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Mini Implants in the Maxillary Arch?

posted in Mini Dental Implants Discussions

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Joan, a dental implant patient, asks us:

From my research, I understand that the most prevalent and successful use of mini implants is to stabilize a lower denture.

From my most recent research, I have learned of the use of mini implants in the maxillary arch, to stabilize an upper denture. The cost quoted to me for 4 mini implants in either arch is roughly $2,000.

Though this appears to be a very reasonable price for the services listed, cost alone is not the main concern (for me). I wonder about the success/failure of mini implants for the maxillary arch? Is it an accepted procedure in this type of case or should mini implants only be used for a lower denture? Thanks for any comments or suggestions.

29 Responses to “ Mini Implants in the Maxillary Arch? ”

• Peter Fairbairn June 7th, 2006

  
  

  Do not go there, even the manufacturers tell to avoid the upper arch..

• Dr Bruno Lemay June 7th, 2006

  
  

  I have been placing mini implants for 5 years now on both upper and lower jaw. I can now see that the success rate is higher on the lower jaw (chin area) But I can see various result on th upper jaw. I think it depends of how many you can place …the more the best to reduce the load on each one. some cases are amaizing they look just like a lower case and some just desintegrate one by one after the first year. I think it depend mainly of the width of the ridge left. I would rather use many 10 mm implants on a large ridge then 18 mm implants on a thin ridge. I choose my case more carefully now and stick to the very large ridge. For the other case I will do it only if the patient does a bilateral sinus lift and we can use the back ridge as support too. If I loose an implant on the upper ridge I bone graft the socket and place a new one 1 year later and it seems to work good!

• Dr Amayev September 8th, 2006

  
  

  I placed mini implants on upper and lower jaw I usually use 6 up and 4 lower and it already 5 years and I don’t see any problems. Patient very happy. When you place them make sure most of the support on tissue not on the implants.

• Anonymous September 20th, 2006

  
  

  I have been placing the MDI for 3 years now. some implants are very much stable while some became mobile within the first month after i put on the metal housing, so what I do now is just reline the denture with soft reline material for about 3 months then do hard pick up after that.

• Anonymous September 20th, 2006

  
  

  Mini implants are transitional implants in the upper. Or NFL implants, NOT FOR LONG. There are no research or long term studies that can dispute this statement. They do very well in the short term, although not as reliable as traditional implants.

• Dr. OSORIO October 10th, 2006

  
  

  I have been put mini implants for 5 years and my experience in upper isn’t good. It depent the quality of bone and if you distribute the load.

• Dr.Iendran October 13th, 2006

  
  

  Can anyone coment on intermezzo mini dental implant system.I am using sendax and placed 2 intermezzo MI without flap procedure.This system is from Megagen korea.The company does not have much published work,so any one using this system please give your comments or e-mail ,endran_dr@yahoo.com

• Michelle March 23rd, 2007

  
  

  It has been suggested by my dentist that I should have mini denture implants put in my upper jaw, instead of regular dentures, I am scheduled to have all my upper teeth removed next month. From everything I have read , this procedure is better on the bottom than the top, however , there is nothing written that is very recent.Has the procedure been improved for the maxillary(upper) arch? Is this a problem to be done at the same time as all the teeth are removed?
  Thank you for any imput.

• Dr. Joeph Como March 27th, 2007

  
  

  I have one question regarding mini implants in the maxilla. Are you getting them because you do not have adequate bone thickness, if so than I recommend six implants and a full denture. these work. If you are getting them because of finances ( cost less) than I would greatly reconsider. Standard implants do cost more but they do have a higher sucess rate. You are making an investment in your health, I am sure you do not want to take any shortcuts, if the mini’s fail then what. If the standards fail you can always fall back on the mini’s, Lastly, ask you doctor about carecredit, a program that finances your dental work ( all of it) interest free for one year. Most importantly pay it off in the year or else you get hit with a large interest rate. This is what my office uses when patients ask for payment plans. It is very good,

• deb May 23rd, 2007

  
  

  i have had 19 teeth extracted 1st may ‘07….now have both upper and lower full dentures……have jutting max. ridge dentist says cannot be removed for six months until the gums have finished shrinking…
  i have been told mdi’s can go in immediately assuming good scan…..and that the implants will aid in stopping the shrinking that usually accompanies un-implanted dentures!
  so who is right guys…..thanks for every little bit of your wisdom and ferocity…..hope springs eternal…..
  an (im ) patient!!!!!
  ps….am marriage celebrant and cannot work at the moment….and the upper is only the beginning…..
  thanks….in ad……

• Dr.W May 23rd, 2007

  
  

  Dear Deb,

  If you just had teeth extracted this May, the extraction sites are now currently filled with immature bone cells that will become mature in the next couple of months.
  If you were to place “mini” implants at the time of extractions, the surgeon could visualize the best boney areas. The other way “mini’s” are placed is thru the gums, when the bone is fully mature. It would not be prudent to reopen the area if possible or go thru the gums since you may end up in very soft maturing “bone-like’ material.
  You mentioned “jutting” maxillary ridge, this may be from denture acrylic thickness creating a prominence as well. Be sure to have the dentist evaluate your profile and lip support for diagnosing the best “treatment option” for you.
  The mini implants have limitations. The shrinkage of bone from implants is from a concept called internal loading of bone, but it does not directly translated to mini-implants, it is a non-mini implant concept.
  Mini-implants were made as a “transitional” or “temporary” procedure to help stabilize an overdenture while the “implants” were being osseointegrated, then removed later like a screw.
  The long term verdict is still out. For many, mini’s works to some extent in stabilizing but no real definitive long term evidence proves it, mostly anecdoctal.

  One final note, remind the dentist that you speak for a living so that they can help you with the phonetics in the final prosthesis (air escape). If you have enough bone, an implant supported fixed appliance ( bridge ) may be good solution for phonetics and “jutting jaw” as it would allow you have have your palate (roof of mouth) back and help seal off gaps between teeth and gums as well as get rid of the acrylic bulk between the gums and lip.
  Best wishes.
  Dr.W

• deb May 23rd, 2007

  
  

  thanks dr w….my dentist does not sound as ‘ educationally well equipped ‘ as you are…i saw him y/day and he is happy with the work….has told me i look 1000% better…..although my husband and friends are astounded by my ‘ new mouth ‘…..he was very contemptuous to say the least and the worst?
  no liason at all…..through any of this….i was never asked along the way about anything to do with my appearance or anything else….my teeth were extracted and two dentures inserted….the bottom had to come out straight away and was another three days being re-made….
  now,because i have spoken out and questioned ‘ the look ‘and mentioned the dreaded second opinion i have no dentist……no real food but i do speak fairly well!!!!i did not expect dentures to come easy and have practiced heaps……
  but……

  i look terrible and have had to cancel ceremonies…

  the dentist was told before surgery that i needed my mouth/smile and that i wanted to have implanted dentures……

  now i seem to be in no man’s land!!!!!

• Dr K May 23rd, 2007

  
  

  Interesting posts, here are my two cents…

  “standard” implants should always be the first implant we treatment plan for. Mini implants work great as transitionals but shouldn’t be seen as a “cheaper” alternative.

  Predictability with mini implants is still in question for all cases. I’m sure many successful cases are restored but I’m assuming the dentist is selective when offering these treatment plans (this is a good thing). Obviously, patients with strong bite forces or parafunctional habits should be treated differently than “soft” biters.

  Honestly, I have seen many questionable things work and some well planned straight forward cases break down. Predictability is the name of the game and I find “standard” implants to be more predictable.

  I hope I haven’t offended anybody with my opinion.

• John M September 10th, 2007

  
  

  I want to know if doing the mini implants works in the back of the mouth on the lower denture. (I have a full upper and lower denture)
  Thanks

• Pam Trampe October 15th, 2007

  
  

  Hello. My daughter(17 years) has been evaluated for implants for both congentially missing lateral incisors. We are told that while she is not the best candidate (due to small space size & having a root canal on the front tooth) but she would be able to have mini implants for both of these areas (with possible bone grafting?) I am concerned because it looks like the success rate for these mini implant are better on the lower jaw. What are some thoughts as she is tired of wearing fake teeth on a retainer. She is a very healthy non-smoking young girl with a great attitude after all the ortho, etc. that she has had to put up with. I feel we have one shot at this, so we need to make sure we do it right. Comments or Concerns? Thanks

• Dr. G October 31st, 2007

  
  

  Greetings,

  I have a patient that has been treatment planned by her dentist to have a fixed maxillary bridge from #3-#14 supported by endodontically treated teeth #’s 3,6 and 14. In between those teeth the doctor placed 5 IMTEC Mini implants in position #’s 5,8,9,11, and 12. The bridge is to be a fixed metal reinforced plastic bridge. Everything spinted together and cemented in place. Does this sound like the standard of care today???

• Dr. G October 31st, 2007

  
  

  Apologize, I actually posted a question instead of a comment. It is very common to replace congenitally missing lateral incisors by use of small diameter implants. Companies are making narrow diameter one piece implants for such situations. It may be best to use one of those tyoe implants as oppossed to a mini-implant provided the space is available.

• Ken Clifford, DDS October 31st, 2007

  
  

  Dr G - I agree that small diameter implants will work in the area of #7 and 10. I have done them using Porcelain to gold cemented with resin, but have had difficulty with a nice looking emergence profile - it is too easy to have a gap between the buccal finish line of the tooth and the gingiva. I have also done these using nanocomposite resin placed directly over the mini implant to eliminate undercuts and then fashioned a composite resin crown to fit the space with a nice emergence profile and cemented it (resin to resin) with a dual cure flowable resin cement. Admitted I have a resin-gingiva interface, but so does any deep class V restoration and they do OK. If an emergence profile issue occurs later it is easy to “fix” by adding resin to the buccal margin. Is this a “permanent” fix? Not sure, but the mini implant is so minimally invasive it does not rule out a standard implant in the future. By the way, the Orthodontist to whom I refer most often says surgeons and periodontists who send him cases requiring future implants always ask for a minimum of 7 mm between the central and the cuspid. He says this is VERY hard to achieve and then have nice cosmetic results - the lateral will often be too wide to look natural. The obvious solution is a 2.5mm mini instead of a 3.5mm internal hex standard implant.

• Ken Clifford, DDS October 31st, 2007

  
  

  Dr G - regarding standard of care for the mixed full arch upper with three teeth and 5 mini implants - I’m not sure how the term standard of care applies here. Many of us, including Dr. Gorden Christianson, are pushing the envelope using mini implants to provide an alternative to removable partials at a price many of our “real world” patients can afford. I believe it IS “standard of care” to provide something which is achievable in no other way. Is it as good as Nobel Biocare’s “all on four” which costs at least twice as much? I haven’t heard much bragging lately about the percentage of success of this procedure. Anyway, I’m happy to hear that at least one other dentist in your area is trying to push the limits of mini implant usage. As I’ve said before, we have a few years to wait until the jury is in (so to speak - I hope!)

• Bentley January 7th, 2008

  
  

  Due to an incredible and hardly comedic comedy of errors during twelve years of, it turns out, negligent dental care, all my maxillary teeth were extracted in March 2007. Since then, I have a new dentist and am doing all I can to hang on to my lower teeth.
  In the meantime, I am attempting, with limited success, to acclimate myself to an upper denture, an experience not unlike cramming a credit card in my mouth.
  I have been receiving conflicting information concerning the use of mini-implants to support an upper denture that does NOT cover the roof of my mouth. I have been told by a periodontist that such a procedure IS do-able but the postings here don`t seem to agree, even when it comes to supporting a conventional upper denture.
  I have dental insurance but am on my own when it comes to any form of implants so cost, unfortunately, is a factor.
  Any advice/observations would be appreciated.

• Bruce McKelvy January 8th, 2008

  
  

  I have placed mini implants in the maxillary arch for use with an open palate denture. However the results are variable. Some patients have had long term success and retained all implants. Others have experienced loss of a variable number implants and some have had their open palate dentures converted back to full coverage.
  I would advise two conventional implants with attachments-I particularly like Zest attachments. Better still 4 implants with an open palate denture with a metal framework to prevent fracture of the denture. An open palate denture constructed entirely of acrylic is not a good idea.
  I am a periodontist and have worked with a prosthodontist on most of these cases.
  Hope this helps.

• Dr SS January 8th, 2008

  
  

  To Bentley
  With the info given and many assumptions being made
  a) you have a full complement of natural lower teeth
  Which are in reasonable condition thus will give the upper jaw a good hammering when you function ,with or without any kind of implants
  b)Mini Implants have less success in the upper jaw period
  c)Mini Implants when opposed by a full dentition as a fixed bridge presents with a host of challenges
  d)My feeling is that this is NOT a mini Implant case
  I would use 4 standard implants as a minimum and an over denture of some kind

  Depends on many clinical factors

  I think you need to dig deep and make your dental health a priority..if you dont the lower teeth will hammer your upper denture causing more bone resorbtion and when you eventually take this advice ..it will be much more difficult and even more expensive ..and less predictable

  Full upper opposing natural lower is no joke clinically

• Norbert February 27th, 2008

  
  

  I am 62 years old and most of my upper teeth have broken off or hanging on by luck. I have diabeties type 2 on meds only..my lower teeth which I have maybe 7 left are so so.
  My old guy dentist wants to pull all 11 of my upper broken and decayed teeth out and place a conventional denture, which I hate.
  I had another dentist (not so old female) examined me for mini implants for the upper denture..she wants to do bone crafts when she removes the first 8 front broken teeth, stitch, then place a full temp denture clued to my back teeth for about 4-5 months to give time to heal. After that she then wants to remove the other 3 teeth, do some more bone crafts.. install six of the mini implants, place my temp denture back for 2-3 months while it heals. Then after that I go back and have my new permenent dentures placed into the implants. All dentures are produce in her office next door. She said the price for all her work plus parts would be about $9700.00, which she says I can finance for 60 months.
  This is an awful lot of money. She claims the bone crafts are needed to support and build the bone which is ok now,,but will make it flatter and stronger for the dentures to sit on. Plus it will make the mini impalnts strong as roots.
  What is your opinion? My old dentist (70’s guy) doesn’t do implants and doesn’t seem to care for mini’s.

• Dr. OA February 28th, 2008

  
  

  I can not tell you exactly about the treatment without seen you but the bone graft its cheap. The material very expensive for the dentist to buy, and of course the price will be high. One thing I can say you get what you pay for, its like you can buy a car with CD player in it and you can buy a car without CD player, and both cars will run. You can get different treatment options from cheap option to most expensive.

• Beth March 4th, 2008

  
  

  I have recently had my upper teeth removed, we are discussing having imtecs put in and a denture with the roof removed placed on them.
  Is this possible and will this be ok since my teeth were removed because of periodental?
  Thanks for any help and info

• eremian gerard May 16th, 2008

  
  

  i just came back from the dentist looking for mini implant
  my few remaining teeth are bad and should be remove
  i was hoping that that we could pull them out and start putting
  in mini implant however
  i was told by the dentist that after removing my teeth
  we have to wait one year before placing the mini implant
  is this always the case
  thank you

• Antonio January 26th, 2010

  
  

  I am shocked to read how much people say they paid for mini-implants. The average cost is about $2,000.00 (I presume US dollars).

  I just had a new lower denture placed on 6 mini-implants. It cost me a few dollars under $12,000.00 (Canadian dollars)! Is this possible to be “correct?”

  The dental team did an excellent work. But $12,000.00?

  I still need to have my upper side–Maxillar–done. But this time I will certainly explore a hell of a lot more!

  Is there any regulation in regards to how much one can charge? Any comments will be greately appreciated.

  Thank you…

• Ken Clifford, DDS January 27th, 2010

  
  

  If you think there should be a “regulation” on how much one can charge, you must not be a capitalist. Any of those left in Canada? Did you ask before the work was done? Why not? In the US, at least for a while still, the fee is decided by the marketplace. As a consumer, find out what is available and what it costs, then make an informed decision based on your research. Mini implants, removable with mini implants, conventional implants, dentures, all cost whatever the dentist and the patient decide the service is worth. If the government decides to regulate the fee, I and many others will simply decide to quit trying to improve dentistry and become beaurocrats. That’s where the money is anyway!

• Richard Hughes, DDS, FAAID, FAAIP, DABOI January 28th, 2010

  
  

  Right on Ken. For those that try to get something for nothing………………..GET REAL

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