27. From Knowledge and Skill to Action

The late Dr. Guldener from Berne, when characterizing dentists, used to talk – at most half in jest! – about the clueless and the knowledgeable, the unscrupulous and the unconscientious. This makes a nice four-field table where each dentist can be assigned a field:

X Those who tinker with BOI without authorization belong in the dangerous category of the clueless unscrupulous.

The term “crestal implant” is a collective term for implants whose most important load-transmitting surfaces are located in the area of the vertical implant axis and that are inserted into the jaw from the alveolar crest. This term thus includes screw, cylindrical and conical implants and also blade implants. The bicortical screw represents a borderline case; while this implant is inserted crestally, by design and by virtue of its macrostructure and microstructure, it does not have any vertical load-transmitting surfaces. Functionally, then, this type of implant would have to be characterized as a crestally inserted BOI – because of its intended lateral and cortical support if nothing else.

Basal osseointegrated implants are a subset of the lateral implants. They are inserted laterally into the basal jaw bone or into the alveolar bone, using a T-shaped access osteotomy. BOI have no load-transmitting surfaces in their vertical aspect.