Anon. asks:
I do a fair number of implant supported bridges. One of the complications that I have encountered is that in some situations, the alveolar ridge width is too narrow for placement of conventional implants. So I am looking at mini dental implants as an option. However, I am concerned about the technique used for connecting the bridge to the mini implant. How is this done? What do you use for a transfer impression coping? In one course I took, the mini-implants were connected to the bridge framework using acrylic. But, I have my doubts of the longevity of such a connection. Any ideas?
Technique to Use for Connecting Bridge to Mini Implant?
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My first question is what mini system are you considering using? I would recommend using BioHorizons 3mm one piece implant and doing a cement on bar. This 3mm is made of titanium alloy and would be much less likely to have issues long term, over a smaller diameter out of pure titanium. Do to the cement space it would be completely passive and I would use the strongest poly or resin based cement you can get your hands on.
I’ve placed several bridges over Imtec minis and just used Rely X or Maxcem and had no problems with them. I use the 2.4′s for bridges/crowns. They have their place on narrow ridges as you mentioned and the cement has held with no problems. If you send the impressions to Shatkins First lab after you place them they have the analogs and will fabricate the bridge to your impression. Imtec also sells the analogs if you want your lab to make the bridge. But any resin cement will hold the bridge/crown.
yes true, the bio H 3.0 can be use for the narrow bone, but mostly my case with bridge, especially with conventional and minis also, better you cement it with the less strength cement, like phosphat. note : if something happen with one of the implant you will be able to open the bridge easy. one of my case is good and be there even only phosphat glued them with the implant.
but if its single crown you can buy the most strong cement in the world
Mfive(MISCH)would always suggest BioHorizons implants
I feel tissue regeneration might be a better solution. Implants should approximate the surface area of the teeth or tooth being replaced.
Agree with don callan-
no one ever mentioned ridge augmentation to place the correct size fixture. this is most likely the best long term solution. it does involve a surgery, and most likely a referral in this case, however, it may be what is best for your patient. there are newer less traumatic ways to augment a single site these days including piezo-electric driven ridge split – many times the fixture can be placed at the same time. rotary ridge expanision is even less invasive. anyway, just a thought