Basal dental implants are a type of dental implant designed to be placed in the basal or cortical bone, which is the hardest outer layer of the jawbone. They are used as an alternative to traditional dental implants, particularly for patients with severe bone loss or atrophy. Here are the key features and characteristics of basal dental implants:
Key characteristics of basal dental implants
Placement
Basal implants are placed directly into the cortical bone, unlike traditional implants that integrate with the spongy bone.
Immediate Loading
Basal implants can be loaded immediately after placement, allowing for the attachment of a temporary prosthesis within 72 hours. This is in contrast to traditional implants, which require a 3- to 4-month osseointegration period before the prosthesis can be fixed.
Design
There are two main types of basal implants: straight cortical implants and angled zygomatic implants. The straight cortical implants are long and screw directly into the cortical jawbone layer, while the angled zygomatic implants are long and screwed into the cheekbone, making them suitable for cases where the maxillary sinus floor is too low for a sizable sinus lift bone graft.
Advantages of basal implants
Immediate Function: Basal implants allow for immediate function, meaning patients can start using their new teeth immediately after the implant procedure.
Bone Preservation: They help preserve bone by avoiding the need for extensive bone grafting procedures.
Alternative to Dentures: Basal implants can be used as an alternative to removable dentures for patients with severe bone deficiencies.
Disadvantages
Complexity
The removal of basal implants is more complex than traditional implants, and the prosthetic part is placed in an open wound, which can compromise osseointegration.
Limited Prosthetic Options
Basal implants offer fewer prosthetic options compared to traditional implants, making it more challenging to change the prosthesis without weakening the implants or surrounding bone mass.
Risks
There are risks associated with basal implants, including infection, chronic sinusitis, nerve damage, gingival recession, and rejection of the implant. These risks are generally considered lower than those associated with traditional implants, but they still exist.
Usage
- Indications: Basal implants are used primarily for patients with severe maxillary atrophy, where there is less than 5mm of available bone for full or partial tooth replacement using implants. They are also used in cases where extensive bone augmentation or graft failure is a concern.
- Regulatory Status: Basal implants are BANNED in some countries, including Germany, Sweden, and Hungary, due to concerns over their safety and efficacy. However, they are still used in many other countries, including Australia and the United States.
In summary, basal dental implants are a specialized type of implant designed to address severe bone loss or atrophy, offering immediate function and reduced need for bone grafting. While they have advantages, they also come with increased complexity and risks compared to traditional implants.
Why are basal implants banned in some European countries
Basal dental implants have been banned or are facing bans in some European countries due to concerns over their safety and efficacy:
Lack of Osseointegration
One of the main issues with basal implants is that they do not integrate with the jawbone through osseointegration like traditional dental implants. The smooth, polished surface of basal implants does not allow bone cells to grow onto the implant surface. This lack of osseointegration results in a weaker foundation and increases the risk of bacterial penetration between the implant and bone, leading to peri-implantitis infections.
Increased Risks and Complications
Basal implants have been associated with higher rates of complications compared to traditional implants, including:
- Inflammation and infection (peri-implantitis)
- Bone loss
- Implant displacement or loosening due to lack of osseointegration
- Difficulty removing the implant and prosthetic bridge
Inferior Quality and Safety Standards
Some basal implants, especially those manufactured in Eastern European countries, have been found to be counterfeit products that do not meet quality and safety standards. This has further eroded confidence in basal implants as a reliable treatment option.
Lack of Long-Term Data
The long-term success and safety of basal implants have not been as extensively studied and documented as traditional implants. The lack of robust clinical data and long-term follow-up has made regulatory bodies hesitant to fully endorse basal implants.
Better alternatives to basal implants in dentistry
Regulatory agencies in Europe and North America are increasingly scrutinizing basal implants and may impose further restrictions in the future if the safety issues are not adequately addressed by manufacturers.
Basal implants are a type of dental implant that takes anchorage from the basal cortical portion of the jaws, offering a viable option for restoring atrophied jaws without extensive surgical procedures.
However, there are several alternatives to basal implants that can provide similar benefits with varying degrees of invasiveness and cost-effectiveness:
Same-day teeth: This technique involves immediate placement of a dental implant in the socket of a removed tooth. It provides primary stability through threading and allows for immediate loading and restoration with a dental bridge or denture.
Mini implants: These are smaller implants that are quicker and easier to place, often at a lower cost. They offer more comfort but may require more implants or fewer teeth restored due to their smaller size.
Dental bridges: These can be conventional or adhesive. Conventional bridges replace missing teeth by preparing healthy teeth at each end of the gap, while adhesive bridges support the missing tooth with wings bonded to the tongue side of the healthy teeth.
Partial dentures: These are removable prostheses that can replace one or more missing teeth. They are often the cheapest solution but require regular maintenance to ensure a good fit.
Do nothing: This option is not recommended as it can lead to complications like opposing teeth over-eruption and adjacent teeth tipping into the gap, affecting overall bite and oral health.
Dental crowns: These are artificial teeth made of ceramic, alloy, or ceramometallic materials. They can be fitted without risk at any age and provide natural tooth function, shape, and aesthetics.
Inlays and onlays: These are used to fill cavities and restore teeth. They can be made of ceramic or composite materials and offer greater resistance and longevity compared to older fillings.
Full-arch bridges on telescopic crowns: These are fixed prostheses that replace multiple teeth in a row. They are less invasive than traditional implants but require multiple crowns to be placed.
Dentures with locks or magnets: These are removable prostheses that use locks or magnets to secure them in place, providing a more secure fit compared to traditional dentures.
Each of these alternatives has its own advantages and disadvantages, and the best choice depends on individual needs, budget, and the extent of tooth loss.