Bi-Korticale TPR (Two-Piece Rough Surface) Implants to Restore Periodontally Mutilated Dentition.

Patients with severely resorbed bone often face the challenge of requiring extensive bone grafting to qualify for dental implant treatment. These cases present a unique opportunity to utilize graftless solutions, offering significant advantages in terms of time efficiency, patient comfort, and clinical outcomes. Bi-cortical implants provide an innovative approach by engaging two cortical bones, ensuring high primary stability, immediate loading, and prosthetic restoration within 3–5 days—even in cases of extreme bone resorption.

Beyond their application in atrophic ridges, Bi-Korticale TPR implants offer a valuable solution for restoring severely periodontally compromised dentition. The presence of a smooth collis collar plays a crucial role in minimizing peri-implantitis risk, especially in patients with a history of poor oral hygiene. This feature helps mitigate long-term complications associated with periodontal disease, making these implants a preferred choice for full arch rehabilitation in challenging cases.

Traditionally, bi-cortical implants were single-piece systems with cement-retained prosthetics. However, the advent of two-piece bi-cortical implants has revolutionized treatment options by enabling retrievable prostheses, offering flexibility and long-term maintenance possibilities. Key features of two-piece bi-cortical implants include:

Minimally invasive surgical protocols: Placement with a single lance drill in softer bone types (D3/D4).
Versatility in challenging cases: Effective in thin bone, engaging cortical structures such as the pterygoid, nasal, lingual, and buccal cortices, as well as intermental foramen regions.
Unique design attributes: A polished crestal collar resists peri-implantitis, even in cases of partial exposure, while the implant’s rough surface promotes osseointegration.
Bone condensation: Enhances stability by densifying soft bone during placement.
Wide range of sizes: Suitable for varying anatomical challenges, from short to long implants.

This lecture will discuss the clinical advantages, biomechanics, and surgical protocols for two-piece bi-cortical implants, emphasizing their application in full arch implant restorations and the rehabilitation of periodontally compromised dentition. Attendees will gain insight into achieving predictable outcomes in graftless solutions for resorbed bone and compromised dentition cases, transforming the treatment experience for both patients and clinicians.