The framework rests on the bone rather than entering it. Ti-6Al-4V titanium, SLM printing, fixation with mini-screws in zones of dense bone.
The framework is manufactured from the DICOM data and placed under the periosteum, over the alveolar processes.
The protruding abutments of the framework carry the prosthetic superstructure; the load is distributed across zones of dense bone identified on the CT.
Long-standing edentulism, periodontitis, trauma or oncological resection lead to bone resorption. Progressive atrophy is a systemic problem: the face changes and chewing and speech are impaired. The patient has already been to several clinics and each time has been turned away or told that “a year of grafting is needed”.
| Bone condition | Standard implant placement | Bonabyte framework |
|---|---|---|
| Sufficient bone | Indicated | Usually not required |
| Moderate atrophy | Often requires bone grafting | Optional |
| Severe atrophy | Difficult | May be considered |
| Severe atrophy | Difficult / not feasible | One of the possible options |
Atrophy classifications (for example, Cawood & Howell) are used as a reference. Indications, patient selection and the choice of method are determined by the oral or maxillofacial surgeon, taking the soft tissues and the clinical situation into account.
Implant survival at 5 years. Retrospective cohort study, n=150. Comparable with zygomatic implants (96.3%), with less peri-implantitis (5.6%).
Zielinski et al., J Clin Med 2025;14:661
Survival with partial rehabilitation. 21 implants in 16 patients, median 36 months. Resorption beneath the abutments ≤0.18 mm per year.
Vaira LA et al., J Oral Maxillofac Surg 2025;83(6):728–737
Mucosal recession is the key risk. The main factors are a thin biotype and mucositis. This data matters for the surgeon's preoperative assessment.
Van den Borre C et al., Int J Oral Maxillofac Implants 2024;39:302–309
| Parameter | Bone grafting | All-on-4 / Zygoma | Bonabyte implants |
|---|---|---|---|
| Bone requirements | Reconstruction before placement | Min. bone for tilted implants | Severe atrophy |
| Number of procedures | 2–3 stages | 1–2 stages | Usually 1 stage |
| Rehabilitation time | Long | Medium | Shorter in selected cases |
| Nerve-related risk | Higher | Moderate | Reduced |
| Sinus-related complications | — | Possible | Not typical |
This comparison is general in nature; the approach, timelines and risks are determined individually according to the clinical situation. In selected cases a subperiosteal implant may be considered as an alternative to multi-stage bone grafting.
A correct CT scan speeds up planning and reduces rework. Download the protocol for this speciality and include a link to the DICOM when you send it.
It may be considered in severe alveolar ridge atrophy where standard implant placement is difficult or impossible. The quantity and condition of keratinised mucosa, the absence of active inflammation, oral hygiene and compliance all matter. Indications and patient selection are determined by the surgeon.
Multi-stage bone grafting can require a long wait and several procedures. In selected cases a subperiosteal implant may be considered as an alternative; timelines and approach depend on the clinical situation and the surgeon's decision.
The key risk is soft tissue exposure (recession); the main factors are a thin mucosal biotype, mucositis and smoking. With careful patient selection the risk is manageable. Any gap in the fit is a source of micromovement, which is why CAD/CAM accuracy is critical.
A Ti-6Al-4V titanium framework, SLM printing (laser metal fusion) and digital planning in BonaPlanner 3D. Fixation with mini-screws in zones of dense bone; the kit includes a surgical guide, an anatomical model, a temporary prosthesis and screws.
Bonabyte designs and manufactures the device according to the treating physician's plan. Medical decisions are made by the surgeon.
These publications are provided as a reference for professionals. They relate to the topic of this section and are not a guarantee of the outcome in any particular case; applicability is determined by the treating physician. The list should be reviewed and expanded by a clinical specialist.
The information on this website is intended for healthcare professionals and does not constitute medical advice, a public offer or a guarantee of clinical outcome. Bonabyte devices are custom-made medical devices designed for a specific clinical task; their applicability depends on the CT data, the anatomy, the condition of the soft tissues, the surgical access and the operative plan. The final decision on the use of a device is made by the treating physician. Contraindications exist and an individual assessment of the clinical situation is required.