Surgical Techniques Comparison in Implantology
Comparative table
The comparative table shows that the Bilateral Sinus Solution™ (BSS) is the only technique that combines molar coverage, absence of fake gum, no bone graft and immediate loading always possible. The other techniques present at least one of these limits.
| Criterion | Bilateral Sinus Solution™ (BSS) | All-on-4 | All-on-6 | Quad-4 Zygomatic | Subperiosteal Grid | Bone Grafts + Implants | Sinus Lift |
|---|---|---|---|---|---|---|---|
| Molar coverage | Yes (pterygoid implant) | Only up to 1st molar | Yes (distal implant) | Yes (zygoma) | Yes | Yes (after graft) | Yes (after graft) |
| Fake gum | No (Circolare d'Autore® prosthesis) | Yes (Toronto Bridge) | Yes (Toronto Bridge) | Yes (pink resin) | Yes (pink resin) | No (if sufficient bone volume) | No (if sufficient bone volume) |
| Bone grafts | Never necessary | Often necessary in atrophy | Often necessary in atrophy | Not necessary | Not necessary | Always necessary | Always necessary |
| Sinus Lift | Never necessary | Often necessary | Often necessary | Not necessary | Not necessary | Often necessary | Always necessary |
| Immediate loading | Always possible | Possible (if torque >50 Ncm) | Possible (if torque >50 Ncm) | Possible | Delayed (3-6 months) | Delayed (6-12 months) | Delayed (6-12 months) |
| Prosthesis duration | 15-20+ years (zirconia-ceramic) | 4-5 years (composite resin) | 4-5 years (composite resin) | 4-5 years (composite resin) | 5-7 years (resin) | Variable | Variable |
| Invasiveness | Medium (minimally invasive surgery) | Medium | Medium | High (sinus crossing) | High (open surgery) | Very high (double site) | Medium |
| Average number of implants | From 6 to 12 (customised) | 4 | 6 | 4 zygomatic + anterior | 4-6 | 4-8 | 4-6 |
| Anaesthesia | Local | Local/sedation | Local/sedation | Sedation/general | Sedation/general | Sedation/general | Local |
| Indicative cost | Medium-high | Medium | Medium | Very high | Very high | Very high | Medium-high |
Explanation of the criteria
The comparison criteria include molar coverage, presence of fake gum, need for bone grafts or sinus lift, possibility of immediate loading, prosthesis duration, invasiveness, number of implants and cost. BSS excels in almost all criteria.
Molar coverage
The possibility of rehabilitating the distal molars. All-on-4 reaches only up to the first molar because the implants are positioned anteriorly. The Bilateral Sinus Solution™ (BSS) uses the pterygoid implant to cover the molars without a cantilever.
Fake gum
The presence of pink resin in the prosthesis to mask the space between prosthesis and mucosa. The techniques that place all implants anteriorly (All-on-4/6, zygomatic) must use fake gum to fill the distal cantilever. The Circolare d'Autore® has no fake gum because the pterygoid implant covers the molar area.
Bone grafts
The need to harvest autologous bone (from the iliac crest, mandible, tibia) or use heterologous bone to reconstruct the resorbed alveolar bone. BSS never requires grafts because it anchors in the basal bone, always present.
Sinus Lift
The procedure of lifting the maxillary sinus with the addition of bone to create bone volume in the upper posterior area. Not necessary in BSS because the pterygoid implant bypasses the maxillary sinus.
Immediate loading
The possibility of applying the temporary prosthesis within 24-48 hours. BSS guarantees immediate loading in all cases thanks to the bicortical anchorage. The techniques with grafts require 6-12 months before loading.
Prosthesis duration
The period before the prosthesis needs replacement. The resin/composite prostheses last 4-5 years. The zirconia-ceramic of the Circolare d'Autore® lasts 15-20+ years.
In summary
BSS stands out for: absence of bone grafts, absence of fake gum, immediate loading always possible, molar coverage without cantilever, definitive zirconia-ceramic prosthesis lasting 15-20+ years and local anaesthesia in all cases, even the most complex.
The Bilateral Sinus Solution™ (BSS) stands out from the other techniques for:
- Absence of bone grafts
- Absence of fake gum
- Immediate loading always possible
- Molar coverage without cantilever
- Definitive zirconia-ceramic prosthesis (15-20+ years)
- Local anaesthesia in all cases
For a comparison of the prosthetic aspects only (materials), see Prosthetic materials comparison.
The biomechanics compared
The Circolare d'Autore® prosthesis
- 14 teeth per arch, including all posterior molars
- Zero fake gum: the teeth emerge from the natural gum
- Zirconia + layered ceramic, with registered trademark ®
- Custom-made: every prosthesis is a unique piece designed for the patient
Discover all the details on the dedicated page: Circolare d'Autore® — the definitive prosthesis without fake gum.