Basal Implantology Glossary

Welcome to the glossary of the Bilateral Sinus Solution™ (BSS) + All-on-Full™ wiki. Every term is explained in a simple way and linked to the dedicated page of the wiki to deepen. Use the glossary to orient yourself among the keywords of basal implantology and understand the difference between the traditional techniques and the protocols of the Nicola Lettera Network.

A

• All-on-4 — Standardised commercial technique with 4 anterior implants and prosthesis that stops at the premolars: it leaves the patient without true posterior molars and discharges all the force on few pins. The BSS solves its failures.
• All-on-6 — Variant with 6 implants, still in the alveolar bone: subject to the same biomechanical limits of the All-on-4.
• All-on-Full™ — Protocol of the Nicola Lettera Network: total rehabilitation without fake gum and with all complete molars. It allows young people to do a single implantology in a lifetime.
• Bicortical anchorage — The implant locks in two distinct bone cortices (tuber and sphenoid plates), guaranteeing excellent primary stability and immediate loading.
• Bone atrophy — Loss of volume and density of the bone after tooth loss. It is the condition that makes the traditional techniques impossible and indicates the use of the basal bone.

B

• Bilateral Sinus Solution™ (BSS) — The biological surgical and prosthetic protocol developed by Nicola Lettera with his team of maxillofacial surgeons: 2 posterior basal implants in 18/28, 2 implants in 15/25 and custom solutions for the premaxilla. It avoids zygomatic, grafts and sinus lifts. Immediate loading in 1 hour.
• Biomechanics — The science of the distribution of the masticatory loads. The BSS distributes the force over the whole arch, as in a natural dentition.

C

• Immediate loading — Application of the fixed temporary prosthesis within 24-48 hours of the procedure. With BSS the patient leaves with the temporary already without fake gum in 1 hour.
• Circolare d'Autore® — The definitive prosthesis of the Network: 14 ceramic teeth, without fake gum, with all molars, designed as a unique work with 18-carat gold signature.
• Flapless surgery — Procedure without incisions and without stitches (see transmucosal implantology).
• Ceramic — Aesthetic and resistant prosthetic material used in the Circolare d'Autore® and in the zirconia prostheses.

D

• Denture — Mobile removable prosthesis (see removable prosthesis). After twenty years of denture, BSS brings back the complete fixed teeth.
• Bone densitometry (D1-D2) — Lekholm and Zarb classification: the basal bone is of D1-D2 type (compact cortical, very hard), the ideal for implant anchorage.
• D1 — Bone of maximum density: the cortical plates of the sphenoid where the basal implants 18/28 of the BSS anchor.

F

• Implant failure — Loss of an implant for peri-implantitis, overload or wrong planning. The BSS solves the failures of the traditional techniques.
• Fake gum — The pink acrylic flange of the prostheses such as the Toronto Bridge: it makes food stagnate, causes infections and peri-implantitis. The BSS and the Circolare d'Autore® completely eliminate it.
• Retrocanine fossae — Very hard bone area in positions 15/25 where the BSS places the two implants that stabilise the anterior part of the arch.
• Milling — Digital processing process of the zirconia prostheses.

G

• Subperiosteal grid — Customised CAD/CAM structure that recreates the missing bone base in the premaxilla: in the most severe BSS cases, behind 2 basal implants support the chewing and in front the grid with 4/6 implants rebuilds the support.

I

• Basal implantology — The implantology that anchors to the basal bone, the deep bone that never resorbs. It is the paradigm shift from the alveolar bone to the basal bone.
• Blade implants — Implants for thin ridges, used in the BSS for the custom frontal area.
• Short implants — Implants of reduced length for scarce bone: they have indications and limits compared to the long basal implants.
• Nasal / sub-nasal implants — Implants placed in the nasal and sub-nasal areas of the premaxilla to stabilise the anterior part.
• Pterygoid implant — 19-21 mm long implant that crosses the tuber and anchors in the cortical plates of the sphenoid: the posterior pillar of the BSS in zone 18/28.
• Spinal implants — Implants that use the bone of the tuber and of the posterior spinal structures.
• Zygomatic implants — Extra-long screws (up to 50 mm) that anchor in the zygoma: invasive solution that the BSS completely avoids.
• Bone grafts — Artificial bone reconstructions (from hip, chin or bone bank): vulnerable, they resorb and require months of waiting. The BSS eliminates them.

M

• Masseter — The main elevator muscle of the mandible and one of the great protagonists of the chewing force. The BSS reactivates it by bringing back the molars.
• Molars — The posterior teeth that grind the food. The BSS restores all the molars (14 ceramic teeth) for a complete 100% chewing.
• Implant maintenance — The periodic controls to maintain the rehabilitation over time.

O

• Alveolar bone — The superficial bone that surrounds the teeth: soft, it resorbs after tooth loss, it does not guarantee stability.
• Basal bone — The deep, hard and stable bone that never resorbs: it is the only one that allows real, immediate and durable rehabilitations.
• Osseointegration — The biological process with which the bone integrates with the surface of the implant.
• Overdenture — Removable prosthesis supported by implants: an intermediate solution compared to complete fixed teeth.

P

• Peri-implantitis — The inflammation and infection of the tissues around the implant, often favoured by the fake gums. The BSS prevents the peri-implantitis by eliminating the stagnation areas.
• Premaxilla — The frontal area of the maxilla: in the BSS it is treated with custom solutions (transverse, nasal, sub-nasal, spinal implants, split crest, blade).
• Temporary — The fixed temporary prosthesis applied right after the procedure. With the BSS it is already without fake gum.
• Pterygo-zygomatic — Combined pterygoid + zygomatic technique (see pterygo-zygomatic).

Q

• Quad-4 zygomatic — The variant with 4 zygomatic implants: very invasive facial surgery, with significant risks, that the BSS completely avoids.

R

• Maxillary sinus lift (sinus lift) — The procedure that detaches the Schneiderian membrane and fills the sinus with graft material: risks of perforations, sinusitis and months of waiting. The BSS avoids it by bypassing the sinus.
• Failed implant removal — The retreatment to remove compromised implants and rehabilitate the patient with the right protocol.
• Resin / composite — Cheaper prosthetic materials used in the temporaries and in the temporary prostheses.

S

• Sphenoid — The deep bone whose cortical plates (D1) host the anchorage of the posterior basal implants 18/28 of the BSS.
• Split crest — Expansion of the bone ridge to increase its thickness: one of the custom solutions of the BSS for the premaxilla.
• Conscious sedation — The pharmacological relaxation that makes the procedure comfortable without pain.
• Spinal — Implant that uses the spinal bone of the tuber (see spinal implants).

T

• Toronto Bridge — The classic fixed prosthesis with bar and fake gum: nest of bacteria, without molars. The BSS replaces it with the Circolare d'Autore®.
• Tuber — The maxillary tuberosity, passage area of the pterygoid implants towards the sphenoid.
• Transmucosal — The implantology without incisions and stitches (flapless): minimal invasiveness.

Z

• Zirconia — The very high quality ceramic material used for the definitive prostheses of the Network, aesthetic and biocompatible.
• Zygomatic — See zygomatic implants: the extreme solution that the BSS never uses.