Jacobs Journal of Anatomy and Physiology

New Systematic Terminology of Cortical Bone Areas for Osseo-Fixated Implants in Strategic Oral Implantology

Published on: 2018-03-20


Immediate Loading in oral implantology requires safe cortical anchorage of the load transmitting surfaces of the implants, because even the most miraculous surface properties of dental implants alone will never lead to the possibility of immediate loading. This article describes a new didactic approach for communicating the principles of this technology. The terminology which we propose should be used both for the purpose of denominating corticals suitable for load transmission and points of occlusion and slopes of mastication with respect to the positioning of the mentioned load transmitting areas. We propose to use the “1-2-3 classification” for the identification of the 1st, 2nd and 3rd cortical as points of interest for positioning of the abutment (at 1st cortical) and for remote initial osseofixation (2nd or 3rd cortical) for axial basal implants in oral and maxillofacial implantology. Furthermore, we propose to use the term “Supporting Polygon” to determine the position of occlusal contacts or masticatory slopes within or outside of a polygon drawn up by the load transmitting parts of the implants in the “2nd-“ or “3rd cortical”. The most significant locations at the polygon are implants on the corners or ends of it, i.e. implants in the area of the canines and the 2nd molars in both jaws. Today we name these position “strategic positions”. If these positions are not equipped properly with implants, or if one or more of the implants in the strategic position is not anchored well in the 2nd and/or 3rd cortical the whole case is prone to failure. Since this treatment concept completely disregards the “1st cortical” or spongious bone for the purpose of load transmission, it is suitable for axial basal implants (i.e. the concept of strategic implantology) and lateral basal implants.


Oral Implantology, Strategic Implant, Supporting Polygon, 1st Cortical, 2nd Cortical, 3rd Cortical, Osseofixation, Strategic Implant Position