Dental Implantology with bone, boneless or low bone volume

We are proud to have the opportunity to give you the smile of your dreams.

Dr. Philippe Cotten

Dental Implants can replace missing teeth and provide a fixed solution. We work with axial and crestal conventional and basal implants as an alternative to bone grafts in order to improve dental esthetics and chewing capabilities of our patients

In the case of lost teeth, our treatments are performed with implants over which crowns or bridges made of resin, ceramic, or zircone are fixed in accordance with therapeutic indications.

Dental Implantology with bone, boneless or low bone volume

There are 2 implantology types, depending on the level of bone, the crestal/axial and the basal.

Dr Cotten graduated in crestal/axial and basal implantology, an alternative for patients that have experienced bone loss.

Axial (or crestal) implantology is recommended for patients who have enough bone to undergo surgery with alveolar bone. This implantology is carried out with conical and cylindrical implants and it is the most common type of surgery. Its disadvantage is that the anatomical places for grafting are limited by issues of height, width and/or bone density.


This is the type of implantology we use for most cases where bone density is sufficient.

When there is lack of bone, autologous bone grafts, allografts and xenografys can be used, although there are cases where such techniques are neither desired nor desirable or they have been previously attempted but without complete success.

Basal Implantology is an alternative to bone grafting and it is recommended for boneless or low bone density patients. The procedure uses different implant types with specific designs, plates, disks or cilindroconical implants. Generally speaking, it is a non-invasive procedure as it it does not require removal of the chin, lip or cranium. It also prevents sinus lift and jaw nerve displacement.


Basal Implantology is recommended for patients with severe bone deficit or patients who have undergone unsuccessful conventional grafts. The lack of professional knowledge in basal implantology, misleading online offers and the sheer desperation could lead a person to take the wrong path and suffer disastrous consequences to their health. At Cotten Clinic we don't take chances when it comes to our patient's health. We study each case rigorously and provide customised solutions for basal implantology without bone grafts.

Basal implantology is an advanced method for inserting dental implants that in many cases does not require incisions or stitches to insert the implant and tooth. This surgical procedure is very advanced.


To place implants it is not always necessary to conduct a bone graft; our treatment consists in using the cortical bone in the jawbone. The basal bone enables implants to be securely (and safely) fixed. This surgical procedure is highly advanced.

Basal bone is extremely dense and less prone to bone resorption and infections, one of the reasons why a patient's recovery does not present problems in most cases.

What kind of implantology can be done when there is low bone density?

This is one of the most frequently asked questions received from patients.

As we age, our dentition and jawbone structure may weaken. When we lose our teeth, the human body determines that the bone supporting the teeth is useless and so we start to lose bone density, height and thickness .

Alveolar bone decreases even more and muscle mass is consumed as the years go by.

Conventional implants are placed in alveolar crestal bone, a lower quality bone more prone to the resorption process. However, in the case of basal implantology, implants are anchored to the basal bone which has a more dense and durable structure. It's for this reason that the dental treatment is more successful and causes less problems than most, even when the lack of bone density is extreme.


Basal implantology is a less invasive method than other treatments because it doesn't require the removal of bones from other body areas and it doesn't involve synthetic bone materiall. However, basal implantology allows for and requires the placement of teeth over implants within 2-3 days with a fixed prosthesis which functions as an external fixture.

Early fixed bridge placement and fewer secondary effects: two great advantages of this method.


Origin of Basal Implantology

The basal implant specialty emerged as a response to patients with severe bone loss...


Gene bone preparation

Gene bone preparation helps to stimulate cells in patient's own bone that improves implant placement...


What kind of prosthesis is it?

Once the implants are settled as if they were natural teeth roots, we proceed to place a fixed prosthesis.

The origin of Basal Implantology

The basal implant specialty emerged as a response to patients with severe bone loss whom wish to avoid bone grafting; today's development in this area even allows for treatment of severe cases of atrophy.


The basal implantology treatment has been practiced for over 30 years. Doctor Cotten has been developing his expertise for over 20 years. The clinical experience is not just guaranteed by his professional career, but also by him being one of the top professionals in his field. He has a University Degree in Basal Implantology from the University of Medicine Nice Sophia-Antipolis (France). More details about Doctor Cotten's career and his team here.

Basal implantology originated and evolved thank to the work of Dr. Gérard Scortecci, a recognised expert in implantology. Doctor Cotten spent several years with Doctor Scortecci studying the lateral osteotomy technique in order to place basal implants and develop specific parts for implant prostheses.

What is gene therapy for bone regeneration?


Do you know exactly why gene therapy is required prior to any implant surgery in order to increase bone density?

Gene therapy helps to stimulate cells in a patient's own bone that improves the placement of implants in a natural way, without the use of bone grafts or synthetic materials. Bone stimulation consists of minor surgery that can improve bone density and prevent sinus-lift. Within 45 days the bone will be fully prepared so that the implant can be placed wihtout having to open the gums or use stitches. Surgical recovery is quicker, there is much less discomfort and fewer side effects than with other interventions.

More details in this link and publication

Cotten Clinic treatment for totally edentulous patients

Patients receiving basal implantology treatment for maxillary issues or a toothless jaw will follow this process:

  • Analysis
  • Preoperative case study
  • Scanner study
  • Osteotensors (if necessary)
  • Planning
  • Surgery: placing implants

48-72 hours after placing implants:

  • We will place the transition dental bridge (or provisional bridge)
  • X-rays at the end of the intervention


**By following these processes we ensure that our patients are able to have their prostheses fixed upon implants within 2 to 3 days after surgery. These transition fixed prostheses last for several months.

**The final prosthesis (zirconium bridge) can be placed 3 to 5 months after surgery, or later if necessary.

**Implantology treatments at Cotten Clinic don't require the removal of bones from the cranium, hip, chin or any other body parts. Our treatment also does not involve sinus lifting or dental nerve lateral shifts.

What kind of prosthesis is it?


A fixed denture over fixed implants is used for all procedures. Once the implants have settled as natural teeth roots, we can place a fixed prosthesis. A resin fixed prosthesis is used firth then, after a month once the patient can eat normally and tissues are stable, ceramic or zirconium crowns are introduced. We determine the dental prosthesis material according to the type of transition or final prosthesis and we always study your particular case in depth.

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What patients say about us


Our patient started to lose teeth, had discomfort and was looking for a quick solution. He was frightened by the thought of being without teeth for a long time. He had been advised to solve the problem with a bone graft because the gums and bone had already begun the process of resorption; Your treatment could last approximately 2 years. He arrived at Clinica Cotten and we heard a solution in basal implantology. Know your opinion about Cotten Clinic.

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(Testimony in Catalan) This patient began with dental problems in childhood that were accentuated in adolescence until it resulted in gingivitis. Implants and a bridge were placed, but the process of resorption had already begun to retract his gums and bone, so the prosthesis moved and caused great insecurity. He started searching for information about us on the Internet and decided to visit us. Watch the video and get to know your Cotten Clinic experience.

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The patient reports a previous negative experience in which she came to a supposed "specialist in basal implantology". She confirms what happens to many other patients, despair leads us to rely on marketing. He also met us on the internet, but the experience is very different from the previous one. Find out why, knowing your opinion about Cotten Clinic.

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We are a team of experienced professionals and we are passionate about our work

Implantoral Club Internacional Espana
Association Francaise o Implantologie
Universite Nice Sophia Antipolis
International Congress of Oral Implantologists