Bicortical stabilization can sometimes be difficult to achieve, however, is an advantageous surgical goal. Biocortical stimulation occurs when a surgeon engages more than a single cortical plate when placing a dental implant. Typically, this is done with the cortical bone of the base of the mandible or the floor of the maxillary sinus or nasal cavity and the crestal cortical bone of the edentulous ridge. However, it can also be done by engaging the lingual and facial cortices.
Biocortical stabilization can reduce maximum stress in the superior cortical plate, assuming no peri-implant defects have occurred. However, each surgeon must decide if the potential gains from this technique outweigh the increased risks that are needed to achieve implant placement with the engagement of more than one cortical plate. Ultimately, the advantages and disadvantages must be evaluated in each patient to determine the best surgical approach.