Dr. Aldo De Blasi, Italy
Conventional mini implant surgery in the edentulous mandible is in most cases, a very quick and minimal invasive procedure. The implants are usually placed trans gingivally and if initial primary stability is achieved then they can be loaded immediately following the surgery.
Dr. Alexandre Minis, France
Case description
68-year-old man, fully edentulous, smoking patient, lack of medical history.
Surgical dental history:
– maxillary rehabilitation by full implant-supported bridge
– failure of 2 mandibular implant surgeries
What are mini implants?
Mini implants are in all respects implants, but with a small diameter, not exceeding 3 mm.
They are produced in a titanium alloy, which is classified as grade 5, and has excellent mechanical properties. They have a sandblasted and etched surface which once inserted into the bone undergoes osseointegration such of that of implants with a larger diameter.
Abstract
Mini implants are a valid alternative to traditional implants to stabilize the rehabilitation of edentulous arches. Patients with full arch prostheses can benefit from this technique which, with a minimally invasive approach, allows to stabilize them with a single operation even in anatomically unfavorable bone conditions. The advantages include a reduced post-operative symptomatology, low-cost therapy and the possibility of using the pre-existing prosthesis. The aim of the seminar is to examine a convenient therapeutic solution, to learn a simple and minimally invasive implant technique and, through the selection of the patient candidate for rehabilitation with mini implants, to discover a new tool for the stabilization of the total prosthesis.
Read the full article on Dental Tribune Magazine
Click here to access the webinar (Italian language)
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Content of the webinar
This presentation describes the use of mini implants as an anchoring device for a full prosthesis in order to provide greater stability and retention. A simple, fast, convenient and low invasiveness technique is shown, which allows to obtain in a single appointment an effective stabilization of the patient’s removable denture. Where the removable prosthesis is the therapeutic solution to the problem of edentulism, the mini implants can provide additional comfort and well-being. Finally, through the exposure of some clinical cases, the use of these implants with a reduced diameter is shown, it is explained how to select the ideal patient and how to plan the clinical case.
Educational objectives
• Learn a simple and minimally invasive implant technique
• Examin a convenient rehabilitation solution
• Discover a new tool for patient rehabilitation.
We present you a Surgical Clinical Case with Flapless Technique performed by Doctor Aldo De Blasi using SD Mini Implants. You will be able to observe all the steps necessary for the stabilization of the lower prosthesis in the interforaminal region.
When visiting the impressive manufacturing facility, with 25 CNC machines alone, you will also come across the “Mercedes” of manufacturing technology such as the Swiss Tornos, a five-axis machine, which at C-Tech is purely tasked with the manufacture of mini-implants. Currently they are the largest manufacturer in Europe for this specific type of implant. Mini-implants are popular as a minimally-invasive option for creating an immediate restoration, which is currently a highly sought-after alternative for fast and good functional care of older patients. An impressive neighbour is the Willemin Macodell (the Rolls-Royce of CNC machines), which can be fitted with 48 different CNC cutters. It can change tools in 1.4 seconds and can be used in any conceivable axis, including for the manufacture of angled mini-abutments. C-Tech was one of the first companies to move over to cooling all computer-controlled machine tools using water-miscible bio-lubricants. The plant-based oil is odour-free, improves machining and even has a wider range of applications than mineral oil products. “And even though of course we run extensive cleaning processes for the finished parts, it’s still one risk factor less”, comments Lütfü Agic with respect to the recently published independent surface study by the University of Cologne, where the C-Tech implant surfaces were tested as an example, in testing applied to very few dental implant surfaces on the dental market.
Der klinische Erfolg von Mini-Implantaten hängt von verschiedenen Parametern ab, die auch untereinander in Beziehung stehen. In der vorliegenden Studie wurde untersucht, ob eine Korrelation zwischen dem Durchmesser der inserierten Implantate und der Primärstabilität existiert. Dabei wurden zudem unterschiedliche, durch den jeweiligen Patientenfall vorgegebene Knochendichten berücksichtigt. Außerdem erfolgte eine Dokumentation der Osseointegration und der Tiefe etwaiger perioimplantärer Taschen über einen Zeitraum von einem Jahr post implantationem. Darüber hinaus wurden der Einfluss des Implantatdurchmessers und der Art des Implantataufbaus auf die Erfolgsrate ermittelt.
Aufgrund der im Rahmen der vorliegenden Untersuchung ermittelten Ergebnisse darf bei einer Verwendung von Mini-Implantaten zur Prothesenstabilisierung mit einer Erfolgsrate ähnlich wie bei klassischen Implantationen gerechnet werden. Da der Erfolg mit der Primärstabilität korreliert, lässt er sich nach deren Bestimmung mit der Drehmomentratsche direkt im Anschluss an die Insertion bereits gut abschätzen. Liegen die ermittelten Zahlen im grenzwertigen Bereich (≈ 35 Ncm), so sollte im Zweifelsfalle eine weiche Unterfütterung vorgenommen werden. Je nach individuellem Fall ist auch zu prüfen, ob zur besseren Stabilisierung ein weiteres Mini-Implantat inseriert werden kann. Hat man die Wahl, so sollte eher ein etwas größeres gewählt werden, d.h. statt des 1,8-mm-Implantats lieber das 2,1er bzw. statt des 2,4-mm-Implantats lieber das MDI Hybrid mit 2,9 mm Durchmesser.
Es versteht sich von selbst, dass eng beieinander liegende Recall-Termine angeraten sind, insbesondere um die planmäßige Osseointegration zeitnah verfolgen zu können. Sie ist keinesfalls nach sechs Monaten abgeschlossen, sondern erfährt in den darauffolgenden sechs Monaten in der Regel noch einmal eine signifikante Verbesserung.
1990 Studium der Zahnmedizin (Universität für Medizin und Pharmazie „Victor Babes“ Temeschburg).
1990-1993 Oralchirurgische Weiterbildung an der Akademie für Zahnärztliche Fortbildung Karlsruhe.
1995 Training in Goldman School of Dental Implantology/Boston, Massachussets.
1998 Spezialist DGZI.
2004 Expert Implantologie der DGOI.
2006-2007 Spezialisierung “Dento-alveoläre Chirurgie” Dr. medic.stom. Henriette Lerner (Universität “Carol Davila” Bukarest).
2006 Praxis im Videnti Zentrum für Implantologie und Ästhetik, Baden Baden.
Mitglied in: DGOI; ICOI; EAO; ASA DGÄZ; DGZMK; BDO; EFOSS.
Nationale und Internationale Referententätigkeit über Ästhetik in der Implantologie, Minimal Invasive Implantology, Curriculum Implantologie, fortgeschrittene Augmentationstechniken.
Evaluation of some morphological oral aspects perceived as decision factors in complete edentulism treatment by mini-implants overdenture. Patients, Material and Methods: An observational study was conducted on a sample of 24 patients (average age of 61 years), through clinical and imagistic methods. The variables taken into consideration were: age, gender, alveolar mucosa status, bone offer, miniimplants characteristics, insertion torque and loading type. Results: 117 mini-implants were applied. Conclusions: Mini-implant supported overdenture can be an alternative to conventional denture and conventional implant overdenture. Its advantages derives from implants’ characteristics (smaller diameter, variable length, O-ring retention system), which adapts better to the particular edentulous conditions. Insertion technique implies less surgical trauma. Choosing implants’ size, number, topography, and the loading method have a great variety, depending on anatomical feature (bone offer, mucosa and relationship with the nearby anatomical structures), functional features and patients’ wishes.
Mini-dental implant supported overdenture can be in complete edentulous patients a treatment alternative to both conventional dentures and conventional implant retained overdenture.
The advantages of this type of treatment derives from the characteristics of this type of implant (small diameter, variable length, O-ring retention system), which adapts better to the particular morphological conditions present in full edentulous patients. Also, the implants insertion requires less surgical trauma, this being a beneficial aspect in the context of usually poor general status.
Proceeding and achieving the treatment requires needs careful evaluation through clinical, imagistic and laboratory methods. Frequently there are identified some unfavorable conditions for implant insertion and a high degree of treatment difficulty. These issues (morphological and functional features, related to general health status, age, gender, etc.) must be linked to implants characteristics, in order to decide the particular treatment features, from surgical and prosthetic point of view. The length, diameter, number, topography, loading method of implants can present a large variety, depending on quantitative bone offer (ridge width and bone height), quality (bone density), functional features and patient’s wishes.
This type of treatment has a lower cost compared to conventional implant supported overdenture, by the lower cost of mini-implants, and also due to the use, in general, just of the panoramic radiography as imagistic method (computed tomography is an adjuvant method, but not essential in most cases). Also by eliminating some surgical intervention, we eliminate also their costs. On the other hand, the benefits related to an improved stability, better functionality and adaptation are quickly noticed by the patient and increases their level of satisfaction.
Due to the relatively simple technique, less traumatic, but with benefits that are quickly perceived, the mini-implant supported overdenture may be the elective treatment alternative for complete edentulous patients.
[3] MELESCANU M, PREOTEASA E, Mandibular panoramic indexes predictors of skeletal osteoporosis for implant therapy, Curr Health Sci J, 2009, 35(4):291–296.
[7] ***, IMTEC Corporation official website, retrieved December 13, 2009, http://www.imtec.com/europe/.
[13] ORDOÑEZ A, EASTMOND V, Mini-dental implants – they’re here to stay, Postgraduate Dentist Caribbean, 3(1):7–12.
Complete dentures are most frequently a challenge for practitioners. The complexity of this disease is often associated with general health problems, but also with the physiological ageing phenomenon, that increases the treatment difficulty. Completely edentulous patients, usually elderly, often complain about the functionality of conventional dentures, especially the mandibular ones, claiming their instability, poor retention and discomfort during wear. Complete maxillary and mandibular dentures have been for over 100 years the standard treatment of complete edentulism. If complete maxillary denture wearers tolerate better the complete dentures, given the better conditions for support, retention and stability, the tolerance of mandibular prosthesis is generally lower. The relatively frequent instability of the mandibular denture, poor retention and associated discomfort were the starting point for the idea of setting the overdenture on 2 implants as first treatment alternative for the mandibular complete edentulism (according to McGill and York consensus) [2, 3, 4].
Implant overdentures are inspired, as treatment concept, from the of the overdentures, the dental implants being used instead of tooth roots. Dental implants that are used for implant overdentures are made of high-strength alloy (TiAl-V), with good biocompatibility, with different designs and sizes that aim to address the prosthetic needs according to the oral particularities and clinical limitations of its execution. The first implants that were introduced in the dental practice were the ones with standard diameter, around 3.75mm. Later on, their diameter was increased and decreased (narrow), ranging between 3 and 6mm. Afterwards, the mini implants with one-piece design for implant overdentures appeared (IMTEC, later 3MESPE), with diameters of 1.8mm, 2.1mm and 2.4mm. Narrow Diameter Implant Overdenture (NDIO) represents a category of implants that combines features from conventional implants and mini implants, with diameters between 3 and 3.5mm and variable lengths (10-18mm), comprising two distinctive subgroups, namely two-piece design (e.g. Seven Narrow Line implants, MIS Implants Technologies Inc. 18-00 Fair Lawn Ave. Fair Lawn, NJ 07410, UNITED STATES, mini Sky 2, Bredent Medical GmbH & Co, Germany, Straumann implant, Straumann Group SIX: STMN, Basel Switzerland) and one-piece design (e.g. uno line, MIS implants). Two-piece narrow implants can be used as the conventional implants (with delayed loading), or as one-piece mini implants (with immediate loading protocol). In relation to anatomical, functional and prosthetic case particularities, the number of dental implants used can be reduced, similar to that of the conventional implants (e.g., two narrow implants for the mandibular overdenture). Mini Dental Implant Overdentures (MDIO) use mostly-one piece dental implants (miniSky1, Bredent, MDI 3MESPE) with diameters between 1,8mm and 3mm and variable lengths (10mm-18mm), that require one-stage surgery for implant placement, followed by prosthesis application in the same appointment, with soft material in the housing area (progressive loading) or fixation of the matrices in the denture base (immediate loading). Within the mini implants, those with a diameter between 2.7 and 3mm are classified as hybrid implants, these having sometimes a two-piece design and can be used as narrow dental implants (e.g., two narrow implants for the mandibular overdenture). The main features of the overdentures on dental implants with a diameter below the conventional one, considering their three main categories according to their diameter, are synthesized in table 1. The decision to use either a CDIO, NDIO or MDIO as treatment for complete edentulism, starts from the acknowledgment of patient’s preferences and expectations, within the limitations of the systemic and oral health-status. In systemic alterations with indications of limited surgery or that negatively affects the healing process, NDIO and MDIO are more indicated than CDIO, due to their reduced invasiveness. Oral particularities, such as the anatomical conditions (bone quality and quantity, the shape of the alveolar ridge, skeletal class), thickness and health of the oral mucosa (e.g., denture stomatitis, candidiasis), available prosthetic restorative space (especially as vertical dimension, given the necessary space for abutment, attachments and prosthesis thickness, in order to prevent its fracture) should all be considered when choosing between the implant prosthesis alternatives.
Stabilization of conventional denture with mini- or narrow-dental implants is beneficial especially for the elderly, considering the improvement achieved through a relatively easy surgical intervention, with moderate treatment costs. In this regard, for mandibular denture stabilization either 4 mini implants or 2 hybrid/narrow implants can be used. Treatment success is strongly related to acknowledgement of patient anatomical and functional particularities, rigorous planning and execution of prosthetic and surgical phase, as well as ensuring an adequate maintenance. Considering that edentulism is and most probably will continue to remain a frequent medical condition mostly found in the elderly, MDIO and NDIO overdentures, through their specific parameters, may replace in time complete dentures and may be the most used treatment alternative.
[1] WHO. Active Aging. A Policy Framework. Madrid; 2002. http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.pdf?ua=1 (accessed 3 October 2014).
[19] Misch CE. Contemporary Implant Dentistry 2nd edition. St. Louis: Mosby Inc; 1999.
[20] Rossein KD. Alternative treatment plans: implant supported mandibular dentures. Inside Dentistry 2006; 2(6) 42-43.
The highest target in our profession is the fulfilment of patient wishes. The greatest wish of our patient is always the fast, painless replacement of their missing teeth or stabilisation of the prosthesis. A fast, stable and esthetic reconstruction of the patient’s dento-facial system is the main goal of every dentist.
At the time, immediate loading was not an issue, the mini implants were used for the stabilisation of a provisional construction for the time necessary for the osseointegration of the conventional implants. Those mini implants were 1.8mm to 3.3mm in diameter. This implant was also developed with a small ball on the top of it that could be incorporated as a snap for a denture, or to secure a temporary bridge. To uncover the standard implants, it was found that around 50% of the mini implants had actually integrated or bonded to the bone. In order to increase the rate of success, the implant design was improved in to follow the rules of osseointegration and the insertion protocol was changed to give the implants the primary stability necessary for immediate occlusal loading.
The general indication for the placement of narrow diameter implants,ridges which, through resorption, become inadequate for placement of standard diameter implants: buco-lingually <5mm, mesiodistally <5mm or both.
The absolute indication will be completed in these cases where the patient does not want an augmentative bone reconstruction or is not indicated from the medical point of view.
a) Edentulous arches The indication for the lower jaw is a 1.8-2.1mm diameter implant. For the insertion of an implant with a diameter of 1.8-2.1mm we need 10mm bone height and 3mm bone width. For the upper jaw the recommended implant is 2.4mm diameter. 4mm bone width and 10mm bone height will be needed.
b) Single tooth restoration The second indication is the insertion of a mini implant in a small gap, in order to replace a front tooth or a premolar, in situations where the standard diameter implant is contraindicated or not possible. A small gap of mesio distal dimension of 5 mm can be replaced with an implant of 2.4mm and a crown if the esthetical considerations will be adequate.
[3] Todd Shatkin, Samuel Schatkin, Benjmin D Openheimer, Adam J Openheimer (2007). Mini Dental Implants for Long-Term Fixed and Removable Prosthetics: A Retrospective Analysis of 2514 Implants Placed Over a FiveYear Period. Compendium 28 (2): 36-41
[13] Sendax VI (1995). Mini implants strategy offers a broad range of uses. Dent Today 14(1): 227–232
[21] Misch CE (1993). Patient force factors. In: CE Misch, ed. Contemporary Implant Dentistry. St. Louis, MO: CV Mosby
[23] Branemark PL (1983). Osseointegration and its experimental background. J Prosthet Dent 50(3):399–410
A 55 year old female patient was referred to our office for a full mouth rehabilitation. Upon clinical examination and a CBCT, we have decided to implant 4 EL C-Tech conical Morse tapered connection implants in the upper jaw for a bar retained over denture and due to financial considerations; was to perform extraction of all remaining lower teeth and immediate post extraction implantation of SD C-Tech mini dental implants. A full muco-periosteal flap was released, teeth were extracted, an alveotomy was performed to achieve an optimal bone platform for the SD mini dental implants and to obtain a bigger vertical dimension for the overdenture!
A 58 years old female patient has come to our clinic for lower jaw rehabilitation. After the clinical examination and OPG, We have decided to extract tooth 33, which is the only one remaining. As thepatient has not accepted a big augmentation procedure, we have decided to implant 4 C-Tech SD mini dental implants for retention and stabilization of the lower denture.
Why should you read this article?
This case report is a guide, how mini-implants can be used as strategic abutments for the stabilization of removable partial dentures and for the support of the remaining teeth.
Introduction: The use of conventional dental implants as strategic abutments for existing removable partial dentures is expensive and requires a sufficient alveolar ridge width. The one-piece mini dental implants (< 2.8 mm) provide an alternative treatment option for this indication. Treatment method: A therapy scheme for strategic mini dental implants (MDI, 3M ESPE Dental GmbH, Seefeld, Germany) includes 3 abutments (teeth + implants) per maxillary quadrant and 2 abutments per mandibular quadrant.
Results: In the first case report, a female patient lost one of her 2 mandibular canine conical crown abutments. Subsequently, 2 mini dental implants were inserted with sufficient primary stability (insertion torque > 35 Ncm) and were immediately loaded with the matrices by using intraoral polymerisation.
The second female patient had 2 remaining molars. After the placement of 4 MDIs (insertion torque 20–25 Ncm), the removable partial denture, which is retained by conical crowns, was relined using a soft material. Four months later, the matrices were polymerized into the denture in the dental laboratory across impression.
Conclusion: Supplementary strategic abutments using mini dental implants requires following the recommendations for the number and location of MDIs, load approach, anatomical knowledge, surgical experience especially in dealing with the jawbone, and sufficient prosthetic experience.
1. Ellis JS, Levine A, Bedos C et al.: Refusal of implant supported mandibular overdentures by elderly patients. Gerodontology 2011;28:62–68
2. Elsyad MA, Gebreel AA, Fouad MM, Elshoukouki AH: The clinical and radiographic outcome of immediately loaded mini implants supporting a mandibular overdenture. A 3-year prospective study. J Oral Rehabil 2011;38:827–834
3. Elsyad MA, Ghoneem NE, El-Sharkawy H: Marginal bone loss around unsplinted mini-implants supporting maxillary overdentures: a preliminary comparative study between partial and full palatal coverage. Quintessence Int 2013;44:45–52
4. Esposito M, Grusovin MG, Maghaireh H, Worthington HV: Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev 2013, Mar 28;3:CD003878. doi:10.1002/14651858.CD003878.pub5. Review
5. Flanagan D, Mascolo A: The mini dental implant in fixed and removable prosthetics: a review. J Oral Implantol 2011;37(Spec No):123–132
6. Fuh LJ, Huang HL, Chen CS et al.: Variations in bone density at dental implant sites in different regions of the jawbone. J Oral Rehabil 2010;37:346–351
7. Griffitts TM, Collins CP, Collins PC: Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:e81–e84
8. Hasan I, Bourauel C, Mundt T, Stark H, Heinemann F: Biomechanics and load resistance of small-diameter and mini dental implants: a review of literature. Biomed Tech 2014;59:1–5
9. Heinemann F, Bourauel C, Hasan I, Mundt T: Mini-Implantate als strategische Pfeiler zur verbesserten Retention von Teilprothesen. Implantol J 2014;18:26–33
10. Huemer P, Huemer B, Gollmitzer I: Mini-Implantate – Möglichkeiten und Grenzen im zahnlosen Unterkiefer. Quintessenz 2013;64:315–325
11. Klein MO, Schiegnitz E, Al-Nawas B: Systematic review on success of narrow-diameter implants. Int J Oral Maxillofac Implant 2014;29:43–54
12. Krennmair G, Krainhöfner M, Waldenberger O, Piehslinger E: Dental implants as strategic supplementary abutments for implant tooth-supported telescopic crown-retained maxillary dentures: a retrospective follow-up study for up to 9 years. Int J Prosthodont 2007;20:617–622
13. Mangano FG, Caprioglio A, Levrini L, Farronato D, Zecca PA, Mangano C: Immediate loading of mandibular overdentures supported by one-piece, direct metal laser sintering mini-implants: A short-term prospective clinical study. J Periodontol. 2014;2:1–13.[Epub ahead of print]
14. Morneburg TR, Pröschel PA: Success rates of microimplants in edentulous patients with residual ridge resorption. Int J Oral Maxillofac Implants 2008;23:270–276
15. Mundt T, Heinemann F, Stark T, Schwahn C, Biffar R: Verlustanalyse von Mini-Implantaten zur Fixierung totaler Prothesen. Dtsch Zahnärztl Z 2014;69:262–270
16. Mundt T, Schwahn C, Stark T, Biffar R: Clinical response of edentulous people treated with mini dental implants in nine dental practices. Gerodontology 2015;32:179–187
17. Preoteasa E, Imre M, Preoteasa CT: A 3-year follow-up study of overdentures retained by mini-dental implants. Int J Oral Maxillofac Implants 2014;29:1170–1176
18. Rammelsberg P, Bernhart G, Lorenzo Bermejo J, Schmitter M, Schwarz S: Prognosis of implants and abutment teeth under combined tooth-implant supported and solely implant supported double-crown-retained removable dental prosthesis. Clin Oral Implants Res 2014;25:813–818
19. Scepanovic M, Calvo-Guirado JL, Markovic A et al.: A 1-year prospective cohort study on mandibular overdentures retained by mini dental implants. Eur J Oral Implantol 2012;5:367–379
20. Shatkin TE, Petrotto CA: Mini dental implants: a retrospective analysis of 5640 implants placed over a 12-year period. Compend Contin Educ Dent 2012;33(Spec 3):2–9
21. Walzer W: Mini-Implantate zur Stabilisierung von Teilprothesen. Dent Implantol 2013;17:396–401
22. Wentaschek S, Scheller H, Schmidtmann I et al: Sensitivity and specificity of stability criteria for immediately loaded splinted maxillary implants. Clin Implant Dent Relat Res 2014, Dec 23. doi:10.1111/cid.12283. [Epub ahead of print]
Introduction: The aim of this study was to analyse possible factors for the loss of mini-implants with diameters between 1.8 and 2.4 mm used in the stabilization of complete dentures.
Methods: A total of 79 women and 54 men (mean age of 71.2 ± 9.8 years) were examined and interviewed in 9 dental practices. The patient records were evaluated retrospectively.
The cumulative implant survival rates were depicted with Kaplan- Meier curves and the potential risk factors were evaluated using Cox regression analyses (P < 0.05).
Results: Out of 336 mini-implants in 54 maxillae 15 were lost and out of 402 mini dental implants in 95 mandibles 11 were lost due to the lack of or loss of osseointegration. Furthermore, 2 mini-implants fractured during insertion and two more were fractured after 4 and 32 months. The 4-year implant survival rate was 95.4 % in the anterior maxilla, 91.8 % in the posterior maxilla, 97.0 % in the anterior mandible and 91.1 % in the posterior mandible. Without including the fractured mandibular implants, the 4-year survival rate was 97.6 % in the anterior mandible and 95.1 % in the posterior mandible. Significant differences were found between anterior and posterior placement areas (P = 0.039) but not between the jaws (P = 0.188). The survival rate of mini dental implants with a length of 10 mm was lower than the survival rate of longer implants (90.7 % versus > 95 %, P = 0.044). The factors sex, age, and smoking habits were not significant. In the Cox regression analysis, neither the placement area nor the implant length showed a significant Hazard ratio after adjustment.
Conclusion: The 4-year survival rates of mini-implants used in the stabilization of complete dentures were acceptable in both jaws. The failures tended to be more frequent in the posterior area and for shorter implants.
1. Andreiotelli M, Att W, Strub JR: Prosthodontic complications with implant overdentures: a systematic literature review. Int J Prosthodont 2010;23:195–203
2. Bulard RA, Vance JB: Multi-clinic evaluation using mini-dental implants for long-term denture stabilization: a preliminary biometric evaluation. Compend Contin Educ Dent 2005;26:892–897
3. Cho SC, Froum S, Tai CH, Cho YS, Elian N, Tarnow DP: Immediate loading of narrow-diameter implants with overdentures in severely atrophic mandibles. Pract Proced Aesthet Dent 2007;19:167–174
4. Ellis JS, Levine A, Bedos C et al.: Refusal of implant supported mandibular overdentures by elderly patients. Gerodontology 2011;28:62–68
5. Elsyad MA, Gebreel AA, Fouad MM, Elshoukouki AH: The clinical and radiographic outcome of immediately loaded mini implants supporting a mandibular overdenture. A 3-year prospective study. J Oral Rehabil 2011;38:827–834
6. Elsyad MA, Ghoneem NE, El-Sharkawy H: Marginal bone loss around unsplinted mini-implants supporting maxillary overdentures: a preliminary comparative study between partial and full palatal coverage. Quintessence Int 2013;44:45–52
7. Flanagan D, Mascolo A: The mini dental implant in fixed and removable prosthetics: a review. J Oral Implantol 2011;37:123–132
8. Fu h LJ, Huang HL, Chen CS et al.: Variations in bone density at dental implant sites in different regions of the jawbone. J Oral Rehabil 2010;37:346–351
9. Griffitts TM, Collins CP, Collins PC: Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:e81–e84
10. Hasan I, Bourauel C, Mundt T, Heinemann F: Biomechanics and load resistance of short dental implants: a review of the literature. ISRN Dent. 2013 May 8;2013:424592. doi:10.1155/2013/424592. Print 2013
11. Hasan I, Bourauel C, Mundt T, Stark H, Heinemann F: Biomechanics and load resistance of small-diameter and mini dental implants: a review of literature. Biomed Tech 2014;59:1–5
12. Huemer P, Huemer B, Gollmitzer I: Mini-Implantate – Möglichkeiten und Grenzen im zahnlosen Unterkiefer. Quintessenz 2013;64:315–325
13. Jofré J, Conrady Y, Carrasco C: Survival of splinted mini-implants after contamination with stainless steel. Int J Oral Maxillofac Implants 2010;25:351–356
14. Lindhe J, Meyle J: Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology.J Clin Periodontol 2008;35(Suppl.8):282–285
15. Morneburg TR, Pröschel PA: Success rates of microimplants in edentulous patients with residual ridge resorption. Int J Oral Maxillofac Implants 2008;23:270–276
16. Mundt T, Schwahn C, Stark T, Biffar R: Clinical response of edentulous people treated with mini dental implants in nine dental practices. Gerodontology 2013, Jul 17. doi:10.1111/ger.12066. [Epub ahead of print]
17. Scepanovic M, Calvo-Guirado JL, Markovic A et al.: A 1-year prospective cohort study on mandibular overdentures retained by mini dental implants. Eur J Oral Implantol 2012;5:367–379
18. Shatkin TE, Shatkin S, Oppenheimer BD, Oppenheimer AJ: Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period. Compend Contin Educ Dent 2007;28:92–99
19. Shatkin TE, Petrotto CA: Mini dental implants: a retrospective analysis of 5640 implants placed over a 12-year period. Compend Contin Educ Dent 2012;33:2–9
20. Slot W, Raghoebar GM, Vissink A, Huddleston Slater JJ, Meijer HJJ: A systematic review of implant-supported maxillary overdentures after a mean observation period of at least 1 year. Clin Periodontol 2010;37:98–110
21. Vittinghoff E, McCulloch CE: Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 2007;165:710–718
22. Wallace RH: The relationship between cigarette smoking and dental implant failure. Eur J Prosthodont Rest Dent 2000;8:103–106
Especially in atrophied mandibles, where conventional diameter implants meet their limits, mini dental implants can be a sensible solution.
This is also true in patients, where an invasive procedure can pose medical risks. Thanks to the diameters of mini dental implants, which are less than
3 mm, cases where the mandible is very thin, the MDIs can be placed with a minimal invasive procedure that often does not require bone augmentation.
The most common indication for the mini dental implants in our practice is for the stabilization of the full denture in the lower jaw. Edentulism is a disability that may even result in the higher mortality of the patient. A prosthesis, which is solely supported by the gingival tissue does not provide an adequate replacement of the missing dentition: especially in the case of the atrophied jaw where the retention is especially low. This compromised situation can result in the avoidance of social situations as well as malnutrition due to food restrictions. Through implant therapy, it is possible to stabilize the prosthesis and thus substantially increase the patient’s quality of life.
Unfortunately, a conventional implant therapy does not come into question for many patients. Especially with senior citizens with medical risk factors there would be large concerns about a heavy surgical procedure where a bone augmentation might be required. Additionally the cost factor plays a large role with many patients. Here mini dental implants offer a cost effective and minimal invasive alternative that is acceptable for many patients.
