Ideal RPM for Mini Implants to Stabilize Lower Denture?

Dr. B, asks:
What is the ideal RPM [rotations per minute] for drilling the pilot holes for IMTEC [3M] mini implants diameters 1.8mm, 2.1mm or 2.4mm to stabilize a lower denture with ball-rubber ring attachments? Should the pilot holes be narrow or sized similar to the diameter of the mini implant? Can you use different sized mini implants for the same case? Do you recommend immediate loading?

8 Comments on Ideal RPM for Mini Implants to Stabilize Lower Denture?

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Carlos Boudet, DDS
4/26/2010
The published drilling protocol for the Imtec mini implants does not mention a drilling speed. The literature suggests low drilling speeds to reduce the chances of heating the bone. The lower the speed, the more likely that the pilot bit will walk. Try 200 or 300 rpm since you only need to perforate the cortical bone (unless you are in dense type 1 bone and then you may need to drill 1/3 to 1/2 the lenght of the selected implant. Good Luck!
Carlos Boudet, DDS
4/26/2010
Didn't see the whole question. The pilot drills are matched to the implant sizes, the 1.1 drill for the 1.8 diameter. They cannot be the same size of the implant since the implants need to be securely threaded in the bone. You can use different sizes, but for what reason? And to answer your last question, these implants are designed and approved to be immediately loaded. Good, Luck!
Ken Clifford, DDS
4/27/2010
Using new drills is the best way to minimize heat and avoid "walking" during pilot hole placement. I actually use my electric motor set to 30,000 with a 30 to 1 reduction handpiece for a speed of 1000 RPM. With a new drill, even in type 1 bone, the placement to 1/3 the length of the implant takes only a few seconds. With continuous water irrigation by my assistant, it does not seem possible that much heat is generated. At any rate, I have very few failures with mini implants. I still contend that the best way to minimize failure is the lock the implants together on day one. I would rather do a fixed case any day than a removable with housings.
I Erwood
4/28/2010
The 1.8, 2.1 and 2.4 IMTEC mini implant pilot holes can all be drilled with the 1.1 mm pilot drill. RPM range with electric motor and external irrigation 1200 - 1800 rpm's (denser bone higher rpm's) Depth of osteotomy 1/3 to 2/3 lenght of implant (denser bone greater depth). Immediate load in mandible after 30 Ncm torque test. I prefer to immediate soft load in Maxilla cases with Secure soft.
CL KOAY
4/29/2010
Interesting observations of different techniques. Basic requirement is do not damage the bone with overheating the bone when drilling.However if you are using the auto advancing technique and thountingat is what makes the mini or small diameter implants unique in placement as compared to the standard or regular diameter then an initial puncture through the cortical into the cancellous is all that is required. Thus in this approach even if the bone is damaged by overheating is of no consequence. Have been placing the Imtec minis since yr2000 and has placed in excess of 1000pcs and still counting.Have always used and still using the airrotor highspeed with crown cutting diamond or tungstun carbide at highspeed. Osseointegration is in the 90+ percentile. The secret is understanding the AUTO ADVANCING TECHNIQUE that the IMTEC or other minis are developed for.Happy implanting from Malaysia.
Paresh B Patel
9/2/2010
A similar manufacturer (Intra-Lock) recommends the drilling RPM to be between 1200-2000rpm with irrigation. One smooth stroke as not to burnish and overheat the bone. The pilot hole should be smaller in diameter than the implant. 1.1mm for the 1.8 implant. A larger pilot bit for the 2.9mm. A common mistake is to insert the mini a too quick of a rate. Everyone seems to forget that the torque when placing a mini generates a tremendous amount of HEAT. We as dentists like the tight feeling when the mini is going in but that can do two things: create too much pressure in the condensation of the bone and overheating of the bone. Do not go faster than 30rpm or 30 ncm of torque when inserting with a handpiece. I dont see why you could not use different size minis in the same case....they all accept the same o-ring housing. If there is primary stability and you have enought minis I dont see why you could not immediate load the implants. Best regards.
Robert J. Miller
9/2/2010
I am not sure where all of the posters got their information for the protocol for placing narrow diameter implants. The Intra-Lock protocol is to drill at 150-200 RPM to no more than 1/3 the depth of the final implant length. The implant is then placed at 15 RPM, using the viscoelastic nature of the bone for compression and intial stability. The final torque value should be 35 Ncm or greater to be immediately loaded. At these speeds, no irrigation is necessary. Check the PDF file on the Intra-Lock website. RJM
Manvant Patel
12/29/2010
Required Lower Dentures Stability. Require different options. I do not have normal bones in lower jaws.

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