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Mini Implant Interview with Dr. Todd Shatkin

posted in Dental Implant Interviews, Mini Dental Implants Discussions

« Mini Dental Implants: Extensive Debate | Passive Fit »

Dr. Shatkin graduated from the University of the Pacific Dental School in 1989 and has been in private practice with his father Samuel Shatkin, DDS, MD and his brother Samuel Shatkin, Jr. MD, both Board Certified in Plastic surgery. Their practice of plastic surgery and cosmetic dentistry is located in Amherst, NY, a suburb of Buffalo. He has placed and restored over five thousand IMTEC mini-dental implants in the last six years. About half of these were for denture retention and the other half for single and multiple tooth replacement with F.I.R.S.T. tm Restorations. Dr. Shatkin has been lecturing for IMTEC Corporation for the past several years teaching seminars and mini residency programs. He can be reached at tshatkin@minidentalimplants.com or at www.minidentalimplant.com.

Osseonews: Dr. Shatkin you have been at the cutting edge in mini-dental implants. What do you think is the most significant advantage to the mini-implant?

Dr. Shatkin: The most significant advantage of the mini-implant is that it is a simple procedure for the doctor and patient, it is cost effective and requires no flap or suturing in most cases. Furthermore, the mini-implant can be restored with a permanent crown or bridge restoration at the time of placement if the F.I.R.S.T. procedure is utilized.

Osseonews: Could you describe the placement and exactly what makes it so simple?

Dr. Shatkin: You place a surgical guide stent with a titanium tube that guides the site and angulation of the pilot drill. An additional Pilot Drill guide is used to angle the drill in the proper direction. The implant is inserted through the tube as well. This ensures perfect placement. The stent is removed for the final torquing of the implant. No need to lay a flap or used guide pins. The stent is made on diagnostic casts. I have developed and patented a system for this called the Fabricated Implant Restoration and Surgical Technique (FIRST).

Osseonews: Could you describe the protocol for restoring a mini-dental implant with a crown?

Dr. Shatkin: The laboratory uses the same guide stent to make the crown. The path of insertion of the crown is along the same axis as the implant. The laboratory makes the crown to insert exactly in line with the implant. Essentially all you have to do is remove the stent and do the final torquing of the implant and then insert the crown. In less than 30 minutes a single implant and lab fabricated fixed crown can be completed and cemented permanently. In about an hour a 3 unit case can be finished and in 3 hours, an experienced implant dentist can place and restore an entire arch of implants and crowns.

Osseonews: Could you describe the configuration of the IMTEC mini-dental implants.

Dr. Shatkin: The mini-implants are 1.8 or 2.3mm in diameter and come in 10, 13, 15 and 18mm lengths. The 13mm and 15mm are the most commonly used. There are two styles of implant configuration. The classic mini-implant had a ball head, square polished neck and threads right up to the neck. The newer version has a polished collar instead of threads just below the neck.

Osseonews: What is the orientation of the correctly inserted mini-implant?

Dr. Shatkin: The square neck should be set about 3-4mm above the gingival tissue.

Osseonews: What are the indications for selecting the mini-dental implant?

Dr. Shatkin: We have used the mini-implants to support single crowns, fixed partial dentures and overdentures. There are few contraindications for selecting a mini-implant. For example if you are placing an implant immediately after an extraction, the mini-implant may be too narrow for predictable healing. You might select a wider conventional implant for that kind of a situation.

Osseonews: Do you feel that most general dentists could be comfortable placing and restoring the mini-implants?

Dr. Shatkin: Absolutely. I am a general dentist and I have placed and restored thousands of mini-implants. As long as you have the proper training and background, you should be able to place and restore these.

OsseoNews: Do you have a formula or system for deciding how many mini-implants dental (MDI) to place. For example, in a square maxillary arch how many MDI’s would you place to replace #7-8-9-10?

Dr. Shatkin: In general we use 1 MDI per anterior tooth and 2 MDI’s for each molar. For example for replacing #7-10 we would use four MDIs. For replacing A maxillary canine we would use an 2.3mm MDI with a max thread.

OsseoNews: What is the proper or ideal alignment of the mini-implant? Long axis of the tooth replaced? What would be the alignment planned for an MDI to replace #8? Through long axis of the cingulum of the prior natural
tooth?

Dr. Shatkin: We place an MDI to replace a maxillary central incisor on the available bone bissecting the buccal and lingual plates. Occasionally we use a custom abutment to angle the implant lingually.

OsseoNews: What kind of abutment interface do you have for cementing a crown or fixed partial denture. The most commonly displayed MDI has a ball at the coronal end and a square neck directly subjacent.

Dr. Shatkin: We cement the crown directly to the ball and square on the implant. The crown is like a pontic with a cylindrical hole under it. We use a resin
cement.

OsseoNews: For a maxillary overdenture do you use MDIs to support a bar or would you use free-standing. How many for each.

Dr. Shatkin: We generally do not use a bar but prefer free standing MDI’s. We use 6-8 MDI’s with the o-balls to support a maxillary complete overdenture with o-rings.

12 Responses to “ Mini Implant Interview with Dr. Todd Shatkin ”

• Mini Dental Implants March 19th, 2007

  
  

  […] « The Changing Role of GP’s in Implant Dentistry | Mini Implant Interview with Dr. Todd Shatkin » […]

• Dr.C.Behnam May 27th, 2007

  
  

  it is about 4 years i ,ve been working with mini and then midi and recently maxi implants.the total result if choosen carefully,is excelent.cost efective and without the syrgery stress for the paitent.you can use minies as fixtures to fit overdentures where the bone is not wide enough(say 3mm)midies as an abutment to sit a crown and maxies to fabricate bridges.in typ 2 or 3 of bone density.

• Ken Clifford, DDS May 28th, 2007

  
  

  I have been using mini dental implants for three years, and doing fixed prosthetics with minis for one year. Please remember that ALL of us mini implant fans will have limited experience for a few more years simply because it is new technology. I personally don’t understand the “controversial” nature of mini implants, because they work in almost all situations with few complications. I am replacing the first “failure” I have experienced this week. The failure was due to lack of maxillary bone, so I had to use 10mm MAX mini implants. Only used two, placed parallel, will do it again now with three, not parallel, placed at the same angulation as the original roots on #3. May or may not use one of Dr. Shatkin’s “big hole” technique crowns - I have done a few now using a more direct method of fabricating a “pontic/abutment” and then using conventional crown and bridge lab techniques for the finished product.
  Again, I UNDERSTAND that the jury is still out (hopefully so-to-speak!), but myself and many other general dentists will continue to work with these devices because they work, we can do them, they are much less expensive for us and our patients, and it’s fun!

• Karen M May 30th, 2007

  
  

  What about MDI mini-implant insurance coding? Since these are so “new”, do we use the same insurance codes for mini’s as we do for standard implants? (D6010)? As an implant coordinator, I am not sure how insurance companies view mini’s? They really don’t know the difference if I don’t change the code on a pre-authorization.

  Thank you.

• deb July 17th, 2007

  
  

  hi there…you guys are great and thanks heaps for helping in the past…i hope this is the last time i will have to bug you…
  i am female,53,in good general health and no longer smoke…opg gives go-ahed for implants…4 lower to retain full denture…i have the guidance of two dentists…one who wants to do mdi’s and one who wants do standard implants….i am very tempted to go with the minis as the news seems good and i feel they could be a good solution for me…as i do not live in or near the city i have to travel and stay for treatments…… BUT i have had a bad run these last three months and don’t want to undercut implant treatment or its success by moving too quickly…
  any advice?
  anything else i should know to help in the decision-making?

  regards…

• Marie September 10th, 2007

  
  

  i’m thinking about having mini implants to support an upper full denture, but I’m not sure if that would be the best choice for me. why are minies less expensive and are there any draw backs?

• Steven Watts DDS October 2nd, 2007

  
  

  I have several female patients who want implants but are taking fosomax or some other osteoporosis preventing drug. Can mini implants be done safely on these patients without causing osteonecrosis?

• Debbie February 13th, 2008

  
  

  What code do we use for the MDI implants and are they used per post ,o-rings & housing
  Please let me know asap
  Thankyou

• Janet Rice February 21st, 2008

  
  

  I was recently told I couldn’t have implants due to not having enough bone to support them in my lower jaw. I’m 50 yrs old and have 8 teeth on the lower that I wanted to pull and replace with a denture and minis. The dentist I consulted stated the healing time would be 6 months at least, yet the information I read about minis states you can walk out that day with everything ready to go. The mini and regular implant look identical, so is there that big a difference in the size and how they are inserted? Do I still have a shot at possibly having minis? Thanks.
  Janet

• Maria Hritz September 14th, 2008

  
  

  I recently lost my last molar(#20) on the left bottom jaw. I am missing molars 19 & 18, as well. I am having convenional implants placed in those spaces and later crowns. I had an I Cat and it showed adequate bone for 18 & 19 but 20 was just removed on the 18th of June this year. My question: Can I have mini-implants rather than the regular. I am anxious over the procedure and it is very expensive. I appreciate your response……..

• Brian Neylon June 20th, 2009

  
  

  I have had MDI implants for 7 years. I have had nothing but trouble with the uppers. Originally I had a regular top plate. I have a very bad gag reflex and could not keep them in. My dentist recommended the MDI implant system. Sounded great. We did the surgery but instead of making a whole new set of dentures he re-fit my exsisting dentures with female recepticles.First off I had 4 implants holding in the uppers till one came out one day as I pulled the uppers out. I now have only 3 implants left.Plus the dentures never seated properly. For 3 years I went without teeth. I moved from Rockford IL to south west Florida. I could not find a dentist that would help me fix my existing dentures or work with me due to the fact ANOTHER dentist installed to little implants. Finaly after years I found one that reluctently made me a new set. I have had the new teeth for a year and a half. They fit perfectly at first. They are very loose now. After an hour they loosen and I am gagging again. Is there ANYTHING I can do to keep my dentures in??? It is affecting my health, marrige, work and self esteem not being able to wear my dentures. Any help would be greatlk appretiated.

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID June 21st, 2009

  
  

  Mr. Neylon, This is unfortunate! AN IMPLANT BAR OVERDENTURE CAN WORK WELL FOR YOU OR IMPLANTS WITH LOCATOR ATTACHMENTS COULD BE USED. THESE TWO OPTIONS ARE GOING TO BE MORE EXPENSIVE, BUT WILL WORK VERY WELL.

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