Anon. asks:
I have been placing and restoring conventional dental implants for 8 years. I am now thinking about introducing mini implants into my practice but am unsure what to say to patients. Do I tell them that they are for denture stabilization only? Or that they are only deemed a temporary solution? I am not sure on the best way to present this to patients. I would appreciate any comments, especially from those of you who have already introduced them into your pre-existent implant program.
Mini Implants: How to Present to Patients?
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Congratulations! By introducing the MDI you have a great opportunity to dramatically affect your patients lives. Here are my recommendations:
1. You should tell your patients the truth.
a. The MDI has been used with great success since the 1970’s.
b. The IMTEC MDI is FDA approved for long-term use.
c. There is no cutting of the gums and little po pain
d. The MDIs can be immediately put into function
e. They can be used for fixed and removable applications
2. Get the best training available. I am a consultant for F.I.R.S.T. Laboratories and recommend their 2-day training program. It is comprehensive for both fixed and removable applications for the IMTEC MDI. It is mostly scientific (i.e. not a sales pitch) lots of case examples and real world management issues addressed.
The Mini Dental Implant may be one of the most important procedures available to patients today. The applications have been realized by thousands of dentists and touted by Dr. Christensen as an important addition to a dentist’s armamentarium. Whether stabilizing upper or lower dentures, replacing single or multiple teeth, or used to salvage failing bridges you should feel comfortable offering the MDI to your patients as a long term solution.
Why to take a risk and introduce something which is less predictible?Its you who will be standing
infront of the patient if it goes wrong and not IMTEC.
I have been using MDI’s for five years. They are not 100%, nothing is. Selecting the right bone quantity and quality is essential. This is true of standard implants also, although you must be more selective if you are using immediate load. I have taught the MDI courses for four years and now teach a combined MDI and Endure course for Imtec. I am not an employee. I am a surgical prosthodontist that does what I think is best for my patients. There are times when the bone is softer than I am comfortable with and I use two stage implants in these situations. There are often time when I can place 4-6 MDI’s and then place soft liner in the denture and the patient begins using them immediately. I do not load the implants immediately with the o-rings as Imtec recommends. I wait 4-6 months before doing so.
Whether it’s the ERA Implant from Sterngold, MDI’s Imtec, or the Dentatus implant, they have all been approved for long-term use. The FDA will not approve any implants under 3mm in diameter for permanent use. Therefore, you need to make the patient aware that they are only approved for long-term or transitional use. But then again, is life permanent? It’s long-term and transitional. If you want something that you can call permanent, then Sterngold has a 3.25mm mini implant that has been approved for permanent use to go along with it’s smaller diameter (2.2mm) mini. It’s like a hybrid system that is more affordable and allows you to service more of your denture patients that can not afford traditional implants.
As a recent (yesterday) recipient of mini implants to stabalize my lower denture, I can’t say enough about the difference this has made. If you still have all your lower teeth, you have no idea how difficult it is to live with a lower denture. Thanks to my dentist for wanting to help.
Correction MDI’s have been FDA approved for long term use. Mortality interferes with permanence. Nothing is permanent.
3.25 mm is a conventional root form implant. At that point you can only borrow from Conventional statistics. The argument isn’t necessarily the cost of the implant, but rather the number of professionals it requires to complete the case. When using Mini’s you have a General Dentist and a Laboratory. That vastly reduces the amount of $ an implant restoration will inevitably cost.
Congratulations! I hope (& trust) that you will have the same success that we have seen with “mini” implants since we began placing them several years ago. As you say, they make a world of difference with lower dentures. Send a nice little thank-you letter to your dentist & team. They will love YOU for it! That is the gratification that helps us go to work every day!
Because the mini-implants have higher failure rates in my office, we no longer present them as
a choice. I’m with Dr. Leo… (and to Jaye-please write back in a year and let us know the condition of the mini’s, and your lower denture)-of course, we all hope for the best.
There is no doubt that minis work with the same success rate as standard implants
The problem is that when a traditional imlantologist uses them it tends to be with an attitude of
“these little pretend implants ..how hard can this be??!” (I am guilty of this myself )
Dont be fooled they are very technique sensitive
The protocol has to be followed to the letter
Makes a lot of sense great practice builder
I place around 500 standard implants a year
Still do, but now do around 300 Minis as well
Well first of all mini implants should be the first option in replacing lower incisors and upper laterals, also for stabilization of lower dentures.
You present them to your patient as a new concept which is flapless and quick and cost effective, I guess this is very attractive to patients.
I would be not comfortable to use them in any other situation than the listed above, however a larger midi implant (2.8 and 3.3 mm) would be more suitable for maxilla in either denture stabilization or crown and bridge work.
I aggressively advertize MDL small diameter implants in my local neighborhoods around my office. I advertize them as an inexpensive way to stabilize a lower denture so the patient can eat better and more. Once the patient arrives to the consultation I also tell them about conventional implants. I have models of both and prostheses of both. I show the patient as much as I can and let them feel and touch the models. If that is not enough I show them photos of before and after cases done at our office. I let them make the choice and believe it or not the patient 9 times out of ten upgrades to the conventional implant. I am not baiting and switching I am just laying it all out so that the patient can make the best decision for their well being and the finances that they want to spend for better eating and the confidence to eat what they want to eat. Hope this helps you.
To clarify statements made by my colleague Dr. Brooksby concerning the immediate loading of Imtec MDI implants, be assured that if bone quality and quantity are such that with the use of a torque wrench you break out at 30-35Ncm at the time of implant placement…confidently go ahead and do immediate loading. If bone quality and quantity are questionable and you don’t break out at 30-35Ncm, then go ahead and do a soft liner for 3-4 months…then follow up with hard liner and housing pick up at a later date. Traditionally, I have loaded upper and lower dentures at the time of MDI implant placement without loss of implants by following these guidelines which, by the way, are the protocol as outlined by Imtec for successful useage of their MDI implant system . If you do not have a torque wrench…get one! Imtec has an excellent torque wrench..reasonably priced and will be a much used addition to your instrumentation and protocol.
hay i have aptient 27 years female had temporary lateral incisor and it is absorbed distance between adjacent teeth 5 mm onlay what i the correct implant here i had mectrone mini implant in use what advice me to do thanks in advance
Is it feasible to use mini-implants for lower molar crowns which presumably experience heavy loads?
HUGE failure rate. I placed around 30 sterngold mini era implants and had almost 100% failure at two years. I ended up eating my shirt because I am in a small community and had to make “good” on the failures. Some failed in as little as three months. I even had one lady unscrew her own implants because they were too bothersome. Ah…maybe I don’t have experience? Took the course. Have placed over 1000 full sized implants with less than 3% failure rate. These just don’t work…ever.
Have heard about trouble with rigid attachment like ERA on minis. O-ball / O-ring combo on other designs of minis is more resilient, making the denture implant retained, not implant supported. Important difference during the osseointegration period.
What is the cost of say 6 implants for upper denture that is about 6 months old, how long should this take to heel? or at least be pain free?
DrGordon Christensen has an excellent 9-minute DVD patient educational/video conscent in English and Spanish on Mini Dental Implants. DrRonaldPPetrosky