We try to get a common denominator. Now, what can maxillofacial do and what is not necessary to do, what we could do without their help. And so that is what we try to figure out, which is the limit of certain surgeries. And as you see, the limit of certain surgeries are these ones, for example. In the upper, the same in the lower, a class IVB, where even if you are skilled implantologist you can’t do anything else than sending it to your maxillofacial friend to do bone grafting procedures which most of the implantologists are not common to use to certain surgeries. And so why we have to do something which is not a protocol in our daily life. So we are risking only. And in this case, that’s the limit of implant placements. Where we have here, we can do only that things, are the box technique of Khoury’s box technique, which is very difficult to do. And I know only a few people are doing that, including Andrea and Otmar. So we have to find our limits. The limits are very well defined with Bicon because we can, as you see, we can have very nice compression with our implants and as everybody told you before in his lectures, we don’t have a real compression on the bone and so we can go very close to the corticals, the post corticals without having an excess of compression and resorption of the bilateral corticals. And so here in this case we can compress implants. Two very fast, two cases which are the limit of maxillofacial surgery and implant dentistry. Maxillofacial surgery, this patient went three times to the maxillofacial. They did different surgeries with her, But it didn’t work out. And then she came to our observation. And as you see, we had only a few bone. But as you know, with short implants, ultrashort implants, you can do miracles. And this is one of the limits. Bilateral sinus lift elevation and bone splitting and all these techniques, yes, it can be done. Sure, if we are in a more critical situation. But that patient after ten different surgeries, decided to come to us and doing a simple surgery of one and a half hours and then waiting six months in this case. This is very important. You use ultrashort implants in an atrophic bone situation, please wait. Less than four months. You have to wait six months. That’s a must. Screw retained prosthetic, why? That’s something else we can discuss in the next congress, but it’s because of a biomechanical force distribution is in certain situations to use the screw retained. And as you see, once again, we didn’t do any osteotomies to maintain that bone. The crest is very important. The shoulder is very important to maintain. Yes, the hemispherical base, say always hemispherical base, but that’s mostly in the single crown restoration. In that kind of restorations, we can barely stay with that and without hurting more that bone, which was hurt in the past. And so we keep everything underneath the bone. We do slight internal sinus lifts. And this is almost the surgeries everybody here, expert Bicon user can do. And that’s the final restoration in the upper. Screw retained. And the lower, the same situation, the patient sixteen times surgery in thirty years. You can imagine they came down from University of Leuven and maxillofacial sent me the patient. And she didn’t want to do any more grafting procedures. We did a lot of grafting procedures. We placed four 3.0 × 6.0mm implants, 3.0 × 6.0mm implants very small implants. But it’s an anchorage. The implant Bicon is anchored into the bone. If you place the bone sub crestally, nothing happens. The very important thing is place the implant two millimeters under the crest. The shoulder has to be covered. And this is the big secret of this implant. Cover the shoulder and nothing happened. Extension of 22mm and 25mm, nine years follow-up and as you see no need of maxillofacial surgery. This is the limit but here we are.
