All the Things I Can Only Do with Bicon Implants

Hi, my name is John Morgan and I have some thoughts on why the implant is sometimes the only implant system I can use in certain situations. I’m an oral surgeon in private practice and I’ve been using the Bicon system for over twenty years. I also use multiple different implant systems for my referral base, but I frequently get asked why I prefer Bicon. The response is that these implants can be placed almost anywhere in both the maxilla and the mandible, regardless of the quantity and quality of the bone. I believe the reason for this is that the Bicon implant, with its unique plateau design, appears to have more of an affinity for bone growth and adaptation around the fixture when compared with other systems. My experience has been that there is no overriding need for primary stability when placing a Bicon implant. I like to say this is a leap of faith, but if you’re familiar with the Bicon system, you realize this to be true. The obvious scenario when there is no primary stability is when I place an implant into an immediate extraction site, particularly molar sites, or molar sockets. I prefer to place implants immediately in extraction sockets whenever I can in order to optimize soft tissue and bone volume. Very often the diameter or void of the empty socket is larger than that of the implant. The Bicon system works very well for me in this situation where the implant can be placed single stage with a healing abutment. My goal is to place the implant not necessarily into one of the root sockets, but into the actual center of the socket. I use the healing abutment to help align the implant so that it remains in the middle of the socket. I will use autogenous bone, harvested from the socket either alone or mixed with an allograft, to help keep the implant abutment complex centered. Without a doubt, there can be significant mobility of the implant initially, but in time it will stabilize and integrate, and is usually loaded in three to four months. The use of a healing abutment at the time of implant placement will eventually allow a nice soft tissue profile and eliminate any need for surgical uncovering at the second stage, making it obviously easier for the patient. I tell colleagues that placing a single stage Bicon implant is one of the most predictable things I do. I’m not advocating that everyone should do it this way, and on occasion there are those real failures, but it does provide obvious benefit for the patient, limiting the number of procedures. I can’t do this with a screw type implant in a predictable manner period. I’m in private practice and I place between three hundred and four hundred Bicon implants a year. If this didn’t work and was not predictable, my referrals would send their patients elsewhere. Another scenario where I can use the Bicon implant with more confidence is the placement of an immediate implant in an extraction site with a provisional crown. I limit this to the aesthetic zone, usually from bicuspid to bicuspid. Again, I find the Bicon implant is more predictable than screw implants due to the clinically observed fact that these implants do not require as much initial stabilization. Typically, I will use an eight millimeters length Bicon implant. Furthermore, I can place Bicon implants where there is bone loss that will require grafting. The classic example of this is the maxillary anterior region where, when a tooth is removed, there is some degree of facial bone loss or fracture. The Bicon implant can work very well with an immediate load and a grafting procedure at the same time. Usually, if I were to use a screw type implant, the procedure would be sequenced. That is, the tooth would be removed, the site would be grafted or allowed to heal, and the implant would be placed months later. Another example where I can’t use other systems right away, or even at all, is the placement of an implant in the posterior maxilla that requires significant grafting with both buccal and sinus augmentation. There are two reasons why I will use Bicon. Number one, because of the shorter implants and their affinity for bone, there is less native bone needed, therefore less grafting required. Secondly, I usually can graft and place the implant at the same time, something I really can’t do with other systems. I don’t necessarily think this is an ideal case to present, but it does show what the Bicon implant can do in extreme circumstances. This patient is now in her mid-80s and she wanted a single tooth replacement in the area of tooth number twelve. This could have been reconstructed with a cortical cancellous graft from the hip or another donor site, then delayed implant placement. I opted to place a short Bicon implant with simultaneous sinus and buccal bone augmentation. This is her two and a half years later. I almost always do some type of sinus augmentation whenever I extract an upper molar and place an implant. I usually will do it as a single stage, where I will use a Bicon titanium healing abutment as my sinus lift abutment. I won’t attempt to use a screw type implant in this manner unless there is good dense bone to stabilize the fixture. The short biconium implants have also made a big difference in my practice for how I treat atrophic mandibular bone, particularly in the posterior quadrants. It used to be that I would graft block bone from the ramus or chin, or do some type of bone grafting procedure, either a ridge split or a membrane procedure, before any implants were placed. Now, with the shorter Bicon implants, I will place Bicon implants and graft laterally at the same time. Again, I find this very predictable. It has eliminated difficult and uncomfortable grafting procedures that prolong treatment time for my patients. I just can’t do this with other implant systems. What is interesting to me is that I will see patients for placement of Bicon implants where other systems have either failed, or with a dentist who prefers to use other systems will reluctantly ask me to use Bicon simply because they know it will work in compromised bony conditions. This case to me says it all about Bicon. This patient had screw type implants placed years ago with a bar attachment for a fixed maxillary bridge. This appears well done. However, he was unhappy that he was wearing partial upper and partial lower dentures. He was always told that he could never have implants in the posterior, upper, and lower jaws because there was not enough bone. Four years ago he had five Bicon implants placed in the lower jaw with simultaneous grafting three in the left quadrant and two in the right quadrant. He did well and was very happy and he wanted something done in the upper arch. In May twenty fourteen he had three implants placed in the maxilla, two on the left and one on the right, placed with sinus augmentation. The final restorations are individual crowns and not splinted. He is doing well and this is him four and two years post op. In closing, Bicon is an excellent all round implant system that offers solid versatility for the surgical clinician in all areas of the mouth. But for me and from my experience in placing Bicons over the last twenty two years, it truly shines in these key situations. One, placement of implants in immediate extraction sockets, especially molars. Two, placement of immediate implants in extraction sites with a provisional crown. Three, placement in the posterior maxilla that requires significant grafting in both buccal and sinus, augmentation. Placement of short Bicon implants and grafting laterally at the same time. Placement of implants in compromised bony conditions. I’d like to thank you for watching this video, and if you require further information, be sure to check the Bicon website. Thank you.