Parobreda

If deeper implant placement is considered the solution to avoid GBR, where is the evidence that biology has changed?

Every few years a new concept promises to simplify implant surgery by avoiding bone augmentation.

The question is not whether surgery becomes easier.

The real question is:

What happens to the peri-implant tissues over the next 10 or 20 years?

Decades of experimental and clinical research have shown that peri-implant bone remodels according to biological principles—not marketing concepts.

When a rough implant surface or implant-abutment interface is intentionally positioned too deep, marginal bone remodels until a stable biological dimension is established. This often results in a deeper peri-implant sulcus, making plaque control and long-term maintenance more challenging.

The easiest surgery is not always the best biology.

Sometimes guided bone regeneration is not overtreatment.

Sometimes it is simply the price we pay for creating a more maintainable peri-implant environment.

Long-term success is determined by biology—not by how easy the surgery was.

This is why, for more than 20 years, ParoBreda has chosen an implant system with long-term scientific documentation over short-term marketing promises.

Our choice remains Nobel Biocare.

Because biology always wins.

Treatment is not about treating an X-ray.

Five years ago this implant showed bleeding on probing and an 8 mm pocket. Because of the patient’s age (85 years) and bisphosphonate use, surgical intervention was intentionally avoided.

Five years later:
• no bleeding on probing
• clinically stable
• radiographically stable

This case does not prove that bisphosphonates prevent peri-implantitis progression.

It reminds us that treatment decisions should be based on the whole patient—not just pocket depth or radiographic appearance.

Sometimes careful maintenance is the most appropriate treatment.