When All-on-4 is the right choice, hopeless teeth and heavily pneumatized sinuses
All-on-4 is often offered when it isn't needed. Not here: hopeless teeth, atrophic maxilla, tilted distals instead of a sinus lift. Follow-up to 3 years.
Implantology
65 articles
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Peri-implantitis with a buccal dehiscence: implantoplasty, xenograft and connective tissue graft in one session. Three years on
Peri-implantitis with exposed titanium at an anterior full-arch abutment: implantoplasty, xenograft and a connective tissue graft under a coronal flap.
Guest Editor for the Journal of Functional Biomaterials: send me the papers that report the failures
JFB Special Issue on implant and oral regeneration materials: what we want, what we send back, deadline 31 March 2027. Guest Editor with Papetti and Manicone.
My dental implant feels loose: what it means and what to do
Crown, screw or implant: what is actually moving, early versus late failure, and what to do in the first 48 hours. Dr. Bruschi's guide for patients.
Buried Alive: The Osteoblast's Three Fates
The osteoblast builds bone, then meets three fates: apoptosis, the quiet of a lining cell, or being buried alive to become an osteocyte.
All-on-4 or All-on-6: the cantilever outweighs two extra implants
In vitro study on 40 zirconia full-arches: with four implants or six alike, strength out in the cantilever zones stays low.
There is no universal implant design
Taper, threads and diameter raise primary stability. Ideal geometry is not abstract — it exists for one site and one patient.
Diabetes, Prediabetes, and Implants. No Problem. But Check Your Glycated Hemoglobin.
Diabetes and prediabetes do not rule out implants: HbA1c (glycated hemoglobin) counts. Thresholds, peri-implantitis, and your diabetologist.
Ode to the Hidden Buttress of the Upper Jaw
The supramaxillary bony arch links nasopalatine recess, canine buttress, and anterior nasal spine: CBCT anatomy that decides upper jaw implant anchorage.
What's Behind the Surge in So-Called 'Atrophic' Implant Cases?
Untreated periodontitis, immediate loading that flattens bone, mass extractions, re-treatments: why 'atrophic' implant cases keep surging. Atrophy we create.
Zone A and Zone B: The Histology of the Peri-Implant Biological Seal
Zone A (40 μm, avascular, fibroblast-rich) seals the implant. Zone B (160 μm, collagenous, vascularized) supports it. Moon et al., 1999.
Fibrointegration: the implant that moves too much to integrate
Fibrointegration: why an implant wraps itself in fibrous tissue instead of bonding to bone, what causes it, and how to prevent it.
«But don't you perforate the membrane?» Almost never: the sinus in three dimensions
Many colleagues think transcrestal sinus lift means perforating the membrane. Almost never. You move the cortical floor, across all three planes of space.
Immediate Loading: Great Treatment, Wrong Hands
Immediate loading is an excellent technique that turns bad as a «one-size-fits-all protocol». The difference is the hand, not the tool.
Smoking after an implant or extraction: how long to wait
Smoking after an extraction triples dry socket risk; after an implant it roughly doubles the failure rate. How long to wait and why.
How long does swelling last after a dental implant
Swelling after a dental implant peaks at 48–72 hours and clears in about a week. What actually works against oedema and when to call your dentist.
Non-Surgical Treatment of Peri-Implantitis with the TST Technique
Severe peri-implantitis treated flapless with TST decontamination. Eight years of radiographic follow-up in a 95-year-old patient.
Guiding Healing Rather Than Chasing Regeneration: Maxillary Rehabilitation Following Bonebenders Principles
Clinical case: full maxillary rehabilitation with 6 post-extractive implants, LMSF expansion and lancet drill. Flapless, graftless.
Bleeding after a dental implant: what's normal and what's not
Light oozing in the first days is expected. Bright red bleeding that won't stop is not. Dr. Bruschi's guide to the first 7 days after implant placement.
Tribocorrosion: a false interface problem, not a titanium defect
Implant tribocorrosion is an interface phenomenon, not a titanium defect: a false problem solved by the conical connection or by one-piece implants.
Titanium, Heavy Metals, and the Great Semantic Fraud
Titanium is not a toxic heavy metal. How biological dentistry uses fear to sell ceramic implants instead of titanium.
Osteo-mucosal Expansion at Site 4.6: From Severe Defect to Definitive Crown
Atrophic ridge at site 4.6 with osteo-mucosal defect: Bonebending 4.0 and simultaneous implant in one session. Three-month result.
ERE Expansion and Immediate Implant: A Premolar in One Session
Clinical case: ERE ridge expansion with immediate implant and simultaneous regeneration. From a failing bridge to an implant in a single session.
Expansion 4.0: Graftless LMSF with screw expanders — case 1.6/1.5
Graftless LMSF clinical case: two implants at sites 1.6/1.5 with calibrated screw expanders. Localised management of the maxillary sinus, no graft.
Surgical Treatment of Peri-Implantitis with the TST Technique
Clinical case of severe peri-implantitis treated with TST decontamination (Ten Second Technique) and guided bone regeneration. Two-year follow-up.
The Expander Inside the Socket: Immediate Implant in Atrophic Bone
How expanders enable implant placement in post-extraction sockets with atrophic bone: biomechanical principle, surgical technique, and limits.
Ridge Expansion: The Bruschi-Scipioni Technique
The Bruschi-Scipioni ERE ridge expansion: what it is, when it is indicated, what the evidence says. The pillar of bonebending.
Dental Bone Grafting: Advanced Techniques Compared
Ridge expansion, GBR, sinus lift, autologous graft: which technique for which defect. Evidence and long-term outcomes.
How Long Do Dental Implants Last? Real Data at 10 and 20 Years
Dental implant longevity according to long-term studies: survival rates, risk factors and what to do to make them last.
GBR or Autologous Bone Graft? Differences, Indications and Outcomes
Guided bone regeneration (GBR) and autologous graft compared: when to use each. Evidence, advantages, limitations.
Bone Regeneration Without Hip Harvesting: Modern Alternatives
Not enough bone for implants? Today regeneration is possible without iliac crest harvesting. Ridge expansion, GBR, biomaterials: evidence and outcomes.
Vertical Implant Positioning: Every Connection Has Its Correct Depth
Bone-level, tissue-level, conical connection: the correct depth changes with connection type. Why getting it wrong causes bone resorption.
Dental Implant Rejection Does Not Exist. Here Is What Really Happens.
Implant rejection does not exist: titanium is biocompatible. The real causes of failure and risk factors according to the literature.
Peri-implantitis and Periodontitis: Microbiota Compared
Similarities, differences and pathogenic mechanisms between peri-implantitis and periodontitis microbiota. A literature review.
Alveolar bone: what it is, why it is lost, and how you rebuild volume
Alveolar bone holds your teeth and your implants. After extraction it shrinks in predictable ways. Anatomy, causes, and what the data say about rebuilding.
Proteins That Trigger Osseointegration: 3 Phases
Three phases of osseointegration: blood wets the implant, cells arrive, bone grows. What the data actually say about hydrophilic surfaces.
A Snare Strangles the Bacterial Ribosome: Lariocidin
Lariocidin, a lasso-peptide antibiotic published in Nature, targets a new ribosome site never hit by any other antibacterial drug.
Afraid of the Dentist? Let Go of It, for Good.
Your mouth is intimate territory. 64% of Italians fear the dentist. Conservative techniques remove what scares people most: grafts, pain, long recovery.
Implant or Bridge: When the Alternative Makes Sense
Implant or bridge? Cost, longevity, risk and benefit compared — a specialist guide to choosing the right solution for your clinical situation.
Malpositioned Dental Implant: Risks, Symptoms and Solutions
A malpositioned dental implant loses 0.25 mm of bone per 10° of angular error. Symptoms, when it's fixable, and when it must be removed.
Split Crest: Does the Partial-Thickness Flap Really Matter?
Split crest works only with a partial-thickness flap. Strip the periosteum and the mobilized cortex resorbs. The evidence, the instruments, the biology.
"Bone Expansion Is Niche" — The Myth That Holds You Back
Bone expansion isn't for specialists. It's the safest way to prepare any implant site — used next to your usual drills, in the same appointment.
Bonebenders vs Bonedrillers 1-0: Speed Beats Complexity
While you run two-stage GBR, your competitors place implants in a single session. The competitive edge of the Bonebenders — with the numbers that prove it.
They Lied to You About Primary Stability
Primary stability is friction — it always means bone compression. Why torque and ISQ thresholds don't predict success, and where to compress.
Wang A1-C3 Alveolar Bone Classification: Beyond Misch D1-D4
The Wang A1-C3 system separates cortical and trabecular bone into 9 real configurations. Why it beats Misch D1-D4 for implant planning.
Force + Implant + Bone = 3? NO! → OSSEOPERCEPTION!
Osseoperception is the sixth sense of dental implants: how the brain rewires to feel touch and bite force through bone after osseointegration.
Conical vs Flat-to-Flat Connection: 5 Differences That Actually Matter
Microgap, crestal bone loss, mechanical stability: why the implant-abutment connection is not a detail. Morse taper vs flat compared.
One Disc Changes Everything: Fast, Efficient, Atraumatic
How the diamond disc makes mandibular ridge expansion fast, graft-free and atraumatic — a real alternative to GBR in dense bone. No overheating, no mallet.
The Genius of the Bur Changes Everything
The Bonebenders modified lancet bur: trajectory correction, interradicular septa, and graftless sinus access for advanced implantology.
Horizontal Bone Defects: The Meta-Analysis on 1,400 Implants
Meta-analysis of 1,400 implants confirms ridge split works: 98.1% survival, 3.3mm bone gain. Why expansion rivals grafting for moderate horizontal defects.
The “Revolutionary” Discovery of Hot Water
A 2024 paper calls the Gingival Open-Wound Technique an 'innovation'. Dr. Bruschi has documented second-intention healing in implantology since 1998.
Your Wound Heals by Itself
Second-intention healing rebuilds bone and gum without sutures. Recent reviews confirm the open palate heals on its own — costly aids rarely help.
Custom Regeneration vs All-on-X?
Custom regeneration isn't the opposite of All-on-X — it's its evolution. When to save teeth, when to go full-arch, and why one size never fits.
Bone Remodeling: The Biological Cycle That Decides Implant Fate
Osteoclasts resorb, osteoblasts build, osteocytes coordinate: how bone remodeling works and why it determines dental implant success.
Primary Stability and Implant Macrogeometry
Implant macrogeometry — body shape, length, diameter, threads — drives primary stability. What recent evidence says and how to choose the design.
Help! I'm Manola and I have periodontitis
Manola has periodontitis. When is root planing enough, when is surgery needed, and why trust between patient and dentist quietly decides the outcome.
Expansion Is Magic: Regeneration That Follows Nature
Osteo-mucosal ridge expansion regenerates bone and keratinized mucosa without grafts or sutures — a full-arch maxillary case with 7-year follow-up.
"Bind me!" Blood and Titanium: love is born in five minutes.
In the first five minutes after implant insertion, blood coats titanium with proteins in a precise sequence — and surface roughness decides what sticks.
What on Earth Does “Shape Innovation” Mean?
Implant "shape innovation": why macro- and micro-geometry, not roughness alone, drives bone healing — threads, healing chambers, distance osteogenesis.
Immediate Loading: Technique, Benefits and When It's Indicated
How immediate-loading implantology works, when it is indicated, and its real benefits over delayed loading. Clinical guide by Dr. Ernesto Bruschi.
Francesco's Story
Francesco lost his upper teeth to dodge the draft, then endured decades of failing bridges. Regenerative ridge expansion rebuilt his bone, and his smile.
A Friend's Story: Rebuilding an Implant-Supported Prosthesis That No Longer Holds
A friend with malpositioned implants and terminal gum disease, rebuilt with new implants and graftless mucosal regeneration using ovate pontics.
Want All Your Teeth Out and Replaced With Implants? Read This First
No dental treatment, implants included, succeeds 100% of the time. The real survival rates — and why minimally invasive care matters when something fails.
Are You Still in Love with Smooth Implants?
Macrogeometry, not a smooth surface, drives implant primary stability: conical bodies, aggressive threads and the right torque beat smooth cylinders.
Immediate Implant Placement Is (Almost) Always the Best Solution
Immediate implant after extraction preserves bone and works even with buccal defects. Indications, contraindications and long-term outcomes.