Transosteal implant in Turkey: what it is and how it works
A transosteal implant is a type of dental implant for the lower jaw that passes right through the bone instead of sitting inside it. It is sometimes called a mandibular staple or Bosker implant. A custom-fitted titanium plate is placed along the underside of the chin, and several threaded posts pass up through the jaw bone and emerge into the mouth. A denture then clips on to these posts. The design was developed for people whose lower jaw bone has become so thin and low that it cannot hold ordinary screw implants, a state called severe mandibular atrophy that often follows many years of wearing dentures. Dental implant centres in Turkey offer it in selected cases, usually in hospitals with oral and maxillofacial surgeons.
This guide explains how a transosteal implant works, what the evidence shows, who is suitable, what it costs compared with the UK, US and Germany, and which alternatives to consider first. For the wider choice see our dental treatments in Turkey.
Why would someone need a transosteal implant?
When teeth are lost, the jaw bone gradually shrinks because it is no longer stimulated by chewing. In the lower jaw this can leave a thin, knife-edge ridge over the nerve and a bone only a few millimetres high. Dentures then slip, sore spots form and eating becomes difficult. Ordinary implants need enough bone height and width around them; if there is too little, they can fail or risk damaging the nerve. A transosteal implant uses the strong lower border of the jaw, which usually remains, and the plate spreads the chewing force across it. That is its only advantage: it is a solution when bone is very scarce and other routes are unsuitable or declined.
How is a transosteal implant placed, step by step?
This is a bigger operation than a routine implant and is nearly always done under general anaesthesia. Before surgery you have a panoramic X-ray and a 3D scan; see cone beam CT scan. The usual sequence is:
- A small incision is made under the chin and the lower border of the jaw is exposed from the outside.
- The plate, made from impressions or a scan model, is fixed to the underside of the jaw with screws.
- Holes are drilled through the jaw bone, and posts or pins are passed through to emerge through the gum in the mouth.
- The skin under the chin and the gum in the mouth are stitched, and a temporary denture or a soft lining is fitted.
The operation commonly takes one to two hours. After a few weeks of healing a final denture, often a bar-supported overdenture, is made to fit the posts. The plate is usually permanent; some teams remove it only if there are problems.
Does a transosteal implant work? What the evidence says
Long-term follow-up reports from the technique's early decades show that many patients kept functioning dentures for years, but they mostly come from a few specialist centres and from older studies. The method has become uncommon in many countries because newer options give predictable results with less invasive surgery: short implants, bone grafting, implants placed in the front of the jaw and fixed bridges on several implants. Evidence comparing a transosteal implant directly with these modern approaches is limited. An honest summary is that it can work for carefully chosen patients with very thin lower jaws, and that it is not the first option for most people.
Transosteal implant cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for a lower jaw, not hospital quotes. They depend on whether the plate is custom-made, the number of posts, anaesthesia and hospital stay, and the type of denture made afterwards. Each hospital confirms its own price in a written quote.
| Country | Approximate cost range (lower jaw) |
|---|---|
| Turkey | €2,500 – €7,000 |
| United Kingdom | €6,000 – €15,000 |
| United States | €10,000 – €25,000 |
| Germany | €5,000 – €14,000 |
What changes the price: the scan and plate design, general anaesthesia, one night in hospital, and above all the final denture (acrylic, metal-reinforced or on a milled bar). A package normally includes the consultation, scans, the operation, a hospital stay, the temporary denture, medication and transfers; ask whether the final denture, adjustments and a possible plate removal are included.
Transosteal implant, bone grafting or All-on-4: how do they compare?
Most people with a thin lower jaw first look at routes that avoid an incision under the chin. Rebuilding bone with a graft allows standard implants to be placed; see dental bone regeneration. Angled implants can fit a fixed bridge into the remaining front bone, as described in our guide to All-on-4 implants and All-on-6 dental implants. Narrow implants are covered under mini implants.
| Option | Best suited to | Typical limits |
|---|---|---|
| Transosteal implant | Very thin lower jaw where other implants are not possible | Extra-oral incision, general anaesthesia, uncommon technique |
| Bone graft plus standard implants | Moderate bone loss, patients who want a conventional result | Longer treatment time; graft may not take |
| All-on-4 or All-on-6 | Fixed teeth when the front of the jaw has enough bone | Needs adequate bone; costs more than a denture on posts |
| Mini implants | Stabilising a lower denture when bone is narrow but not very short | Less strong; limited for heavy chewing forces |
Who is a good candidate for a transosteal implant, and who is not?
Suitable patients are adults in good general health with a severely resorbed lower jaw, a solid lower border of the mandible and a need for a stable denture who cannot have or do not want grafting. It is less suitable if the lower jaw is extremely thin and at risk of fracture, if you have had radiotherapy to the jaw, if you take bone-affecting medicines such as bisphosphonates, if you smoke heavily or have uncontrolled diabetes, if you have an active infection or if you cannot manage cleaning around the posts. Because of the operation's size, the surgeon will also check your fitness for general anaesthesia.
What results can I expect, and what is the recovery after a transosteal implant?
The aim is a lower denture that no longer moves, so you can chew a wider range of food and speak with more confidence. It will still be a denture, not fixed teeth, and the upper jaw is treated separately. Swelling and bruising of the chin and neck peak in the first days and ease over two to three weeks; the chin skin may feel numb for a time. You eat soft food for several weeks and keep the posts very clean. Most people spend four to six days in Turkey for the operation and first check, return to desk work after about one to two weeks and need a second visit weeks later for the final denture, or have it made in two stages with a local dentist. Sutures are removed after a week to ten days. Fitting and bite adjustments continue after that.
Risks and complications of a transosteal implant
Possible problems include infection or inflammation around the posts, swelling, bleeding, numbness or altered feeling in the lower lip and chin from nerve injury, a visible scar under the chin, loosening or exposure of the plate, and a fracture of the thin jaw bone. Inflammation around the posts (peri-implantitis) is a lasting risk if cleaning is poor. The risks of general anaesthesia apply as for any operation. Professional bodies such as the British Society for Oral and Maxillofacial Surgery and the American Academy of Implant Dentistry advise that complex implant surgery in a severely thin jaw is done by an oral and maxillofacial surgeon or a specialist in a hospital setting. Ask what happens if the plate must be removed and who will deal with it abroad.
How do I choose a clinic for a transosteal implant, and what are the red flags?
Look for an oral and maxillofacial surgeon who has placed this type of implant before, a hospital with general anaesthesia and 3D imaging, and a written plan based on your own scan. Red flags include a quote without a CT scan, promises of fixed teeth in a day, no discussion of grafting or other alternatives, no named surgeon and no plan for aftercare at home. Read how our process works and request a plan through our free quote page: the hospital reviews your scans and sends a written plan and price.
What should I ask the clinic about a transosteal implant?
- How much bone height do I have, and why are other implants not an option?
- Has the surgeon performed transosteal implants before, and how many?
- Would bone grafting, mini implants or All-on-4 be possible instead?
- Is the plate custom-made, and what happens if it has to be removed?
- Is the final denture included in the price, and how many visits do I need?
Hospitals with Dental Treatments in Turkey
Frequently asked questions
A transosteal implant is a lower-jaw implant in which a titanium plate under the chin carries posts that pass through the bone and emerge in the mouth to hold a denture. It is used when the jaw is too thin for ordinary implants.
Approximate ranges are €2,500 to €7,000 for the lower jaw in Turkey, against about €6,000 to €15,000 in the UK. The price depends on the plate, anaesthesia, hospital stay and final denture; the hospital confirms it in a written quote.
For carefully chosen patients with a very thin lower jaw it can give a stable denture for years, but most evidence comes from older reports. It is not usually the first option, since newer techniques may avoid an incision under the chin.
It is used much less today. Bone grafting, short or mini implants and fixed bridges on angled implants are usually tried first, and a transosteal implant is kept for specific cases.
It is done under general anaesthesia, so you feel nothing during it. Afterwards swelling, soreness and bruising of the chin are common and are managed with prescribed painkillers for a few days.
Swelling eases over two to three weeks, soft food is advised for several weeks and sutures come out after about a week to ten days. The final denture follows after healing.
Risks include infection around the posts, numbness of the lower lip or chin, a scar under the chin, plate exposure or loosening and, rarely, jaw fracture. The usual risks of general anaesthesia also apply.
They suit different situations. All-on-4 needs enough bone in the front of the jaw and gives fixed teeth; a transosteal implant is for very thin jaws and carries a denture. A surgeon decides from your scan.
No. The technique is designed for the lower jaw, which has a strong lower border. The upper jaw is usually treated with grafting, sinus lifting or other implant designs.
Plan four to six days for scans, the operation and the first check, with a second stage for the final denture either on a later visit or with a dentist at home.