The CONO-IN® Nasal implant is Leader Medica’s advanced surgical solution for severe vertical and horizontal atrophy of the anterior maxilla (Cawood & Howell Class IV and V). By securing bicortical anchorage into the dense cortical floor of the nasal aperture (piriform rim), this extra-length fixture eliminates invasive autologous bone block harvesting from the iliac crest or chin symphysis, while leveraging the impenetrable biological seal of a 1°+1° Morse Taper connection.

1. Clinical Concept of Bicortical Nasal Anchorage

• Bypassing Extensive Onlay Grafting: In patients with less than 5–6 mm of residual alveolar bone beneath the piriform aperture, the nasal implant engages the thick cortical bone of the nasal cavity floor as a secondary anchorage anchor, routinely surpassing 45 Ncm of insertion torque.
• Stable Cortical Substrate: The nasal floor cortex represents one of the most stable anatomical bone plates of the midface, remaining dense even in advanced physiological or disuse atrophy.
• Immediate Loading Viability: Rigid bicortical stabilization allows same-day immediate functional or non-functional provisional bridge loading.

2. 1°+1° Morse Taper Connection & Hard Tissue Preservation

• Mechanical Cold-Welding: Authentic 2° total conical friction fit shrinks the interface micro-gap below 0.5 µm, eradicating dynamic micro-movements, bacterial percolation, and crestal saucerization.
• Inherent Platform Switching: Naturally offsets the abutment junction inward, protecting the thin labial cortical bone plate in the anterior esthetic zone and safeguarding papillae.
• Atraumatic Spherical Apex: Rounded apical profile prevents mucosal perforation of the nasal respiratory floor during cortical engagement.

3. Grade 4 Titanium & DAS® Bioactive Surface

• High-Strength Medical Grade 4 Titanium: Engineered to withstand peak lever bending moments across long fixture lengths (16 to 22 mm).
• Alumina-Free Dual Acid Etch (DAS®): Pure chemical subtractive microroughness (Ra = 1.35 µm) promoting rapid osteoblastic adhesion.
• Argon-Oxygen Cold Plasma Glow-Discharge: Purges all hydrocarbon contaminants, imparting high surface wettability and rapid osteogenic stimulation.

4. Step-by-Step Surgical & Drilling Protocol

• CBCT 3D Planning: Map nasal aperture floor morphology, anterior nasal spine, and distance from the incisive canal.
• Pilot Osteotomy: Extended-length Ø 2.0 mm pilot drill at 800 rpm under chilled irrigation until tactile resistance of the nasal cortical floor is engaged.
• Controlled Cortical Engagement: Advance 1.0 to 1.5 mm into the cortical plate under tactile feedback without tearing the schneiderian nasal respiratory lining.
• Final Insertion Torque: 40 to 50 Ncm insertion torque ensuring high primary stability.

5. Prosthetic Portfolio

• Direct Morse Taper solid and angled abutments (7.5°, 15°, 25°).
• CONO-IN Multi-Unit Abutments (MUA) for screw-retained cross-arch splinted prostheses.
• Complete CAD/CAM digital workflow (Ti-Bases and intraoral scan bodies).