Mini Implants - MSmiline

What is a Mini Implant?

Mini implants come in four diameters and different lengths.The the 2.9mm diameter mini is called a "Hybrid" since it is nearly the diameter of the smallest available rootform implant, but can still be placed using the simplified surgical procedure shown below.  Hybrids are used exclusively for the softer bone densities found in the upper arch.  The smaller diameter implants are for the denser bone types.  The length chosen by the surgeon is determined by the amount of vertical bone available to retain the implant.  Very dense cortical bone is better served with a shorter, thinner implant.  Generally, four mini implants are placed in the anterior portion of the lower jaw. 

 

Unlike standard implants, mini implants allow immediate loading.  This means that the patient walks out of the office on the day of surgery with a lower denture which is not only solidly stable, but can be used to eat immediately.  Mini implants can often (not always) be placed in the lower jaw without cutting an incision in the gums.  in other words, they can often be placed right through the gums directly into the underlying bone.  Most of the time, the only anesthetic necessary is an injection directly over the position in the gums where each implant is to be placed.  The old lower denture can then be retrofitted over the newly placed implants, and the patient can use the denture immediately without waiting for the three to six months necessary for a standard implant to integrate.  Furthermore, because the implants are about the size of a standard wooden toothpick (they are made out of a titanium alloy), patients who have been told that there is not enough bone to accommodate standard implants can generally be fitted with minis.  The entire procedure (placing the implants and retrofitting the old denture so that it is supported by the newly placed minis) takes about 90 minutes.  It is generally painless, and produces very minimal post operative discomfort.

 

Patients can be fitted with these implants and begin using the newly stabilized denture immediately because these implants do not require months of waiting time to integrate.  The implants are "screwed" firmly into the bone so integration is immediate (although further integration on a microscopic level has been shown to take place for months after the initial placement of the implant.  Finally, since the procedure generally involves no major incisions, there are very few contra-indications to the surgery. 

 

The only medical conditions that absolutely preclude the placement of these implants are the following:

  • Uncontrolled diabetes

  • A history of radiation treatment to the jaws (generally for cancer)--this does not include diagnostic x-rays

  • Immuno-suppressed patient

  • Substance abuse

Factors which place the prognosis for these implants in doubt include the following: Note that these factors do not necessarily preclude the use of mini implant retained dentures.  However patients who exhibit these traits are more likely to suffer complications and possible failure of one or more of the implants.

  • Heavy smoking and/or drinking

  • Sjorgren's syndrome

  • Alzheimer's disease (these patients may be unable to insert and remove the dentures after the implants are placed)

  • People who clench their teeth.

  • Young persons who are still growing

Even people with heart disease, high blood pressure, or other serious medical conditions usually have no difficulties retaining mini implants.   Old age is NOT a factor!  Persons taking anticoagulants like coumadin and wafarin need to stop taking their medication several days before the procedure only if the dentist determines that an incision will be necessary in order to place the implants.  The surgery is very short (about 90 minutes) and very little bleeding occurs.  Furthermore, there is generally very little post operative discomfort.  Tylenol, Advil, or Aleve for the first twelve hours after surgery are often sufficient.  If an incision is used, the dentist may prescribe a narcotic for the first twelve hours after the surgery.  If no incision is used, many people require no pain medication at all. 

 

Patients on immunosuppressive therapies such as methotrexate for rheumatoid arthritis may be successful with mini implants if the dose of the immunosuppressant is low, and the patient is able to take a drug holiday for at least a week before the implants are inserted and a week afterwards.  Always check with your physician before doing this.

 

Oral bisphosphonates(for osteoporosis or Pagets disease of bone--drugs like Actonel, Boniva and Fosamax) are not considered a contraindication for implants.  While implants have been known to fail in patients taking oral bisphosphonates, studies indicate a very low risk of either implant loss or BRONJ (Bisphonate Related OsteoNecrosis of the Jaw) following implant placement.  This is especially true if the patient has been taking the drug for less than three years and has no other complicating factors.  If the patient has been taking their bisphosphonate for more than three years, some authorities recommend a two to three month drug holiday before the implants are placed, extending to about a month post-op.

What is involved?

The first visit is a general "meet and greet" during which the doctor gets the necessary information from the patient and explains to the patient what to expect.  In some offices, this visit is a free consult.  At a subsequent visit, the dentist will generally take two x-rays;  a panorex and a lateral jaw film to assess the amount of bone available, and to determine which size implant is appropriate for the case.   Many offices will charge for the x-rays, but apply the fee to the final cost of the case when it is completed.  In a very few instances, we find cases in which the amount or quality of bone is not suitable even for mini implants.   The old denture is assessed for suitability to receivehousings with o-rings.  These housings remain permanently in the denture and will engage the implants.     If the denture is not suitable to receive housings, or the patient has decided to have a new one made after the implants are placed, the dentist will simply reline the old denture with soft reline material.  The soft reline material engages the denture nearly as well as the housings, but should be changed every six months.   If the patient is a suitable candidate, he/she is given all the information necessary in order to decide if he/she really wants to go through with the procedure, and then the patient is asked to sign an informed consent document.

 

Note: More information could be find at : www.doctorspiller.com