Basal implant - a newer variety of implant system

a pictorial presentation on basal implants

1. PROSTHETIC REHABILITATION BY BASAL IMPLANTS Dr. Bhupendra Rizal

2. Implantology starts where others gave up. Basal implants also offer a unique opportunity for the implantologist to treat cases which cannot be treated with the conventional implant systems. Dr. Bhupendra Rizal

3. “Basal Implant” is a term used in reference to the principles of utilizing basal bone areas which is free of infection and resorption, and the employing of the cortical bone areas. The load bearing tolerance of the cortical bone is many times higher than that of the spongious bone BASAL IMPLANTS Dr. Bhupendra Rizal

4. COMPARISON BETWEEN CONVENTIONAL CRESTAL AND BASAL IMPLANTS Dr. Bhupendra Rizal

5. There are four basic types of basal implants available II Disk Form. IV Other Forms. Both of the types can be further categorized into- I. 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) Dr. Bhupendra Rizal

6. Triple disc BOI implants with or without beveling , larger disc at the bottom Dr. Bhupendra Rizal

7. Basal Disk Implant / Basal Osseointegrated Implant (BOI); Bi-Cortical Screw (BCS) Implant KOS Implant with Compression Screws; b. KOS+ Implant with Compression and Bicortical Screws Dr. Bhupendra Rizal

8. a) Basal Osseo-integrated Implant (BOI) b) Trans-Osseous Implant (TOI) c) Lateral Implant 3) Plate Form a) BOI-BAC Implant b) BOI-BAC2 Implant 4) Other Forms a) TPG Implant ( Tuberopterygoid ) b) ZSI Implant (Zygoma Screw) Dr. Bhupendra Rizal

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10. BOI and BCS Implant Morphology Disk of dimension of 9 mm × 12 mm or 10 mm × 14 mm with lengths 10–13.5 mm. The disk is usually 0.6 mm in height The BCS has been developed up to 12 mm diameter and can be inserted immediately into extraction socket. Dr. Bhupendra Rizal

11. KOS and KOS Plus Implant Morphology These implants are designed like compression screws, i.e.; these implants when screwed into the bone will compress the cancellous bone surrounding the implant to form more compact and dense bone Dr. Bhupendra Rizal

12.   Advantages of basal implants Immediate loading Avoidance of bone grafting Single piece implantology Basal / Cortical bone support Minimally invasive (‘key hole’ implantology) Solutions for unfavourable bone situations Extremely low failure rates Virtually no incidence of Peri-implantitis … Dr. Bhupendra Rizal

13. BOI(Lateral basal implants ):- is inserted from the lateral aspect of the jaw bone and it require minimum bone height of 3 mm. Peri-implantitis incidence : Peri-implantitis is the single most common cause for failure of conventional implants. Judicious use of monobloc, smooth surface basal implants eliminate the threat of peri-implantitis by almost 98%. Dr. Bhupendra Rizal

14. Revolutionary designs and features   of the basal implants help the implantologist in treating a wide variety of cases which cannot be attempted with the conventional two / three – piece crestal implants. Many of the implants have smooth surface designs which do not permit bacterial colonization on the implant surfaces which in turn brings down the incidence of peri-implantitis considerably. Dr. Bhupendra Rizal

15. Prosthetic Rehabilitation The aim of prosthetic rehabilitation is to provide esthetics, enable hygiene practice and mainly to avoid overload osteolysis. Esthetics is taken care of by following the three FPs given by Dr. Carl E. Misch . Overload osteolysis is prevented by providing appropriate occlusal schemes which can be bilateral balanced, group function, mutually protected and lingualized occlusion. Dr. Bhupendra Rizal

16. COMPONENTS Dr. Bhupendra Rizal

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18. Maxillary arch - Prefabricated complete denture Lower arch – thin crest of residual ridge and worn out Dr. Bhupendra Rizal

19. Mandibular arch-8 Implant placed OPG after implant placement Dr. Bhupendra Rizal

20. Abutments are bent to make them almost parallel and TRA – transfer caps used to take closed tray pick up impression Only putty used to pickup the TRA , Light body not used as it may get left behind in extraction sockets Dr. Bhupendra Rizal

21. Wax may be used to seal the drag lines if needed Model for provisional prosthesis using dental stone Dr. Bhupendra Rizal

22. Modifications done to the PFP on the mounted casts proper positioning for occlusion , function and aesthetic Dr. Bhupendra Rizal

23. BOP or TRA , then placed intraorally. They will be picked up by resin in the PFP, by intraoral reline procedure, while PFP is kept in place by occ;uding against upper teeth prosthesis Dr. Bhupendra Rizal

24. Basal implant placed , Care is taken to engage the apex of the implant in cortical bone. One Tubero Pterygoid implant cortical implant is placed on each side Residual maxillary ridge Dr. Bhupendra Rizal

25. TRA- transfer caps used to take closed tray pickup impression Light body and putty used for pickup impression Dr. Bhupendra Rizal

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