Mini Implants to Support Fixed Bridges ?

Dr. K. asks:

I read in Dental Economics where Gordon Christensen has proposed using mini dental implants to help support fixed bridges. You place the mini implant in the pontic region and then you connect the metal framework to the mini dental implant and natural teeth. In the case he described, the natural teeth, which will serve as the abutments, were not ideal and were to some extent questionable. BY using the mini implant and the natural teeth together as abutments, he felt this design would suffice for this particular case.

In order to prevent the natural teeth from intruding, he recommended using resin cement and roughening up the surface of the axial walls to increase retention.

Has anybody tried this technique? What are your thoughts?

9 thoughts on “Mini Implants to Support Fixed Bridges ?

  1. The technique that you saw performed by Dr. Christianson is a good solution to buy time for failing fixed bridges,patients on tight budgets who do not want to go edentulous, and for elderly patients with questionable fixed prosthesis, and whose health is questionable…. you can keep them going on what they are used to having in their mouths, and put off the need for removable appliances for a while.

    About 20 years, a famous Italian opera star walked into a Manhatten dentist’s office, because of a problem he was having with a failing fixed bridge (some of the abutment roots were decayed or needed to be extracted)but the singer absolutely required that fixed bridge to stay well fixed in his mouth, comfortably in order for him to perform that night.

    The resourceful dentist looked into his armentarium of goodies he had in the office, and decided that if he would sterilize some titanium Dentatus screws used for making post and cores, then maybe he could incorporate them to get the same bridge to function.

    He used the engine reamers that were supplied for these screw posts, and drilled through the gingiva and into the cortical bone… with the smaller diameter drills……he manually screwed in the posts he needed firmly into the bone , attached these posts to the fixed bridge, in any areas he could…i.e. the pontic areas were retrofitted to recieve the posts….and low and behold…….the technique worked and the birth of the mini transitional implants was discovered along with the born again philosophy of immediate loading.

    The resourceful dentist was Dr. Victor Sendax, the resourceful leader of Dentatus who substituted Titanium for the previously manufactered screw posts that were brass is Bernard Weissman, and the famous opera star is Pavorotti.

    So the next time you make a cocktail party for your cultured friends who are opera fans and the names of the Three Tenors come up…. Luciano Pavorotti, Placido Domingo and Jose Carreros……correct them……the three tenors that changed our world of dentistry are Pavorati,Sendax and Weissman!

    Excellent technique, has its place…try it.

  2. I read this article also. I have used the mini
    (1.8 and 2.4 mm) dental inplants for stand alone
    tooth replacement where the interdental space is
    less than 6 mm. Lower incisors, upper laterals,
    where space has been lost due to shifting of teeth. The mini has worked out on narrow arches
    combined with larger diameter two stage implants.
    The use of an intrigrated dental implant under a three unit bridge with poor abutment teeth does not seem to be a sound treatment option. It would seem to me that the lack of movement in the implant would act as a fulcrum (much like a see-saw) between the abutment teeth which have movement as they are set in their periodontal
    ligiment.Teeh move within their boney socket,
    whereas dental implants do not move when intrigated.
    If the teeth are headed to failure in the dentist’s openion why not seperate the risk
    by restoring them individualy? If course the
    patient has the right to make an informed decission which way to go. I do not understand how an implant placed in this position will prove to be a long term benefit to a three unit bridge. It will complicate bridge construction for the lab
    and complicate home care for the patient.
    But that is my openion.

  3. I have experienced failure within 1 year of placing mini-implants as supplemental support under a bridge in an atrophied mandible. The bridge was 4 units, 28-31, with 31 supported by a titanium implant. The unilateral fixture was supported by a titanium implant under 31 , and mini-implants under 28,29.

    I would NOT recommend the dentatus mini-implant as a long term (greater than 6 month) solution. And, tangentially, if you must use it, premedicate with antibiotics — otherwise risk infection that typically do not see with titanium fixtures

  4. Dear Dr. Gerald Rudick,
    Luciano Pavoroti just left our presence recently.A wonderful singer who has blessed so many with his powerful renditions of famous opera.
    I am quite overwhelmed by the thought that if not for minis, he might not be able to sing as he did!
    Please pardon me for asking, but can you please confirm that your account is actual fact and that Dr. Sendax is the extraordinary dentist who did it? Can Dr. Sendax confirm it? And which actually were the teeth or bridge involved? And did he actually used them to the end of his illustrious and supremely entertaining life? My apologies again to have to ask. And my great appreciation to a great singer and to a great dentist if true.
    Regards.

  5. I consult with dentits every day who place the IMTEC MDIs for Fixed and Removable uses. Like Dr. Christiansen reports in his articles, the MDI should be an option to patients especially when conventional implants are not (for whatever reason). I have seen first hand great long term success in my own practice as well as in an overwhelming majority of cases from colleagues.

    Dr. Sendax shows a full arch reconstruction case from 1976 using 10 – 12 MDIs. The patient passed away in 2004 with the MDIs still in place. That’s 28 years of success.

    I agree with Dr. Christiansen for all the reasons that he supports the use of MDIs. Dentists need to learn about these implants even if they choose not to place them. Shortly, they will begin to see them walk into their practices more and more often.

  6. I too have heard this story of Victor Sendax and Pavarotti..its a nice story
    I dont think there is any doubt that mini Implants have a place in dentistry
    Although initially controversial they definatly work
    i use them often for fixed cases
    Biomechanics and design needs to be spot on otherwise failure is inevitable In my view their only disadvantage is limited aesthetics/emergence profile for single teeth
    However for lateral incisors and lower incisors ..this is the treatment of choice
    Rule of thumb if well designed use for premolars and forward
    Further with mini Implants you are able to serve a far greater group of your patients due to the low costs ..even if it lasts for a little less time
    An excellent string to your bow

    Regarding combining teeth to implants ..the literature is replete with protocol
    To name but a few
    Combine if adjacent to implant and tooth is in excellent condition
    Do not have a pontic inbetween implant and tooth
    Do not have terminal abutments on teeth with Implant inbetween

  7. By the way… Although Pavarotti was a patient and close friend of Dr. Sendax, he is not the opera singer that was restored over 20 years ago. Her name was Beverly and she was a Juilliard teacher and performer. She is the patient that Dr. Sendax refers to in his lectures. The mini implants were placed in 1976 and she passed away in 2004 with all of the original minis still integrated in the bone.

  8. You can start with these articles:
    1: Fixed partial dentures and crowns supported by very small
    > diameter dental implants in compromised sites.
    > Flanagan D.
    > Implant Dent. 2008 Jun;17(2):182-91.
    > PMID: 18545050 [PubMed – indexed for MEDLINE] Related Articles
    > 2: Immediate placement of multiple mini dental implants into fresh
    > extraction sites: a case report.
    > Flanagan D.
    > J Oral Implantol. 2008;34(2):107-10.
    > PMID: 18478906 [PubMed – indexed for MEDLINE] Related Articles
    > 3: Measurement of the fatigue life of mini dental implants: a pilot
    > study.
    > Flanagan D, Ilies H, McCullough P, McQuoid S.
    > J Oral Implantol. 2008;34(1):7-11.
    > PMID: 18390237 [PubMed – indexed for MEDLINE] Related Articles
    > 4: Flapless dental implant placement.
    > Flanagan D.
    > J Oral Implantol. 2007;33(2):75-83.
    > PMID: 17520950 [PubMed – indexed for MEDLINE] Related Articles
    > 5: Implant-supported fixed prosthetic treatment using very small-
    > diameter implants: a case report.
    > Flanagan D.
    > J Oral Implantol. 2006;32(1):34-7.
    > PMID: 16526580 [PubMed – indexed for MEDLINE] Related Articles

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