;3:565-572.
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