From a clinical Point of View... Biological width has great implications on how we place dental implants and the restorative schemes that go along with them. The patient treatment below shows a very typical situation where implants are placed in the posterior mandible. The posterior mandible always presents the limitations of the location of the mandibular neurovascular bundle. In an attempt to get as much implant support as possible in this area, it is often the policy to place implants here in a one stage procedure making the maximum use of bone supported implant structure.

If there is only 11.5mm of bone above the neurovascular bundle, one could place a 10 mm length implant and place the head of the implant at or slightly below the crest of bone. When the implant is uncovered and joined to an abutment, you will loose an additional 2mm of bone due the re-establishment of the biological width. The net result will be to have only 8mm of implant supported by bone. If you were to place a 13mm implant leaving 2mm of the implant supercrestal, the net result would now be to have over 10mm of implant supported by bone.

 

The three implants at the left were place in a one stage procedure to maximize the use of the available bone height.

 

 

 

In the radiograph you can see how the head of the implant is approximately 2mm above the crest of bone.

 

 

 

The final restorations may still be properly contoured providing for an excellent restoration with more than adequate bone support for the implants.