Ihde implant risks and side effects

Splitting the risks into two groups makes things easier. The first group exists in every implant operation: swelling, bruising, infection, bleeding and the chance of numbness that comes with working close to a nerve. The second group is specific to this approach: the anchorage being taken from the hard cortical layer deep in the jaw, the implant sometimes being extended up to the boundary of the sinus or the floor of the nose, the body being thin and in one piece, and the teeth being loaded without waiting for osseointegration. It is the second group that makes the difference.

First, the state of the evidence. A review published in 2025 screened 21 articles from the past ten years, covering a total of 9732 basal implants in 1219 patients. In the 13 studies that reported success or survival, the rate for intraoral implants ranged from 90.3 to 100 per cent. In the four studies that reported a loss rate, it ranged from 0.3 to 3.2 per cent, and in the seven that reported mobility, from 0.3 to 2.4 per cent. Bone loss around the implant was reported at between 0.33 and 7.89 mm. The figures are encouraging; but most of the studies are small and observational, and some of their authors are linked to the foundation that developed the method.

Those looking in from outside are more cautious. On its disc implant (BOI) page, implantate.com, a patient portal in Germany, writes that there is no evidence-based information about these types of implant and that the scientific professional bodies in Germany do not recommend them; this is the portal's assessment, not an official statement by a professional body. In other words, the statement 'the risk is low' rests on published observations, while the statement 'the evidence is insufficient' rests on the type and source of those observations. Both can be true at the same time.

The nerve risk becomes important in the lower jaw. The nerve that gives feeling to the lower lip and chin runs through a canal inside the lower jawbone. A meta-analysis published in 2025 looked at the distance to this canal in conventional implant placement: no change in sensation was seen with implants placed 1 mm or more from the canal; the rate was 68 per cent for those placed between 0 and 1 mm away, and 53 per cent for implants that entered the canal. These data are not specific to corticobasal implants, but the logic is the same: in a plan that aims to reach the deep layer of the bone, tracing the canal on the CBCT scan is non-negotiable.

The sinus risk arises in the upper jaw. In this approach, the tip of the implant can deliberately be anchored in the cortical wall of the sinus or the floor of the nose, and can even pass through the sinus to reach bone further back. In a study published in 2020, 217 implants were followed in 70 patients; 204 protruded up to 3 mm into the sinus and 13 passed through it. No implants were lost during follow-up, and only one adverse reaction was seen in the sinus. In another study, 45 implants protruding into the sinus or the floor of the nose showed no signs of sinusitis over 18 months; however, where the protrusion was deep, the sinus lining did not cover the tip of the implant. The authors of both studies are from teams that use the method.

The mechanical risks come from the thin body and from the bridge. Some one-piece implants are designed so that they can be bent at the neck to fit the bridge. A study from a team that uses the method reports that bending the neck did not affect success in the implants they followed. On the bridge side, a five-year study published in 2025 recorded that 154 of the 5108 implants placed were lost, and also recorded damage in 5 of 170 metal-acrylic bridges, 6 of 206 full-arch metal-ceramic bridges and 11 of 215 partial bridges. We could not find a reliable summary that gives a separate fracture rate for the implant body, so we do not state one.

A loading error is the most preventable risk of this approach. Fitting the teeth without waiting for osseointegration is only safe if there is enough mechanical anchorage from the first day. That is why the torque is measured, and an area that does not reach the expected value is not loaded that day; delivery is postponed. Ignoring the measurement to keep to the timetable may gain a few days in the short term and cost you the implant. A single spot touching first when you bite is another silent route to the same outcome.

When it comes to inflammation around the implant, the picture is disputed. The manufacturer's circle says peri-implantitis is not seen with these polished, thin-bodied implants; a study in which a single clinician who uses the method followed 5100 implants for up to 57 months also says it was not seen; in the same study, 105 of these implants were lost. According to the European Federation of Periodontology, however, when plaque builds up, mucositis develops in the gum around an implant, and if it is not treated it can progress to peri-implantitis, which involves bone loss. This holds regardless of design: inflammation can start under a bridge that cannot be cleaned, around any implant.

One risk that is rarely talked about is removal. A series from a single centre in Israel covering 11 years reports that removing blade-type designs classed as 'basal' left serious bone defects and that the chances of placing implants again were low. This series does not measure disc or screw-type corticobasal implants separately, but the lesson is the same: if an implant anchored in deep bone fails, taking it out can also be a major procedure. This possibility needs to be discussed at the planning stage.

The same method can be low-risk in one mouth and an unnecessary gamble in another. The breakdown below is the framework for what is checked at the examination; the final decision is made after the CBCT scan.

The sequence below shows where the risks are controlled. Skipping any one of the steps means the related risk goes unchecked.

1. 1

   Marking the canal and sinus boundaries on the CBCT scan

   The nerve canal in the lower jaw, and the sinus and floor of the nose in the upper jaw, are measured separately for each implant. The distance to the canal is the plan's first checkpoint.

2. 2

   Choosing the target layer for each implant

   Which cortical wall the anchorage will come from, and whether there will be protrusion into the sinus, are decided at the outset. With a one-piece design, this decision cannot be changed afterwards.

3. 3

   Placement and measuring the torque

   The anchorage of each implant is confirmed by its torque value. An area that does not reach the expected value is not loaded that day and delivery is postponed; this is not a promise but a decision based on measurement.

4. 4

   Balancing the bite

   When the final bridge is fitted, the load is spread evenly across the implants. A single spot that touches first will, over time, cause both damage to the bridge and a loading problem in the implant.

5. 5

   The first check-ups

   The bite is measured again, and you are asked about any loss of sensation or sinus complaints. Most problems are caught at this stage while they are still small.

6. 6

   Cleaning and regular follow-up

   You are shown how to clean under the bridge, and the gum around the implants is assessed at check-ups. Mucositis can be reversed when it is spotted early.

No route is risk-free; each one moves the risk somewhere else. It helps to look at them from this angle when comparing.

The cards below summarise the findings above. For each one we have set out what it is and how it is noticed.

Most side effects appear in the first few days and then subside. What matters is telling the expected course apart from a warning sign.

1. The first few days

   Swelling, bruising and pain peak during this period and then subside. Cold compresses, sleeping with your head raised and the medication you are given keep this period manageable.

2. The first week

   The swelling goes down. If numbness in your lower lip or chin continues, this is not something to wait and see about; tell your dentist.

3. The first few weeks

   Your bite is checked and any spots that touch first are corrected. Chewing starts with soft foods and gradually returns to normal.

4. The long term

   At regular check-ups, the gum around the implants and the bridge are assessed. If a night guard was planned, it is worn regularly.

We do not give figures. But when comparing quotes, seeing where the risks are prevented, and who takes on what if a problem arises, matters as much as the total figure.

Planning and the CBCT scan

3D planning, in which the nerve canal and the boundaries of the sinus are measured, is the step where most of the risks are prevented. A quote that saves on this step may look cheap but can end up costing more.

Check-ups and bite adjustments

Ask whether the check-ups after the teeth are fitted are included in the quote. Most mechanical problems are caught at these check-ups while they are still small.

Night guard

If you clench your teeth, one may be needed to protect the bridge and the implants. It should be discussed as a separate item.

What will be done if a problem arises

How procedures will be handled if an implant is lost, the bridge needs repairing or an implant has to be removed should be set out clearly in writing before treatment.