Basal Implants in chennai

Crestal vs. Basal implants

Criteria	Crestal (Axial / Screw)Implants	Basal Implants
Shape and structure	Root form - designed to imitate roots of a tooth	The implants look like an inverted T
Endosseous section	Screw shaped with machined / sandblasted / HA coated surfaces.	Flat / blade like surfaces with spaces permitting bone in growth.
Technique	Insertion thro’ crestal bone and communication with oral cavity much more than basal implants	Insertion thro’ lateral aspect of basal bone. Load bearing area of implant has no communication with the oral cavity.
Bone requirement	Vertical bone – both crestal and rarely a small portion of basal bone.	Basal bone is what is needed. Horizontal aspects of the bone are fully utilized along with the inner and outer cortices.
Armamentarium	A large set of instruments are necessary for procedures	Instrumentation relatively a lot simpler
Bone grafting procedures	Essential in cases of deficiency in bone height. Grafting procedures give unpredictable results	Not essential.
Bone displacement	Considerable bone substance displacement / loss occurs and varies with size and length of implant. Crestal bone is more susceptible to resorption	Displace upto 60% less bone substance. Bone integrity and perfusion are barely impaired. Basal bone - highly resistant to resorption
Mucosal penetration diameter	Larger. Chances of peri implantitis, vertical bone loss, crater like bone loss and infections are relatively high	Smaller (1.9 – 2.3mm. only). The whole vertical implant part is polished – hence, chances of problems seen as in the case of crestal implants relatively very low.
Anatomy – proximity to Maxillary Sinus & Inf.Alveolar Nerve	Very important consideration and technique is to be modified accordingly. Bone augmentation essential in most cases.	Overcoming unfavorably placed MS and IAN is possible
Abutment angulations	Two piece implants have to have pre-angulated abutments. KOS single piece implants provide angulated as well as bendable abutment provisions.	All BOI implants have bendable abutments.
Loading	Two piece implants often require delayed loading & two surgical phases at times	Immediate loading
Healing	Prolonged healing time – clinically significant	Bone healing time not clinically significant
Masticatory forces	Act in the vertical direction along the sides of the screw structure	Transferred to the basal plate deep into the cortical bone areas which are able to accept large loads and have great capacity for regeneration.
Resterilization of implant including abutments	Impossible	Possible after pre-cleaning
Applications in destructive periodontitis & after multiple extractions of teeth	Placement nearly impossible and success is unpredictable.	Placement of implants very much possible and results are excellent.
Smoking patients	Failure rate is nearly 100%	Best option for smoking patients
Controlled diabetic patients	Crestal implants always run a risk of failure in cases where there are blood sugar variations	Blood sugar variations may not affect the survival of the implant at all.

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Basal Implants Vs Zygomatic implants

BASAL IMPLANT

Zygoma implant

If you have been told that there is less bone in your upper jaw for dental implants, do not worry. The best solution for cases with severe bone resorption in upper jaw is Basal implant. Basal implants are replacing zygomatic implants as the best solution for patients requiring dental implants for upper jaw. Such patients were going for sinus lift or bone grafts as per old techniques. In a single procedure we place Basal implant and place the permanent crown in 3 days. As we use single piece implants the procedure is flapless and done under local anaesthesia.

The advantage of basal implants over zygomatic implants

	Basal implant	Zygomatic implant
Type of implants	Single piece Implants is used. No screw loosening and no crestal bone loss.	Screw based implants used. Screw loosening is a problem
Cantilevers	No cantilevers placed	Molars if given are placed as cantilevers, which decrease the life of the bridge and cause screw loosening on the implant.
Criteria	No contraindications	Symptom free and pathologically free sinus
Relative risk of failure	Since sinus is not involved, no risk of sinusitis	Risk of sinus infection
Permanent bridge	Permanent ceramic bridge on 3rd day of implant placement, as the implant engages hard cortical bone.	Acrylic/plastic for first 4 months. Then cantilever permanent ceramic bridge given after 4 months.
CT scan	Not needed.	Compulsorily needed
Surgical guide	Not needed	Compulsorily needed
Anaesthesia	Local anaesthesia with or without sedation	General anaesthesia
Cost of implant	Being regular sized single piece implant it is relatively cheap.	Zygomatic implants are very long manufactured specifically for the purpose, hence very expensive. Cost of the technique is more as CT scan and surgical guide is used.
No of implants for full upper jaw	6-8 for upper jaw.	8 -10 for upper jaw
No of teeth	14 teeth are given. Teeth replaced till second molar	10 teeth or 12 teeth given. 2nd molar is not given.
No of trips	One trip, as permanent ceramic crown or bridge is placed in 3 days	Two trips. Permanent teeth fixed after 3 months of implant placement.
Warranty	Lifetime warranty on implant	No warranty

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When the patient requires fixed teeth on dental implants in upper jaw, then the options are:

»	Cantilever bridges: For example in All-on-4 or All-on-6 techniques, implants are placed in anterior regions only and as such 1^st molar crowns are placed as cantilevers and 2^nd molars are not replaced at all. Sometimes only 10 teeth are placed. Another disadvantage of cantilevers is that the permanent ceramic bridges are fixed after 3-6 months.

What are BASAL IMPLANTS

Basal implants are implants located even when bone is less in upper jaw. They allow the prosthetic rehabilitation on dental implants in upper jaw. The applied forces go to the pterygomaxillar buttress area allowing immediate loading of the implants.

Advantages of BASAL IMPLANTS

»	Eliminates the need of sinus grafting.
»	No cantilevers from front teeth or implants
»	Efficient chewing is possible as teeth upto second molars are replaced. In cantilevers and zygomatic implant cases or in all-on -4 and all – on – 6 techniques 2^nd molars are not replaced. If replaced then they are made as cantilevers which make the last implant weak and the bridge susceptible to fracture in the long run.
»	Bone in pterygoid area is cortical in nature, and hence very strong and rigid allowing Immediate loading with permanent crown in 3 days.
»	Single piece implants are used which are strong in comparision to conventional dental implants
»	All patients who want dental implants in upper jaw are good candidates as bone is always available in pterygoid area.
»	Flapless technique is used, as such patients have no swelling or bleeding and patients need not stop blood thinners, if they are taking any.
»	Lifetime warranty given as strong single piece implants are being used in strong cortical bone.
»	100% success rate. life time warranty visit us at www.drmurugavel.in www.youtube.com/bestdental contact us at dr_mrgvl@yahoo.co.in