ask a question Discussing the Latest in Implant Dentistry
Mini Dental Implants
Dr. Todd Shatkin provided OsseoNews.com with an exclusive interview about Mini Dental Implants. Read the first interview by clicking here. Read the second interview by clicking here Feel free to post your thoughts on this interview, by adding your comments below. For additional discussions on mini dental implants, please visit our mini implants section.
September 10, 2005 in Mini Dental Implants | Permalink
Advertisement
Comments
Mini implants has major desing problems first it is a terrible idea to place an implant without incision it is agood marketing tool but in the short term dr s will see the problem. it is like doing surgery with your eyes closed. the problem with that you can not always predict where the
buccal bone is. your mini implant might be too buccal or lingual the second probleb is their
size and immediate loading to put full denture immediatly will create problems in short immediatly. and patients will loose more bone.
Posted by: kayhan civelek | Jun 1, 2005 4:05:07 AM
I have used the mini-dental implant system now for about 3.5 years. It has been a great addition to my practice and to my patients. Many times I have had very mature patients present to me frustrated and dissatisfied with what their previous dentist has recommended for them as far as major costs, procedures, and surgery. The mini-implant system is mainly used in my practice for three different groups of patients. These are patients who are financially, medically, or anatomically compromised. My success with these implants has been great! Patients who have experienced this system have referred their friends and family for similar procedures. With proper diagnosis, case selection, and proper insertion the mini dental implants has proven to be a great asset to practioners and patients. 98% of my cases has been for loose dentures in the mand. region.
Posted by: Ara Nazarian DDS | Jun 1, 2005 3:45:27 PM
SHOW ME ONE STUDY with long term (greater than 5 years) results that supports DR. Shitkin's results of placing "thousands"(his words) of "permanent" (his words) crowns, bridges, or overdentures.......
Sorry.....publish, or perish....
Sorry, also....Dr. Joe Gillespie, Mt. Pleasant, SC, hasn't yet placed THOUSANDS of IMTEC's......and until I see ONE reliable study placed in a reliable journal, I WON'T believe it.......
Posted by: David K. Oyster, DMS, MS | Jun 1, 2005 8:39:56 PM
Dear Readers,
Please take some of these comments with a grain of salt. We are currently doing a statistical anaylisis of close to 5,000 MDI's. Our preliminary findings are 95%-98% success with crowns and denture stabilization. We will be publishing this within 6 months. Thanks,
Todd Shatkin, DDS
Posted by: Todd Shatkin | Jun 2, 2005 10:20:51 AM
I have never seen an FDA 510k for the permanent use of a temporary mini implant. Why would a licensed doctor use a procedure that uses a product in a way that it was not designed or approved to be used?
Posted by: Larry Gandel, DDS | Jun 2, 2005 11:38:32 AM
I think that the most interesting thing about the IMTEC is how I started using them as a transitional implant to allow my dentist patients to "function" immediately while their other implants intergrated. Easily, 9 out of 10 times the mini could not be removed without breaking them. They were intergrated. The published reports I know are coming. To speak to the FDA issue...I was wondering how many dentist were cementing abutments well before the 510K said you could on implants?
Posted by: Jeffrey Hoos DMD FAGD | Jun 2, 2005 6:10:03 PM
For everyones information, the FDA has actually approved the MDI for use with LONG TERM, not transitional, not temporary but LONG TERM USE for denture stabilization, single crowns, multiple crowns splinted or unsplinted. If anyone would like a copy please contact Steve Hadwin at IMTEC Corporation. This approval was granted over 2 years ago based on 25 years of studies including those of Dr. Sendax, myself and others. Please check your information before making bold negative statements. Thanks
Posted by: Todd Shatkin | Jun 3, 2005 10:43:37 AM
i dont believe because no sufficent evidence.we need proper reference and stusies on it.
Posted by: Dr .Ejaz khawer | Jun 4, 2005 12:23:10 PM
Dr,may i know the diffrence between the 1.8mm and the 2.3 and the appropriate use for each one.
as well the diffrence between the oball and the square head.
Posted by: | Jun 8, 2005 12:53:17 AM
can we be a little more friendly please.......
It is tough world out there. We should stick together ........
Posted by: william dds | Jul 23, 2005 1:16:29 PM
Dr. Shatkin or others:
Can someone please comment on the long-term viability and durability in using a mini-implant on my top front incisor?
My periodontist has recommended a mini-implant to repair a single missing tooth instead of a traditional, single-tooth implant. My dentist is not so sure. The literature is simply not clear on whether I should be concerned about using a mini-implant or not.
Posted by: Patient | Sep 15, 2005 11:57:34 AM
Dear Patient,
The mini implant can be successfully used to replace a single incisor. The main reason to use the MDI is because the surgery is simple, it is non invasive with little to know discomfort, It is cost effective, and the results are nearly immediate. In fact, if your dentist using F.I.R.S.T. Laboratory and our technique, the implant and crown can be completed the same visit within 1 hour. Thanks for posting your question here and feel free to ask any other questions you may have. Thanks,
Todd Shatkin, DDS
Posted by: Todd Shatkin, DDS | Sep 20, 2005 4:15:16 PM
Dear William,
Thamks for the comment. I agree, this is a tough world and we dentists should support each other as much as we can. As for the question on the diameter of the MDI's. The 1.8mm is used in more dense bone and the 2.3 is used for softer bone like in the Maxilla or posterior mandible. I use the 1.8 for lower anterior cases 95% of the time. I use the 2.3 very often for fixed cases or for upper denture stabilization. Thanks,
Todd
Posted by: Todd Shatkin | Sep 20, 2005 4:18:31 PM
Having placed both mini and standard size(over 3.0mm wide) implants in an "immediate load" protocol, I have found that success of any size implant is most dependent on the amount of torque (n/cm) that is applied during the final turns of seating. If, generally speaking, I can see more than 30 n/cm with mini's and 45 n/cm with standards, I am very confident there will be no problems short term or long term. If I have a thin ridge and don't feel comfortable using a larger (wider) implant, then I'll consider a mini. However using the widest implant possible, mini or standard, has been, and continues to be, I feel, the smartest course to take. Quite frankly, this little battle that seems to be waging in the profession today, between the traditional stantard implantologists, and the mini implant advocates, is all really quite silly. Bone physiology is not a sentient being, and therefor incapable of discrimation. Most doctors feel a well placed 3.5 mm wide/12mm long implant will last a long time and call it a PERMANENT Implant. And many of those same Doctors will scoff at the idea that a mini in the same place could ever last as long and would never call it permanent. But if the "Mini" were 2.5mm wide and 18mm long would it not have the same "holding power"? To think that healthy bone will osseointegrate around a 3.5 but not a 2.5 is ludicrous. I've talked to many Doctors over the last few years I've been doing my own implants, and no other issue seems to stir emotions like mini implants vs standard. But in this humble writer's opinion the whole issue will simply fade away, as the differention between mini and standard is already becoming very cloudy with the introduction of 2.5 and 3.0 and 3.2 immediate load implants. More sizes will be available as more manufacturers get in the game. Soon it will simply be a matter of asking guestions. How much height and how much width does the patient have. More height less width, use a longer, narrower implant. more width less height use a wider shorter implant. Period! Of course a multitude of other factors must be considered when choosing an implant. General health, bruxisum, # of teeth left, presence of deep overbite etc. so no one can diagnose "over the phone" so to speak. If you have enough bone height so that the longer mini implants could be used, it may be an option for you. A consultation with an experienced Mini Implant Doctor such as Dr. Shatkin would be your best bet. Now would be a good time, as I hear it's beautiful up there, this time of the year!
Posted by: Dr Tedesco | Sep 20, 2005 5:33:45 PM
I have placed about 8-9 lower overdenture cases and one upper lateral crown using minis. What I like best about the technique is it's forgiving quality. When a mini snapped upon insertion, I simply placed another nearby without any negative effect. When two of them pulled out due to soft bone, I again replaced them into stronger, denser bone. I won't compare them in strength or quality to regular implants but I will say that my patients upon receiving an affordable, reversible and easy way to retain their dentures or replace a missing tooth have always shown joyous enthusiasm and long-term studies or guidelines won't change my mind.
Posted by: Ira Bauman | Sep 20, 2005 7:32:11 PM
i use these stricktly transitionally.. even though permanent use is approved, i find 1/3 fall out prematurely, and therefore i dont feel confident for long term use. iti implants have been in my hands greater than 99% successful, si if im defidient in bone i graft, widen , displace to create ideal bony anatomy and place implants with long term proven results.
Posted by: david ettinger | Sep 21, 2005 5:43:48 AM
I have been placing regular and wide diameter implants since 1993 and mini implants since 1999.
It is interesting to see so much controversy on this topic, mini implants are to regular diameter implants what regular diameter implants could be to wide diameter implants (5's and 6's), I believe each option in the field of implant dentistry have indications and plays a role. Mini implants are an excellent player and are here to stay; they work excellent in overdentures (stick to the protocol) and they are showing very nice results as an option for fix cases in which space, bone and health is a problem, not every patient for different reasons will want or can have orthodontics, or bone regeneration and in those patients single mini implants play an important role. If we stick to the concept of surface area, the longer mini implants will have a very decent surface area which in addition to a good management of occlusion will make an impact in the longevity of the restauration.
Do they work? yes they do! do they work well? yes they do! the questions is related to the ability of the practicioner and the selection of the case.
We have been using them for 6 years now and when I look back, there are cases that I did with regular implants that would have been better managed with mini's if I had the experience I have today.
We have never lost a mini implants, we keep strict follow up procedures in these patients and I am impressed of the results, I have not place thousands like Dr Shatkin but a very decent number for a decent number of years, also I have the advantage of having placed regular and wide diameter implants so I can compare.
As I said, they have indications, protocols that have to be followed and no question abou they are safe!
I personally believe mini implants are the way for drs to get in to implant dentistry!
Dr Ordonez
Posted by: alvaro ordonez | Sep 21, 2005 7:44:40 AM
I have restored over 50 mini dental implants over the past 10 months in various edentulous situations. Dr. Tedesco has the best response so far. You can't be "narrow minded" when treating your patients. Mini's do work in certain circumstances and when placed correctly.
Posted by: wade | Sep 22, 2005 8:54:10 PM
The beauty of mini implant is that you don't remove so much of precious bone that is left.
Posted by: | Sep 29, 2005 10:09:36 AM
I believe as a doctor we must be open minded to be able to work on new ideas with scientific basis. First bone healing will be the same around both standard & mini implant,and it could be betteraround mini imp.types because of preservation of good blood supply as result of minor invasive surgery and less bone destruction. The second point is more mechanical,which include load distribution over bone implant interface,and also retention of the implant. From my point of view, the implant diameter plays an important role (especially up 1/3)in load distribution,while the implant length is important for implant retention. I think the point is load distribution(bone implant interface). So my point of concern is: How is the crestal bone resorption around mini implants after 2 years of loading?
Posted by: hossam bargash b.ds m.d.s | Oct 4, 2005 3:45:03 AM
I truly agree and believe Sendax MDI’s are a good way to have docs get started in placing implants.
I also think that it gives us an edge, as today's hot topic for many speakers in the main podium is “ Immediate Load this , Immediate teeth that, Teeth in a minute ,etc...
Aren't we already doing
"Immediate Loading" using this protocol ?
Could the same criterias be used for “Regular Implants” in the placement for immediate load?
I certainly think so. The advantage of MDI's is the ease of placement in thin ridge rather than bone grating or filing , making of large incisions overly exposing bone which we all know affect in delayed wound healing, bone loss, period.
I think we as dentists can learn from each other, success or experience, rather than criticize.
Guys please remember, not all mini’s are created equal…
Posted by: russell | Oct 4, 2005 9:34:20 PM
I really appreciate all the comments re the mini dental implants. I am considering them, and have found a really negative attitude from the dental profession in general - especially in Edmonton, Alberta. In fact, no one here even does them. It would be great to hear from a few patients who have had them done, and their comments for or against. As they say: "The proof is in the pudding."
Posted by: Maria Johnston | Oct 6, 2005 7:30:44 AM
Also, I appreciate the comments by Dr. Ordonez.
Posted by: Maria Johnston | Oct 6, 2005 8:02:36 AM
Do they actually osseointegrate? I have placed many, but present them to patients as non-traditional implants, and a second place alternative to traditional ones. Mini's have huge advantages to the patients and docs alike as mentioned above but they simply don't have the documentation that "traditional" ones have. I personally don't think that means they are less likely to work long term or that makes them bad it just means they come with a little less documented predictability (risk). I think good research is now slowly coming in in favor of the mini's but at the time of my IMTECH training they had no data on osseointegration success. They had great data on case success (high number of cases but from few providers) but overtly avoided the issue of true osseointegration. Hey, I'm a keep it simple kind of guy, if it stays in and preforms its function then it works. My point is that you can't extrapolate data from traditional implants to mini's because some of the magic that makes oseointegration work is because of the CP titanium. Since the mini's are smaller they are alloyed to increase strength and therefore reduce the likelihood of fracture. They are probably just as likely to truly integrate but a good non-biased scientific mind has to respect the fact that although I believe they will work just as well they do not enjoy the same scientific backing yet as the traditional ones. That by definition adds a little more risk to using the procedures and materials. It shouldn't prevent you from using it but it should be considered in presenting options to the patient.
does this make sense, your thoughts?
Posted by: | Oct 6, 2005 7:16:36 PM
Dr Christenson said at the meeting last weekend that studies show, the average horz. bone loss for implants is .1 mm per year. So even standard sizes loose stability over time. He also loves mini's. He says they allow us to be very imaginative in our treatment plans, but have limitations. Mini's were designed for full denture stablization. Using them for fixed crowns is possible if you don't mind pontic type crowns, but certain rules must be followed, to maximize success rates. In the anterior segments use the longest implant possible. Molars need 2 implants each, in fact I've used 3 mini's in a tri-pod arrangement for the #30 of a bruxer, after we attained 12mm of ridge width, 8 months after Bone Augmentation surgery. Now that molar is stable! He loves it, says it's the strongest tooth in his mouth. I placed 3 - 2.5mm mini's, 15 mm in length. That's 7.5mm x 15mm in surface area. Is their a stability advantage here over say, a single, 6mm wide - 15mm long, standard implant? Think about a table with one large leg in the center, vs. the same table with 3 legs out from the center. Which one will resist the LATERIAL forces of chewing the best? Which will stress the bone /implant interface the least?. (This should stir some debate with everyone.) Before anyone gets on me about this, my patient is a 30 year friend of mine, we discussed all his non-implant options and he wasn't interested. He had many evaluations with Oral Surgeons and Prosthodontists,and received many quotes in the $5000.00 Range. After reviewing an appropriate informed consent sheet he was excited that I could help him for less than half the fee of everyone else. I was able to place the implants and permanent crown in 3 hours. I'm excited and you can bet my Patient was excited with the result. In the same vein, if you do say 2 molars as a "Bridge" place the mini's in a stagered line. This gives you a ton of stability that you don't get by placing them in a straight line. More resistance to lateral chewing forces. I learned that the hard way, had to bone aug. and replace 10 months later, on my dime. But the patient was thrilled to have a much stronger segment to chew on. Even the failures end up being opportunities for success and patient satisfaction. You just have to inform properly before surgery, and manage your cases gracefully and mini implant dentistry, as well as standard size immediate load dentistry, can be supremely satisfying for everyone. (Well....maybe not the Oral Surgeons.) And...here's another thing. My patient's don't drive Lexus's and BMW's. My people drive Ford, GM, and now they too, can benefit from Implant Dentistry! That's what it's supposed to be all about, isn't it? Helping all our patients chew again - not just the rich ones.
Posted by: Tedesco | Oct 10, 2005 6:27:35 PM
Browse by:
In The News