[A new tricortical implant]

We wish to introduce a new type of implant intended for use in the posterior maxilla when only 8 mm or less of the resorbed alveolar ridge is present, without the need for sinus lift procedures or ridge augmentation. The implant is called "Excalibur" and will be available in varying lengths with either an internal or external hex. The implant is supported at three points in the cortical bone due to the use of an apically positioned screw, which passes through the implant and the buccal and palatal cortices at 90 degrees to the long axis of the implant. The bicortical screw is inserted via a minimal full thickness flap or through a small incision in the gingiva at the proposed point of placement. The additional stability provided by this screw allows for immediate loading at the time of implant placement. In comparative tests with regular implants, the "Excalibur" was found to be far more resistant to forces applied to the implant resulting in far less stress on the neck of the implant, which was shown on the finite element modeling. Two clinical cases are presented: 1) Excalibur implants were placed in the posterior maxilla and four months after the surgical procedure the permanent prosthetic rehabilitation was completed. 2) Excalibur implants were placed at the time of extraction, with an immediate temporary acrylic bridge. Permanent prosthetic rehabilitation was begun four months later.