What is "Basal Implantology"?

The term “basal implant” was brought into our profession approximately in 1998. It reflected the idea and the principle, that the load transmitting surfaces of implants should be positioned in basal bone areas, because these areas are stable and the bone there is not prone to atrophy. The bone that survives everything and is present after many edentulous years was utilized.

“Basal bone” is the bone which will not be resorbed throughout life, it is structurally needed. Typically it is not the alveolar bone created during teeth eruption and for teeth. Note however that crestal cortical bone resorbs or re-locates during the resorbtion process which is called atrophy.

Another aspect of basal implantology is the usage of cortical bone areas. Cortical bone should be used for implant anchorage for good reasons: bones typically consist out of a strong, highly mineralized outer cortical and an inner portion of bone, called “spongious bone”. While cortical bone areas are structurally needed and always repaired, spongious bone areas are (from the bones mechanical point of view) not needed.

One reason why implantologists should preferably utilize corticals, is that cortical defects created during the implant surgery are always repaired. This promotes/guarantees the implants integration. Another reason is, that cortical bone is highly resistant due to its high mineralisation, allowing immediate loading protocols

In the last decade the combined usage of basal and cortical bone areas with the help of BOI^® /TOI^® implants and elastically designed basal screw implants (BCS^®, GBC^®) has been introduced into our profession. Hence the old term “basal implantology” does not cover all principles behind this concept. We better describe the technology today as “cortico-basal implantology”.

Today elastic basal screw designs are used in combination with lateral basal implants. Basal implantology has made implantology free from the ties of the mandible and the maxilla, it works independently from bone being present in those bones. Today we utilize bone areas of the maxilla, the mandible, the sphenoid bone and the zygomatic bone. In the maxilla-facial field lateral basal implants have opened new treatment options when it comes to replace noses and eyes, especially in radiated bones. Prof. V. Konstantinovic from Belgrade is the pioneer and the driving force of this field, i.e. in the placement of lateral basal implants in the frontal bone and the glabella.

What once has started with BOI^® has become a movement based on deep surgical knowledge, on the thorough knowledge of the bone's properties, and on consequent application of a prosthetical protocol.