High Costs for Implant Screws for Orthodontic Anchorage: How to Manage?

Anon. asks:

I am an orthodontist and I try to stay at the leading edge in research. I have been using the mini-implant screws for orthodontic anchorage. But the costs are getting extreme. I have been referring my patients to an oral surgeon for placement and my patients are paying $450 per mini-implant screw. But, it takes minutes to place each one and there is very little danger of complications. I think the procedure is so simple I am considering doing it myself to conserve the cost of treatment. Are any of you orthodontists out there placing your own mini-implants for anchorage? Did you have any start up costs? Was there any learning curve?

18 Comments on High Costs for Implant Screws for Orthodontic Anchorage: How to Manage?

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satish joshi
4/29/2008
My friend grass always seems greener on the otherside.Why you guys charge $5000 for simple Class I crowded case?How much pack of bands,brackets,wires and rubber bands cost? It is not cost of implants,it is about time and money spent for extra training just like ortho.( I know,I know Implant dentistry is not speciality like ortho) Of course you can save money for implants, If you are ready for training and extra liability associated with it. By the way I do my ortho cases, so I know the difference.
osurg
4/29/2008
Don't Expect your friendly OMS to pick up the case if you end up in a nerve or vessel or have a post- op problem. If you place implants you shouuld you owe it to you patients to be well trained by taking the appropiate courses to cover all aspects of the field.
Frank Nelson
4/29/2008
Interesting comments. In the locations needed for ortho anchorage, I would expect very little danger of ending up in a nerve or vessel. I guess what really matters is the operators working knowledge of dental and skull anatomy. If the orthodontist went to dental school then straight to ortho school and has really never operated under the tissue, perhaps caution is in order, however, if he had a lot of surgical experience prior to his ortho training, placement of the type of anchorage needed is quite simple and I think it is a little over the top, frankly, to create fear like this. I would agree, however, that the expertise of the oral surgeon is very valuable if the orthodontist is unsure. We are in an interesting time like never before in the profession, aren't we? Technology is changing the face of how we do things. Just the battle over who has the pervue over placement of implants I believe is just starting. Should it be the Oral surgeon who is used to surgery all day long, and the specialty that pioneered implant placement....or, should it be the periodontist who works in a more "micro" way with surgery, thus the logical choice for such a precise surgery, no maybe the prosthodontist or well skilled general dentist used to complicated prosthodontics is the best, because he will have to restore it, thus, should place them to know more realistically where they should go, but wait! what about the Endodontist? Since we are trending toward earlier and earlier implants vs endo when restorability is not as predictable, why shouldn't the endodontist be able to place immediate implants, since he will know when it is restorable or not? It will be interesting times! regards fmn fmn
Alejandro Berg
4/29/2008
We have been placing this rocky mountain implants for quite some time now( maybe 400 or so) and I know I may come from a totally different reallity (we are located in Chile) but in terms of surgery we only charge 155 dollars for an ortho implant. do you think that is ok for a patient?
SFOMS
4/29/2008
Certainly, with the proper training and 3D visual perception, anyone can place mini-anchorage implants. In our OMS training, we assisted orthodontic residents during placement, because it was so easy, and the fee didn't really justify the time spent on the case. So price or fee is not absolutely reflective on how difficult or easy the procedure is, but that it generates a profit. If one is going to buy a mini-anchorage screw, pay for disposable goods/supplies, assistant chair time, DDS chair time, calculate in risk of damage for a tooth and charge $450 per screw, i'd say its reasonable. Its not like some are placing 10 of these screws in 30 minutes... Its also the value of the results of procedure that also influences the cost.
dr mike
5/1/2008
dr. jason cope, an orthodontist in dallas, tx is presently teaching orthodontists how to place the Imtec mini-implant. however, his understanding of implants is quite limited. he downplays the negative consequences and associated problems. also, knowing how much orthodontist hate giving shots, he also downplays the pain by teaching other orthodontists to use a pneumatic gun to inject local anesthetic under the mucoperiosteal membrane. HOWEVER, the gun is very unsafe and harbors bacteria that cannot be properly sterilized. i forget the name of the pneumatic gun, but i called the manufacturer after i took his course and they admitted that it cannot be properly sterilized.... very unsafe in today's world. MY SUMMARY: if you are going to place the 'ORTH TAD', at least take a mini-implant course from Imtec, get an Aseptico 7000 series implant motor and the Monte Blanc handpiece. i use CTscans for all of my implants with surgical guides also and feel it is soon going to be the STANDARD OF CARE for TADS and implants. FINANCIAL: get a knowledgable periodontist or oral surgeon to do your TADS for you and build it into your fee for ortho. dr. mike
almez
5/3/2008
we are currently in the era of specialty. i don't know, why would an orthodontist, no offince, would like to drill into bone, since he/she likely even foregot how a periostium looks like .... ortho and omfs works together in a lot of orthognathic surgery cases, it wise and better for the pt to have every specialist, do what he/she used to do.
david,omfs
5/6/2008
the high failure rates of tads i the maxilla and probable need for plate fixation makes me concerned about unskilled people performing operations. i could be taught to perform bypass surgery over the weekend but would not risk the pt to my limited skills, complications are usually referred and then its your problem, best luck so you can make maor money david omfs
Dr aisha
5/29/2008
i need to ask when do u use anchorage implants when there is no molar tooth for anchrage and after putting impalnt how long do u wait to put force on it..
mike
5/29/2008
I haven't had much success with the TADS either. I like bone plates and I will have an article coming out soon using IMF screws in the ramus to upright the horizontally impacted second molar. This technique has proven quite successful for us. I'm an OMFS but I think if your office is surgically set up for these procedures and you get the surgical training, then go ahead. Be ready to handle infections and possible need to debride dead bone if the implant gets infected. I don't know to many ortho offices in my area that are set up surgically. There is more to the total patient care than drilling a hole and placing a screw. The screws are not warranted like the implants as well. You may have to eat the cost of a second screw, so take that into account as well. We charge cost of material plus 10% and $150-$300 pending area of placement, flap or no flap. There are new codes for these procedures yet most good ole dental insurance companies aren't paying for them yet. SHOCK!
kathy edry
7/3/2008
I am a patient who needs your help. Three years ago a dentist performed four root canals on me which became infected requiring the teeth to be removed. This dentist's secretary said the root canal program he was using at that time (sounds like Orbtura???) has been recalled. The dentist has offered to put in implants. Should I be wary of him doing any more to my teeth? Is there any way he could be held responsible to have the implants put in at an oral surgeon's office? (I just read some of your comments concerning surgery by a dentist and am scared for him to now attempt the implants.) Help.....I need your input please!
R. Hughes
7/4/2008
Some times ther is just too much infection, inflammation and just bad biology on the patients part. There could of been additional canals that your Dr. could not see, heck even the endodontist do not always find all tha canals. Endodontics is far from a perfect science, but that is the way it is. It's too bad but things happen.
Cory Cooper
7/21/2008
If you are looking to try on your own, I may can lend some help. There is a new mini-implant on the market for ortho called the Infinitas system. It is sold by ClassOne Orthodontics out of TX. Interesting thing about this implant system is the unique head design for ortho and the fact it has a Stent Guidance System that lets you build a quick essix stent on the model. When patient arrives, you just place stent and screw now goes in with accuracy. I have found that orthodontists wanting to try implants love this system because of the ease of use and confidence it gives them in regards to insertion site.
Jim Pollard
11/27/2008
cf. Frank Nelson: By the way, OMFS's didn't pioneer dental implantology--general dentists did!
Dr/ Dody
1/20/2009
Place screw or implant for orthodontic anchorage is very very easy and I use it in my clinic without any training it is very simple,up till now I have not any complication.
maryruth swift
2/16/2009
what is the average price of a mini implant and also the price of fixed bridge per tooth.........thank you
RAJESH PATIL
1/15/2010
Implants are a fantastic addition in orthodontic armamentarium to fight malocclusions. I think one can save a lot of money by investing in BIO-MK implants. they are top notch from land of korea. you can email me at rajeshp_us@yahoo.com for more details regarding implant placements or implant supplies.
dr. sachin doshi
6/29/2016
TAD is a boon to Orthodontists.....although it might be frustrating initially to see a few tads getting failed ... but don't worry its always a learning curve....once you have mastered it its fun to use and its real quick.

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