Prof. Dr. Gioga Cherana, PhD
University of Bucharest, Romania
I’m really honored to be here. And before I get started with my topic today, I want to thank Doctor. Morgan. Thank you and to express my gratitude to Dr. Morgan, Prof. Marincola for twenty years of supporting us, for your legacy. Thank you to entire family of Bicon because as Drauseo was saying, there’s a family here. Be good to us family. Well, twenty years of academic with Bicon system started in 2005 with the first lecture and first visit of Bicon team in Bucharest. But before that, for me, started with a common idea or with my theme that led my activity for more than thirty years about minimal invasive medicine. And when I reached Bicon and I started to study and to understand the principle, the back scientific background and the different approach to human biology than was first love at first sight and the collaboration began continue and I hope will continue from today on. We all know already, we witnessed with every implant, year after year, we know the multiple different advantages of Bicon system, there are so many, we have it listed here, all the concept because it’s a concept, with all the system and we have so many advantages and again we witness this every single day of our activity, But working and using Bicon over the years, we noticed some other multiple advantages. When I received the invitation to present here the topic, this topic and Professor Marincola suggested to me this theme, in my mind was immediately to go back in 2005 and to remember daily activity with my students and to honor our activity with academic accents, daily accents, because we started to use the system against the encouragement of our professor and colleagues around, which encouraged me in so many different ways, saying, if you want to professionally commit suicide, we can suggest you something else. Or I will always remember the classification made by a very dear professor of mine, that he said, a thirteen millimeters long implant is a good implant, an eleven millimeters long implant is for beginners, eight millimeters is for cowards and six millimeters is for ignorance. Well, I continued to be an ignorant, but thank God I had around me my undergraduate students, my resident doctors, and I brought this legacy, the system, the concept, I am so grateful that they embraced it and we collaborated and as I was saying, I decided to honor their activity, it’s not that much about me, it’s more about them, about our activity, and the fact that we started to think out of the box and to highlight the unique aspects of Bicon system. Well then, as I said, I decided to honor their cases, our cases, and our way of thinking out of the box. It’s a rather boring X-ray, nothing special nowadays. But twenty years back, an eight millimeters implant was indecently short. And they were asking me, are you sure, professor? Are you sure doctor that it will work? And we started to do it. This is one of the first cases that we planned and treated together. We had this special situation with a heavy smoker, only being heavy smoker, more than three packets a day. At that moment, you know, one of the first rules in niche book is don’t insert implants to smokers, it’s still available today. We decided to give it a try and we did. And that was in 2006 and then we have we checked the X rays a few years after and we still have the good bone around, stable bone around. And then ten years later, still having the bone, gained bone when the patient came for a fracture of the superior teeth and we noticed the presence of a cyst and we wanted to have as short as possible period of time of treatment and we decided with my students to do it in the same day with the cystectomy, again using the different biochemical process, healing process around the Bicon system, using again, we started to combine with the concentrated autologous blood concentrates, combining it together using piezo surgery and we did it in the same day with the cystectomy, and nineteen years later we see the bone is still there, gained bone, stable, with a very good healing around the implant that we inserted after cystectomy. 2006, nineteen years back, seventy two years old female patient with a compromised general health status, with poor financial activities, being excluded socially because every single time she was trying to open the mouth, actually the dentures were coming out of her mouth. And then not having the financial support, we decided to do that treatment, but that back then, the custom was, though the indication of the implantologist was to insert four implant screws with bicortical anchorage in order to have better resistance, and then we decided having poor bone, we decided to insert two Bicon, eight millimeters, again at that time it was indecently short, And then we have the O rings inserted a few months after and nineteen years later, the lady is still happy, ninety two years old, happy, smiling, with only two implants, three sessions coming to us and then being re included socially and she was really grateful for that. Now, having this they are mixed together anyway seeing this implant seems to be inserted to go through the mandibular canal, but it is not actually. Sorry, I don’t have the initial three d image because of a digital accident, let’s say. A few years after, you see actually this is not what I mean, but anyways Here. Actually, it is quite in contact with the alveolar inferior dental nerve with no hypoesthesia at the time of the insertion day. Why? Because we know that the healing process, the biochemical environment, during the healing process around the Bicon implant is different and as what Professor Schaeffer was saying previously, the inflammation reduced because of the healing chambers and then the whole biochemical environment being modified, no hypoesthesia because it’s a different type of healing process around this system. Few years after, after extraction of the molars, we inserted a short implant. The same idea of my student was saying, do you think it’ll work? Trust me, it does. We already know that. It’s witnessed already, but I would again the bone maintenance and bone gain around the Bicon implant and stability after twenty years. This is the case that I’ve been told that it’s professional suicidal because was young, very vocal and successful lawyer. We suggested having this situation, we suggested a orthodontical treatment with the extraction of the cysto, an orthodontical treatment because of the displacement of middle line to the right side, she completely refused to have any other extraction and we managed it as it was by inserting a short, an eight, and an eleven. Nothing special again today, at that time, eighteen years ago, it was really special because everybody around was telling me that it will not work. 2024 proved us wrong. It worked. Proved them wrong, actually, not to me. And we see something else, what can happen actually these three the implants were used during she accepted the orthodontic treatment, not in my clinic, some others, and they used Bicon implants as distal anchorage and like this, fifteen years ago we understood that that can be done and we did, we used, we did that several times after. And again, don’t mention the maintenance of the bone and the stability eighteen years later. Actually, the implants are in the same as they were inserted here the day before. Nowadays, in a case like this, for sure, we will actually the patient was suggested, received several treatment planning including pterygoid implants, zygomatic implants, sinus lifting, bone augmentation, and one after another he refused them all and he came to university where we work and we said let’s give it a try. The main actually, a problem was which will be the temporary bridge, let’s say. And we kept we used TRINIA as a temporary bridge. We kept some of the teeth, only three of them, and TRINIA worked well for few months and the patient has a very good comfort using that. Well then, again, knowing that the healing process around Bicon implant is different, we even was an active cyst, over infected, we inserted eleven just to have the primary stability after cystectomy and we avoided sinus lift, zygomatic, pterygoid, whatever. We avoided and the patient was really, really happy and that is actually what is sent to us years after. He doesn’t want to continue. He’s really happy with this. He doesn’t want to continue because believe it or not, he is not grateful that we avoided sinus or zygomatic implants but he’s happy because we kept a few of his teeth and he’s not feeling that old because he still has some of his own teeth. Again with my students eleven years ago, we had this case with actually enough bone to insert an eight millimeters, but we decided to use short, ultra short actually, with a minor internal sinus lifting. And again, my students, actually, that was during the master program, they asked me, Are you sure? Isn’t it better to have longer implants? And I said, Okay, let’s do it and see if it will work. And it did work. Eleven years after, we have this Actually, this implant should have been eight millimeters long but my nurse dropped the implant and then we used the four point five to six And eleven years after we see that the bone gain is quite significant. Again, doing this labour and seeing this that it’s not much even one to one, it’s one to two, let’s say. And it works in same manner that long implants are working. Well then, the youngest patient that we inserted at the faculty, again with my students, that we inserted a Bicon implant was this young girl, fifteen years old when she came. A few months after we did because at the beginning it was necessary to treat this subcondylar intracapsular fracture of the condyle. And a few months after we inserted, we extracted, we managed to save actually the second premolars, insert two implants. Nothing spectacular, nothing so special except that at the end we try to keep as well the inferior, the three six, but we finally decided we are losing bone and finally decided to insert an implant. Eight years after, we see that the level of papillae, the stability and that it was kept aesthetic buccal curvature on both sides. Actually the contour of the alveolar process is similar with the neighbor natural teeth and using the implants for orthodontic anchorage, we understood that because of the locking taper, because of different kind of bone around the Bicon implant, it acts as a tooth actually and we were able, of course, with controlled force to bring them in the correct buccal arch compared to neighbor teeth. And this photo is attached to express that opening of the mouth in the condyle, the fracture of condyle healed very well. Eight years after, as I was saying, the same healing bone, the same particular way of not losing bone but gaining bone. So what is happening? Nowadays, since we have with the students, are developing this digital flow, All the young colleagues are so thrilled to work with oral scanners. We have an i700 implant, we started to develop with our students and resident doctors this digital flow in three meetings, even though it’s an over infected bone all around. We decided, actually the patient refused have an internal sinus lifting with an implant but he refused completely to have the sinus broke as he said. We just inserted a long, an eight and a six millimeter. In three meetings the patient had a temporary bridge until the occlusal aspects of the treatment will be treated. But he is very satisfied and it works very well and then we see again the bone gain and the good aspect and stability of soft tissue around the temporary bridge. Years ago, I promised myself that every conference about Bicon will finish with this, will be ended with this case as a statement not only because of particular and important advantages of Bicon but because as a statement about the A pediatrician that had this implant sixteen years ago, he developed AIDS one week before he retired. The only area where he felt cured to have some mastication was this implant and this is about proven bacterial sealing. So twenty years of activity, they became, they was published, they had projects, publications, a book with my colleagues from University in Bucharest with a chapter from 2017, chapter about short implants. And again, it was not about me, this is what we did with my colleagues and students. By the way, some of them are here with me today. Thank you guys, love you. And this is my message to take at home. Primum non nocere and respect biology use Bicon because from the day of inception respected biology. And as Bicon says, sometimes less is more. I’m very proud about this case done with my sixteen years ago with my students in the faculty. Not using this kind of treatment, indeed sometimes less is more. Thank you for kind attention.