Bicon Bulletin - July 2006

New! Bicon 5.0 x 6.0mm Short Implant

The recently introduced 5.0 x 6.0mm short implant is another revolutionary addition to Bicon’s existing selection of implants. The 5.0mm width offers an alternative to clinical situations where a wider implant would not be an option. The short length of 6.0mm allows dentists to avoid vital structures with confidence, and eliminates the need for many grafting procedures. This innovation is only possible because of Bicon’s elegant plateaued design, which provides cortical-like bone with central vascular systems around the implant. This cortical-like bone not only grows faster, but also provides for functionally different capabilities than the appositional bone around non-plateaued implants. With Bicon, longer implant length is not necessarily better.

Bicon Short Implants by Dr. Bill Schaeffer

In our daily practices, as dental professionals we are often confronted with patients who meet the ideal criteria for implant treatment, but have shallow bone. Your patients may have missing teeth, knowledge about dental implants, desire for a permanent solution, and the financial means to afford implant treatment, but the one key factor that they often lack is sufficient bone height for longer implants. Bone grafting may partially solve the issue, but bone grafting can be expensive, is time-consuming, involves inherent risks and is always uncomfortable for the patient. In my experience, and in my practice, short implants provide an excellent alternative to bone grafting and can allow patients to more easily enjoy the benefits of implant treatment.

Anatomical Considerations

In placing longer implants, there are two major areas for anatomical concern when faced with shallow bone height. In the maxilla, the maxillary sinus can pose a hazard when placing longer implants. Driving an implant through the sinus floor and into the sinus may not be a medical emergency, but if you’ve not planned to do it, it can sure ruin your day! It can also require extended explanations and assurances to calm a concerned patient.

In the mandible the inferior alveolar nerve poses a much more serious risk. Parasthesia is a real danger to your patient if the alveolar nerve is damaged when placing a longer implant. As a result, an associated lawsuit could be damaging to your practice and livelihood.

Parasthesia and Lawsuits

Parasthesia. The mention of the word can chill a dental professional’s blood, and lately, it has become a favorite lawsuit with jury awards upwards of $350,000. We should not spend our professional lives in constant fear of negative outcomes and runaway lawsuits, but solid business sense (as well as plain common sense), says that we should always manage our risks.

“Why not just graft?”

I love grafting (well, I am a surgeon after all), but I’m very aware that my patients don’t enjoy it nearly as much as I do. It may seem sensible to graft every patient with shallow bone, but grafts can be expensive and often require extended periods for healing. Patients may not want to pay for grafts or wait 6-8 months for a graft to heal. In addition, bone graft procedures have risks involved, are surgically invasive and are extremely technique sensitive. Grafts are not a simple solution and patients don’t like them. You will be amazed at how your case acceptance will soar when you don’t have to mention bone grafting to your patients.

A Simple Solution: Bicon Short Implants

Short implants can provide an easy and simple solution and allow your patients to enjoy the benefits of implant treatment. Bicon’s short implants are available in lengths as short as 5.7mm and uniquely offer a massive surface area, thanks to their innovative finned design. The fins and plateaus of the Bicon design provide at least 30% more surface area than a screw design of a similar length and width. These fins and plateaus distribute the forces of occlusion evenly over the implant surface. In addition, the Bicon design promotes mature haversian bone around the implant, and in and around the fins. Contrary to the appositional bone found around screw-designed implants, this haversian bone offers unique clinical capabilities. One of those capabilities is increased crown-implant ratios. You would be amazed at what these little implants can do!

“But they look so weird! How can they possibly work?”

The Bicon short implants do appear strange at first and the large crown-root ratios go against what we are conventionally taught for teeth. But these implants do work—and they work really, really well even in the most challenging situations of limited bone.

Implants are not like teeth in that they do not have a periodontal ligament and instead they are ankylosed to the bone. The conventional rules about crown-root ratios simply do not apply to dental implants.

“Prove it!”

The Bicon short implants have been clinically researched since 1997, and were introduced in 2002. According to Gentile, Chuang, and Dodson, IJOMI November/December 2005, Bicon short implants “can be a clinically acceptable option to facilitate prosthetic restoration where alveolar bone height is limited or anatomic limitations exist.” Since their introduction, Bicon’s short implants have enjoyed tremendous success.

But I’m not an academic and even more impressive to me are the cases after cases that they have on the Bicon website showing the incredible bone levels around these short implants after more than 7 years in function as unsplinted single molar units. You have to see it to believe it!

Treatment Planning and Keys to Success

When placing implants into limited areas of bone it is vital to know how much bone you have to work with. X-rays before you start the case are of course mandatory, but I strongly advise anyone treating these patients to get another x-ray after the pilot hole has been drilled. You’ll see exactly where you are in relation to the nerve/sinus floor, and if you still have any more room to play with. These cases can be stressful for anyone and the comfort level that this simple step will give you is definitely worth it.

Once you have confirmed a safe pilot hole depth radiographically, the rest is easy! The Bicon reamer burs are not end cutting so you simply cannot go any deeper than your pilot hole with them—yet another safety feature of this system. Sequentially enlarge the osteotomy until you have achieved the required diameter, place your Bicon short implant and take your post-op x-ray—there really is nothing more to it than that!

Incorporating Short Implants Into Your Practice

If you are ready to start placing and restoring Bicon short implants, I would suggest that you start off with a few very simple cases. As with all implant systems, choosing initial cases in non-aesthetic areas can be quite helpful. Try to select patients with excellent bone quality and healthy soft tissue. Eventually, you will learn the finer points of the Bicon system and quickly be able to attempt more advanced cases. You will soon find that Bicon short implants can be an invaluable option in the services that you provide for your patients.

To get on the fast track with Bicon short implants, I would recommend taking a Bicon Institute course. The Surgical and Prosthetic Principles course provides an excellent overview of the Bicon system over a three-day, hands-on course. This course will get you up to speed quickly, and is widely praised as one of the best implant courses in the industry.

	This lovely 90 year old lady is planned for two implants on the lower left to support a bridge (only opposing a denture).
	The inferior alveolar nerve is illustrated in red showing limited height of bone above it.
	The pilot holes are drilled and paralleling pins show that they are both safely above the nerve. It also shows that I can safely deepen the distal pilot hole a further 1mm.
	Both implants have been placed safely in minimal bone above the inferior alveolar nerve.

Product News

UPDATED! Implant Overlay: Bicon has recently updated its implant overlay to reflect the revolutionary additions to Bicon’s existing selection of implants in a new and improved format. Order your Bicon Implant Overlay online at www.bicon.com. Part # 260-103-004

NEW! Abutment Overlays: Bicon is pleased to announce the introduction of the new abutment overlays for both the Non-Shouldered and Stealth Shouldered Abutments. These new overlays have been designed to allow clinicians to select the appropriate abutment for each case. Order online today!

NEW! 6.0mm Osteotome: Designed to facilitate the internal sinus lift for placement of a wider diameter implant in the maxilla. Now available at the online store. Part # 260-901-560

NEW! Sinus Lift Temporary Abutment with a 3.0mm Post: The 6.5mm sinus lift temporary abutment works as an anchor to prevent the implant from migrating into the sinus during the one stage surgical procedure. For more information please visit www.bicon.com. Part # 260-365-503

NEW! Stealth Transitional Abutment: Stealth transitional abutments are made from biocompatible polymer and are indicated for cases in which a transitional prosthesis is required for 180 days or less. They are designed to be used in conjunction with the stealth acrylic sleeves. To order, please visit the online store at www.bicon.com.

NEW! Resorbable Collagen Plug: Intended for use in oral surgical procedures as a resorbable material. It is used in the area of dental implants, bone defects, or ridge augmentation procedures to aid in wound healing after surgery. Part # 260-509-400

NEW! Patient DVD: Bicon is delighted to announce that the new Bicon Patient DVD is now available. This DVD will familiarize your patients with the concept of dental implants. It contains the Patient Video in eight different languages, before and after pictures and several patient testimonials. Order yours today! Part # 260-102-112

2006 Bicon Educational Opportunities & Events

As always, our calendar is replete with educational opportunities for you, your referring dentists, staff, and laboratory technicians. Courses, lectures, events, and exhibits are frequently added, so please refer to our online calendar for the most up-to-date information.