Background/Objectives: The rehabilitation of severely resorbed anterior alveolar ridges presents significant clinical challenges due to esthetic demands and the limited bone volume in this region. Basal cortical implants, which are designed to engage dense basal bone, could offer an alternative by providing stable anchorage in compromised sites. Methods: This report evaluates the ARi® Implant System, which features cortical anchorage and a calcium-incorporated nanostructured surface (XPEED®) in two anterior ridge defect cases. Soft tissue augmentation using a vascularized interpositional periosteal (VIP) flap was applied in one case, and biphasic calcium phosphate (BCP) grafting and collagen membranes were employed for ridge contouring in both cases. Results: At a two-year follow-up, both cases showed stable peri-implant tissues and satisfactory esthetic results. Conclusions: Although basal cortical implants provide good primary stability, their use does not eliminate the need for bone augmentation, especially in the anterior esthetic region. Future clinical studies are required to substantiate long-term outcomes and broader applicability.
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