Basal Bone
The basal bone is the deepest and most stable portion of the maxillary and mandibular bone. Unlike the alveolar bone, the basal bone does not resorb over time and is made of compact cortical bone tissue (D1-D2), extremely strong and dense.
Characteristics
The basal bone is the deep and stable portion of the maxillary and mandibular bone, classified as D1-D2 according to Lekholm and Zarb. It does not resorb with age or tooth loss, is located deeply relative to the alveolar bone and has excellent vascularisation that favours the osseointegration of dental implants.
- High density: classified as type D1 or D2 bone according to Lekholm and Zarb
- Stability over time: it is not consumed with age or tooth loss
- Position: located deeply relative to the alveolar bone, it constitutes the load-bearing structure of the facial skeleton
- Vascularisation: excellent, favours osseointegration
Basal bone in the upper jaw
In the upper jaw, the basal bone includes the maxillary tuberosity (tuber), the pterygoid process of the sphenoid, the pyramidal process of the palatine bone and the premaxilla (nasal and incisive area). These regions represent the anchorage sites for the pterygoid and nasal implants of the Bilateral Sinus Solution™ (BSS).
In the upper jaw, the basal bone includes several anatomical regions of great implantological interest:
- Maxillary tuberosity (tuber)
- Pterygoid process of the sphenoid
- Pyramidal process of the palatine bone
- Premaxilla (nasal and incisive area)
| Basal Bone | |
|---|---|
| Type | Compact cortical (D1-D2) |
| Resorption | Minimal or absent |
| Use | Anchorage of pterygoid implants |
| Technique | Bilateral Sinus Solution™ (BSS) |
| Advantage | Avoids grafts and sinus lifts |
Role in the Bilateral Sinus Solution™ (BSS)
The basal bone is the foundation of the Bilateral Sinus Solution™ (BSS). While the alveolar bone resorbs in atrophies, the basal bone remains intact and available. The main areas used are the pterygoid area (pterygoid implants in 18/28), the nasal area (transverse nasal implants in 15/25) and the frontal subnasal area.
The Bilateral Sinus Solution™ (BSS) is based precisely on the use of the basal bone for implant anchorage. While the alveolar bone can be severely resorbed (as in atrophies), the basal bone remains intact and available.
Anchorage areas
The main basal bone areas used by the technique are:
- Pterygoid area (posterior): for pterygoid implants in 18/28
- Nasal area (anterior): for transverse nasal implants in 15/25
- Subnasal area (frontal): for subnasal implants in 4/6
Advantages of the basal bone
- Primary stability: the D1/D2 density guarantees a high insertion torque, ideal for immediate loading
- No resorption: the basal bone remains stable for the patient's whole life
- Biocompatibility: excellent osseointegration thanks to vascularisation
The composition of the basal bone: the scientific secret
The basal bone is the stable structural base of the maxilla and mandible: it is not affected by tooth loss and is composed of 60-70% inorganic mineral fraction, 20-30% organic fraction and 10% water. Unlike the alveolar bone (which surrounds the teeth and resorbs if they are lost), the basal bone remains intact for life and is mainly formed by compact (cortical) bone tissue of very high density.
🔬 Inorganic component (60% - 70%)
It guarantees the hardness and compressive strength of the jaw.
- Hydroxyapatite: calcium phosphate crystals that mineralise the matrix.
- Calcium carbonate: present in smaller percentages.
- Mineral salts: traces of magnesium, sodium, potassium, fluorine and strontium.
🧬 Organic component (20% - 30%)
It provides elasticity, flexibility and resistance to torsional and tensile masticatory forces.
- Type I collagen: represents over 90% of total proteins.
- Non-collagenous proteins: osteocalcin, osteonectin and osteopontin, which regulate mineralisation.
- Proteoglycans: molecules that retain the hydration of the matrix.
🧫 Cellular component (included in the organic fraction)
- Osteocytes: mature cells trapped in the matrix, responsible for tissue maintenance.
- Osteoblasts: cells specialised in the production and deposition of new bone.
- Osteoclasts: giant cells responsible for bone resorption and remodelling.
Learn more: the composition of the basal bone in detail →
Chewing on the basal road (compact bone)
The basal bone reacts to chewing based on the principle of absolute structural rigidity. Basal implants bypass the superficial areas and connect directly to the deep cortical areas (such as the lower profile of the mandible or the pterygoid pillars of the skull). During chewing, the forces do not meet yielding spongy areas, but discharge directly onto the lines of force of the facial skeleton.
The long-term advantage: since the basal bone has a very high mineral density and an extremely slow cell turnover, the mechanical connection between the screw and the bone does not deteriorate over the years. The masticatory force expressed by the patient can be maximum from the first days, because stability does not depend on the healing of a bone wound, but on the solidity of an already formed and immutable skeletal structure.
Learn more: alveolar vs basal chewing →
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