History of the BOI® Implant

Basal implants were developed and improved in several stages, primarily by French and German dentists.

The first single-piece implant was developed and used by Dr. Jean-Marc Julliet in 1972. His design was available in two sizes and has been in use, unchanged, until this very day. But since no homologous cutting tools are produced for this implant, its use is fairly demanding.

It was not until the mid-1980s that the French dentist, Dr. Gerard Scortecci, presented an improved basal implant system complete with matching cutting tools. Together with a group of dental surgeons, he developed two types of implants, called “Diskimplants”, with internal and later external connectors to the prosthetic superstructure.

Since approximately the mid-1990s, a group of interested dentists and dental surgeons in Germany have developed new implant types and more appropriate tools, as well as practical accessories, based on the Diskimplant systems. These efforts than gave rise to the development of the modern BOI® implant.

In 1997 Dr. Ihde Dental has started producing lateral basal implants in the way the "Diskimplants" were made. These implants were round and not many shapes were available. The surface was initially roughened.

Soon Dr. Ihde Dental developed improved types of basal implants:

  • the formerly round base plates got edges, this prevented early rotation of the implants in the bone before integration.
  • in 2002 the fracture-proof design of the base plate was invented and later patented in Europe and the United States.
  • bending zones in the vertical implant shaft were introduced.
  • from 2005 on the experiences with lateral basal implants were transferred to screwable designs (BCS, GBC).

Regarding the surface structure in 1999 the vertical implant parts were produced polished, and from 2003 on all the basal implant was produced polished. The reason was, that polished surfaces show no tendency to inflammation (no mucositis, no peri-implantitis), and in case of sterile loosening, reintegration of the implants was possible if the loads were adjusted in time. It was also observed, that roughened osseous-surfaces have less tendency to re-integrate.

The design was developed into skelleted direction, leaving enough elasticity for the development and functional stimulation of bone.

The abutment design was also developed:

  • initially basal implants were designed as two-piece designs, later one-piece designs were introduced.
  • two head sized became available for cemented constructions.
  • internal screw connections were developed. These designs are important for maxillo-facial use and the fixation of epitheses.

Of course, the development will not stop here. Today the basal implants produced by Dr. Ihde Dental are the best basal implant system currently available.

Thanks to the passion and dedication of Dr. Stefan Ihde and other BOI users, the BOI technology has progressed to the point where it is an accepted part of received academic medicine and that dental implantology would seem inconceivable without.

Fig.1: Jean-Marc Julliets's lateral implant form 1973

Fig.2: Modern basal implants, designed and produced by Dr. Ihde Dental AG, Switzerland

What is “Basal Implantology”?

The term “basal implant” was brought into our profession approximately in 1998. It reflected the idea and the principle, that the load transmitting surfaces of implants should be positioned in basal bone areas, because these areas are stable and the bone there is not prone to atrophy. The bone that survives everything and is present after many edentulous years was utilized.

“Basal bone” is the bone which will not be resorbed throughout life, it is structurally needed. Typically it is not the alveolar bone created during teeth eruption and for teeth. Note however that crestal cortical bone resorbs or re-locates during the resorbtion process which is called atrophy.

Another aspect of basal implantology is the usage of cortical bone areas. Cortical bone should be used for implant anchorage for good reasons: bones typically consist out of a strong, highly mineralized outer cortical and an inner portion of bone, called “spongious bone”. While cortical bone areas are structurally needed and always repaired, spongious bone areas are (from the bones mechanical point of view) not needed.

  • one reason why implantologists should preferably utilize corticals, is that cortical defects created during the implant surgery are always repaired. This promotes/guarantees the implants integration.
  • Another reason is, that cortical bone is highly resistant due to its high mineralisation, allowing immediate loading protocols

In the last decade the combined usage of basal and cortical bone areas with the help of BOI® /TOI® implants and elastically designed basal screw implants (BCS®, GBC®) has been introduced into our profession.

Hence the old term “basal implantology” does not cover all principles behind this concept. We better describe the technology today as “cortico-basal implantology”.

Today elastic basal screw designs are used in combination with lateral basal implants. Basal implantology has made implantology free from the ties of the mandible and the maxilla, it works independently from bone being present in those bones. Today we utilize bone areas of the maxilla, the mandible, the sphenoid bone and the zygomatic bone.

In the maxilla-facial field lateral basal implants have opened new treatment options when it comes to replace noses and eyes, especially in radiated bones. Prof. V. Konstantinovic from Belgrade is the pioneer and the driving force of this field, i.e. in the placement of lateral basal implants in the frontal bone and the glabella.

What once has started with “BOI®”, has become a movement based on deep surgical knowledge, on the thorough knowledge of the bone`s properties, and on consequent application of a prosthetical protocol.