Mini Implant Systems

Dr. Lendran, from Malaysia, asks:

Can someone please tell me what the diffrence is between all the mini implant systems, i.e. Sendax MDI, Intermezzo and NobleBiocare IPI and others?

I am currently using sendax MDI. It works well for lower over dentures but is it good for single tooth replacement? I recently discovered Intermezzo and used it for upper lateral incisors.
I am looking for some comments on mini dental implant practitioners from around the world, as I’d like to understand which system to use in each particular case. Would appreciate a summary of the benefits /features of each system. Thanks.

68 thoughts on “Mini Implant Systems

  1. Victor I. Sendax, DDS says:

    As the originator in 1976, and patent holder of the minimally invasive, immediateley functional Mini Dental Implant concept, I have had the unique opportunity to see MDI technology evolve from a transitional to an FDA approved long-term
    implant system. I licensed the IMTEC corporation to exclusively manufacture, market & distribute the IMTEC/Sendax MDI System which has the longest proven clinical track record.
    As to single tooth replacements the MDI is ideal for such special applications owing to its ultra-streamlined 1.8mm width, which allows it to auto-advance its way into mature, supportive bone, usually without flap surgery or osteotomy, and with only a minimal-width 1.1mm “starter” opening drilled directly through attached gingiva and cortical bone.
    For Type III or IV ossteo-porotic bone the slightly wider thread of the MAX MDI
    will usually provide a better “take” in such bone.
    If you want encouragment on the use of the MDI for both removable & fixed applications you might well order Dr. Gordon Christensen’s new Mini Implant DVD due out this Fall. His first MDI video & DVD released several years ago pioneered effectively by introducing this modality to our profession. I predict that his follow-up DVD will prove to be even more useful in helping our colleagues receive unbiased help in evaluating MDI clinical applications & devices.

  2. Anonymous says:

    Remember, regulatory bodies in North America do not recognize “mini-implants” in their language. They are transitionals or provisionals first and always for denture stabiliztion. They are not implants when one uses the description of what these regulatory bodies are looking for. Dental governing bodies protecting the public are aware of the difference. The FDA states an implant cannot be less than 3mm in diameter. That being said, 1.8 mm diameter is not an implant. These mini’s work but know what you are using. Understand the limitation. Get informed before using anything.

    3mm implants are sold by Nobel, Lifecore, Biohorizon, Zimmer.

    3mm implants with a ball abutment as part of the implant are sold by Biohorizon, Intralock to my knowledge.

  3. Alejandro Berg DDs PhD says:

    Dear Dr Lendran:
    MDIs are implants designed to make a definitive restoration(fixed or removable) as also are the arrow(alpha Bio Israel) and many others. The IPI is a Steri Oss(originally) system designed for provisional implant reatined restorations(provisional being the KEY WORD) so no comparisson

  4. Todd Shatkin, DDS says:

    Dear Friends,
    The IMTEC MDI is FDA approved for long term use. I can not comment on the others, however, I can state that I have placed more then 5000 MDI’s over the past 6 years. About 1/2 of these were used for fixed crown and bridge reconstruction. I have had better then 97% success for single and multiple teeth replacements over that time period. This is a better success then I was getting using other larger conventional implants which I have used for the past 17 years. I would be happy to speak to you anytime about the IMTEC MDI and use for crown and bridge reconstruction. We have a lab which assists dentists in planning and fabrication of restorations using stents and finished crowns. Thanks for reading and have a nice day!

  5. kfchow-mostdi-msia says:

    I find the FDA specifications for an implant if true very strange if not arbitrary. Is 3mm a magic figure or what? Why not 2.5mm or 3.5mm or 2.88mm? If that is really their criteria, then on what rationale have they came out with the magic number of at least 3mm diameter before a dental implant is called a dental implant? Would have thought that adequate osseointegration should be the primary criteria and the rest should be merely complementary. Can somebody from the FDA or privy to their line of logic please enlighten. Thank you.

  6. Anonymous says:

    Dr. Berg,
    they are not implants. They are transitionals.
    Dr. Shatkin, yes they are approved by the FDA for long term use. What is approved.? why do you not call it an implant?
    I do not doubt your success and i appreciate that you choose your words wisely. You mention better success than conventional implants. That statement makes it very clear that imtec is not a conventional implant otherwise you would call it an implant and not guard your words.
    3.25mm was the smallest diameter at one time approved by the FDA. Fracture occurs today on 3.5mm fixtures. A 3mm,2.5mm, 2.88mm are almost always one solid implant, no screw hole. The screw hole will create a thin wall so no screw hole.
    At 2.5mm, 1.8mm etc., breaking of the fixture can occur. 3mm is actually stronger in tensile strength than a 3.25mm or 3.5mm because of it being solid.
    imtec or any other transitional can break. In fact, and this is only second hand information so it can’t be substantiated, it has been said that if an imtec breaks on insertion just put another beside it.
    There is a place in my humble opinion for transitionals. I am a tad weary of hearing a “fixed” crown on a transitional.

  7. Anonymous says:

    Dear Dr. Lendran, from Malaysia.

    In response to the Intermezzo, their product is designed only as a temporary implant for removal after 6-10 weeks. This is confirmed by the statements in the 510K approval letter. It is manufactured from Grade 3 titanium which is known to be weaker than titanium alloy.

  8. Mr.Goldman says:

    I originated the mini -implant design,now there is a new company that has its factory in West Palm beach, and it is superior to MDI due to multi use ability in restorability. FDA apporved for immediate function.
    MDL is much superior in all aspects than a 1.8mm MDI, it is 2.2mm. We include the o-ring at no extra charge. No extra fees! If you want fixed , we have a special abutment that other company tried to copy but couldn’t. Our system is unique.
    You have to pick out the best of the companies which can be more versatile.

  9. kfchow says:

    What is a transitional and what is a provisional and what is an implant and what are their differences? I guess a transitional and a provisional is synonymous and by definition means something temporary until something permanent can be placed. Its probably something like a temporary resin-acrylic bridge until a permanent ceramic bridge is placed.Though nowadays we are seeing more and more composite bridges which last a long time. What do we call them then…..long term use composite bridges? In the mentioned case the transitionals as they grow stronger and more lasting are gradually morphing into permanents! Or should we call them pretenders to the throne? If what Todd says is true, he has at least 2000 fixed crowns and bridges masquerading as permanents for the last 3 to 6 years.Are they now still transitional, longterm, temporary or permanent? Who is the authorised guardian of these terms? Maybe as professionals, we should be wary of being tied down to terms without understanding the rationale behind them. What is important seems to be will it work clinically without compromising basic science and material characteristics. Hope these does not confuse too much but bring about returning regularly to first principles to make sure we are not propagating some standard that was set some time ago and has remained static although the dynamics has changed due to new knowledge and materials. Like Branemark’s arbitrary 6 months wait and 350rpm that has been challenged now time and time again. A good standard but lets just not accept and copy without reviewing regularly in the light of new knowledge and advances even to the likes of not infallible bodies like FDA.

  10. Anonymous says:

    you would challenge the FDA?
    Not impossible but there is a protocol to challenge the FDA. That does not mean arbitrarily one should just make up their mind and say “well it works so the FDA is wrong”
    What about liability?
    Are you going to use a medical device not for its intended use WITHOUT getting from the patient informed consent?
    I appreciate forward thinking but lets not get ahead of ourselves.
    Dr. Shatkin, what do you think?

  11. Anonymous says:

    Indication for Use
    510(K) Number (if known): K053354
    Device Name: Intermezzo Plus Fixture
    Indications for Use:
    Intermezzo TM Plus are designed for use in dental implant surgery and are intended to be used in a manner in which the implants integrate with the
    bone (osseointegration). The system is intended for use in partially or fully
    edentulous mandibles and maxillae, in support of overdentures.
    Prescription Use ~, _ AND/OR Over- The-Counter Use
    (Part 21 CFR 801 Subpart D) (21 CFR 807 Subpart C)This is in respose for who ever said it was only for temporary use.So that coment was like below the belt.Please be more responsible on public forum.

  12. Anonymous says:

    You are claiming substantial equivalence to K051018 which uses the terms “provisional” and “temporary” Big trouble with the FDA for misrepresentation.

  13. Anonymous says:

    “like below the belt”?
    I apologize if I offended intermezzo. Truthfully I never heard of it.
    If it is less than 3mm in diameter, it is not an implant.
    I think I am being very responsible thank you.

    The comment by the poster regarding misrepresentation is correct.

  14. Anonymous says:

    Intermezzo is available in 3.1mm diameter as well but it is marketed as a mini implant.Regarding misrepresantation please do a search with FDA on K053354 as well.Yes it is used as transitional as well as long term in narrow anterior edentulous space.

  15. Anonymous says:

    We seem to be getting bogged down here in terminology. Are these mini-implants (less than 3.0mm diameter) for permeanent placement or are they for long term provisional placement? What is the simple truth here?

  16. Anonymous says:

    No, they are NOT for permanent placement or they would be IMPLANTS!.
    They are for long term denture stabilization.
    It is never stated to cement a crown to it.
    It amazes me that the first ones to flog their wares are no where to be heard from.

  17. Dave Sklarski says:

    The term mini implants derived form people calling them “mini’s” due to their obvious size difference and reasoning for calling them implants. The ERA attachment was solicited for years to be licensed to these companies until we came out with our own “mini” 2.2mm implant with the ERA attachment on the prosthetic end rather than the traditional “ball and O-ring” which transmits 100% of the occlusal load onto the implant. This is what made our “mini” so popular but it is not approved by the FDA for permanent use and neither are any of the other so-called mini’s. It is very popular as a true transitional implant as it gives the patient immediate load of a provisional denture after surgery and it acts as a vertical stop protecting the traditional implants that were placed. We then introduced the 3.25 ERA implant which was approved for permanent use by the FDA and we introduced a protocal of placing 2 “mini” 2.2 ERA’s as transtional and 2-3.25 ERA, FDA approved at same day of surgery. This has become the most widely adopted protocal for overdenture patients as the most cost effective and most satisfying treatment to the most needed application for implants in general dentistry. Here, the implant acts as a carrier for the most popular attachment system in the world that both clinicians and patients are familiar with.It gives vertical resiliency and angle corection that no other system offers. In essence, the perfect solution for the overdenture patient.

  18. Anonymous says:

    Dr. Sklarski:
    You have clarified this issue. The 3.25mm implants w/ ERA attachments are for permanent placement. If we place 2.2mm implants w/ ERA attachments they will serve as transitional (temporary) until the 3.25mm implants are integrated. Or we can load both 3.25 and 2.2 at the day of placement.
    I thank you for this very important clarification.

  19. true believer says:

    How can we challenge god! We will have to wait for the FDA to decide that a 2.5mm diameter screw can be called an implant first before we dare to. We can pray hard after all the FDA has reduced the divine number from 3.25 to 3.00 so there is hope. Lets all pray harder and have faith!

  20. Anonymous says:

    Dr. Sklaraski,
    It seems that you believe that if you throw out the seeds and spread the manure your words will grow in the minds of the uninformed. The o-ring is the most widely used attachment used on mini implants in the world. The cap that Imtec sells with their implant has space above the the implant so it does not transfer 100 percent of occusal load to the implant. You make the claim that the ERA mini implant has “become the most widely adopted protocal for overdenture patients as the most cost effective and most satisfying treatment to the most needed application for implants in general dentistry.” Most post on the internet about ERA’s these days are are not positive can you prove any of these claims?

  21. Nicholas Varras, CDT says:

    Mr. Sklarski is not spreading manure. Why such a harsh statement. I thought we were all adults in this forum.

    While it is true that all resilient attachments will work when they have a spacer. We all know that we can NOT always place the implants so that they are parallel. In these instances, the ERA attachment system is the only one that can physically correct this misalignment, thereby maintaining the resiliency. Think of unparallel door hinges. Can we lift the door off it’s hinges if they are not parallel? If you want proof, read the study: “Comparison of Load Distribution for Implant Overdenture Attachments”. International Journal of Oral & Maxillofacial Implants Volume 17, Number 5, 2002.

    And for the benefit of everyone in this forum, try not to sound so bitter in your posts.

  22. Dave Sklarski says:

    To the individual addressing my comments but did not identify himself/herself. I want to be certain to clarify that I am not a clinician but the owner of Sterngold that manufactures and markets the ERA attachment system worldwide. I think I have a pretty clear picture of where our product fits into the marketplace and our recent ERA Implant Forum held in Las Vegas this past April confirmed that for us. Remember that the ERA Attachment system has been on the market for 20 years in various forms and what Nick states above is 100% correct. Remember that vertical resiliency and angle correction are key to clinical success for this application and the ERA is the most desirable and clinically proven in that regard. Our success in the marketplace is proof of that.

  23. Xe says:

    Im confused with all these.My question is simple. I want to use 4mini implants to support a lower overdenture as a PERMANENT solution.Which of all the mini systems should i use and why?

  24. Gerald Rudick dds says:

    I was first introduced to dental implantology in 1968 by Dr. Leonard Linkow, while doing a post graduate program working in the department of Prosthodontics at the Hebrew University in Jerusalem Israel. Dr. Linkow demonstrated his concepts of placing different shaped titanium fixtures into the existing residual jaw bone
    ( an assortment of “blades”, screws,endosteal stabilizers, intramucosal inserts, subperiosteal frames,and even a coined titanium “Star of David” into the jawbone of a rabbi, ; and he called them all dental implants.

    An artificial device that can be embedded into the jawbone and protrude into the oral cavity such to support a tooth or teeth is, in my humble estimation, a dental implant. I can understand the point of view of the FDA to place a value on the engineering specifications of the strength of a fixture, and decide that anything less than 3mm in diameter is not strong enough to be considered a permanent fixture, and is therefore not considered a dental implant, in order to place guidelines to protect the public.

    However, if dentists like Dr. Victor Sendax did not have the moxy and ingenuity to go beyond the “established guidelines” of definition, and help out a famous opera star when his permanent bridge was falling out of his mouth before a performance ( and sterilized a titanium Dentatus post and screwed it directly into the bone to support the failing bridge)…. we would not know of minitranitional implants, nor would we attempting immediate load dental implants (contrarary to the Branemark philosophy) which was exactly what Dr. Linkow demonstrated to me almost 40 years ago with his concept of immediate load.

    We see a complete shift in the philosophy of placing dental implants over the years…..and yet each philosophy is correct, and is still applicable today, used in accordance of what the clinical situation presents.

    It has been pointed out that conventional dental implants wider than 3mm in diameter have also been known to fracture, particularly if they have an internal connection and interior screw chamber…… so why should implants narrower than 3mm in diameter lose their right to be classified as a dental implant?

    In my years of experience with implants less than 3mm in diameter, I found that the original minis were manufactured of pure surgical grade titanium, which were bendable, and with time, the occasional one would fracture, but the trend these days is to use titanium alloy, so there is less tendancy to fracture and more predictabilty for long term usage.

    It is said that “every person has a name”, I maintain that every freestanding artificial structure that is embedded in jaw bone and can support function loading forces, should be classified as a dental implant, regardless of their size.

  25. true believer says:

    Rudick, I agree with you. But don’t you see that we cannot challenge god!….I mean the FDA! If the FDA declares by fiat anything at 3mm diameter is a dental implant and anything below that is not a dental implant …that’s it. But like I said, there is hope because they have reduced their declared fiat from 3.25 to 3.00 in the past. One of our esteemed believers have consistently pointed out the divine authority of the FDA and that we should not challenge IT, hang the logic behind it, faith is important.

  26. Anonymous says:

    true believer,
    please understand engineering.
    A 3.25mm conventional impllant has a hole down the center along the vertical axis.
    A 3mm solid implant is solid.
    Which would be stronger if you tried to break it in half?

  27. Bruce Seavey says:

    Actually the 3.25 with the hole down the middle is stronger, as far as engineering goes. Given: a 3mm solid cylinder is a bit stronger than a 3mm tube. But wait, there’s more! It depends how you would like to break it in half. Pure compression, eccentric axial loading (column), bending, shear, in torsion, etc. Why are hollow pipes used for structural support (my kid’s swing set)? Why is hollow tubing used for racing car (or bike’s) frames? The “stuff” in the middle has little to do with the strength of this beam.. Yes, in these examples, getting rid of the metal in the middle reduces cost, and for the car / bike, weight. It is the material the furthest away from the neutral axis that has the most effect on reducing bending, buckling or fracture.
    To be more specific(not my words):

    The stiffness of a beam is determined by its “moment of inertia”, which is a
    property of its cross section. Material that is out toward the edges
    (farthest from the axis of bending) is more important and adds more strength
    per unit area than material closer to the axis. That’s why I-beams have
    thick steel at the top and bottom, but only a thin membrane holding them
    The formula for the moment of inertia I of a tube being flexed is

    I = pi/64 * (D^4 – d^4)

    where D is the OD and d is the ID of the tube. The larger this number, the
    stiffer the tube, for a given material.

  28. true believer says:

    Yap. A hollow tube is stronger than a solid tube provided you do not screw something into it intimately so much so that it is not just resisting forces from without but it is also fighting a third column of forces within that is persistently trying to force it to explode, and that is why one of the main drawbacks of 2 piece implants is connecting screw failure! A 1 piece solid implant of 2.5mm diameter is on measure still more advantageous to a 3mm diameter hollow implant with a screw tight inside trying to push it apart. So, maybe the FDA may begin to see the light and pontify down the magic number below 3mm as long as it is not hollow. By the way, whether Pluto is a planet or not depends on whether you are a faithful nolstalgic traditionalist or a sort of a curious gungho advancing experimentalist determined to improve and simplify things.Elegance should not be complicated but simple yet functional.

  29. Anonymous says:

    Sorry Bruce, fractures occur on dental implants unfortunately quite frequently.
    The modulus of elasticity to any metal can be guaged. Different types of titanium and/or alloy can assist in the strength integrity of an implant. The inner and outer diameter do play a role in the m/e of an implant.
    What is stronger, using the same grade of titanium, 1.8mm, 2.5mm or 3mm solid implant if you put torsion, shear, compression forces on it?
    My answer would be the 3mm.
    The FDA sets the parameter. I would not argue your calculations but your examples are apples to oranges.
    3.25mm with a hole down the middle vs. 3mm solid would be a great test. My feeling would be that if I put a rod down the middle of a tube and started to exert forces laterally,axially (if that is a word) rotaltional forces etc. I would be able to cause damage to the tube most likely at the contact points of the rod and the tube. I would be hard pressed to cause the same damage on a solid piece. Just my thoughts.

  30. Bruce Seavey says:

    The monent of inertia is what determines how a beam will react to bending forces.
    3^4 = 81 for a solid 3mm
    (3.25^4 – 2^4)=111.5 for a hollow 3mm with a 2mm hole all the way through. This comparison shows the hollow one would bend 18% less than the solid one. Of course there are many other things to consider as to which is better, but the question I was answering was:

    “true believer,
    please understand engineering.
    A 3.25mm conventional impllant has a hole down the center along the vertical axis.
    A 3mm solid implant is solid.
    Which would be stronger if you tried to break it in half?”

    My point being is that round beams get stronger really quickly (to the 4th power) as you increase the diameter. Conversely, they get weak really quickly as you make them smaller in diameter (minis). Maybe the FDA took this into consideration when determining where the cut-off point was for permanent implants?

  31. Anonymous says:

    Dea Dr. Ruddick,
    I feel that your clear statement is completely true.
    However, we must have guidelines. Hence, the FDA sets them. I think pioneers should be recognized for their evolutionary movements as well as their disasters as we all learn from them.

    I feel that my biggest issue with this whole blog is that marketing is first before science, research and FDA requirements. I do not want to isolate MDI or and other “mini”. The marketing issue traverses all implant related products. Inately, people will say what needs to be said to sell their product. This is a reality in the world we live in. As Proffessionals, we need to be aware of all these tactics. If we are not, even with best intentions, we could suffer the wrath of any. This being said, I would and have used these types of products but not for what is being discussed today. I am fearful of backlash. If MDI, Intermezzo, Dentatus, would state that they are implants clearly and they can be used as such, I am not comfortable in using them as an implant.

    Do you not find it interesting that these blogs are not started from a standpoint or title regarding diameter to diameter or length to length or manufacturer to maufacturer?

    We have titles of discussion on mini implants. This equates to simple controversy and it is great and healthy but why all the discussion?

    My answer is that it is not a simple answer and the manufacturers of these companies or the Dentists that promote them would jump up and state the proof if they had it.

    Thank you for letting me make my point.

  32. true believer says:

    Who brings progress to man? The playitsafers or the reachupfortheskyers? The very fact that we are practising the blessed art of dental implantology is because of people like Linkow and Branemark who in their time were vilified and branded as a bit of their heads. Linkow was labeled a “mad dentist”. But today we are thankful for them and their ability to accept critism with magnanimity.

  33. wade says:

    Did anyone answer the original question? How old is this patient in question and how long do they want their implants to last? Don’t bombard the patient with stats, find out what their expectations are and deliver.

  34. T. Giorno says:

    To answer Bruce, I made the experimentation of comparing a solid 3mm screw (made of Ti alloy) Vs a 3.75mm screw with external hex connection (made of Gr ! CP Ti) on one hand and another identical 3.75mm but made of Gr4 CP Ti.

    Static fracture test and fatigue test.
    Guess which is the strongest?

    Of course, the solid 3mm, by very very far….
    If interested, I can submit the whole report by email.

  35. Anonymous says:

    Just a simple note on this torque testing being discussed. All discussions have consisted of generic simplistic statics. The tube-solid debate is being over-simplified. The outer diameter is not the main consideration. These parts have threads. The minor diameter of the thread, pitch, and type of exiting, which induces stress-risers create the areas that will contribute to failure. In the case of the implants with ID threads the same applies. Thread size pitch, etc. These considerations carry more bearing than a simple tube to cylinder comparison. Implants do not follow the simple model being debated.

  36. kfc says:

    Dear T. Giorno,
    Does it follow that a 2.5 solid Titanium alloy screw will be pretty stong too? Can you please email me the whole report? Thank you.

  37. Anonymous says:

    You people are missing the point.
    Stop trying to figure out if the FDA has slipped up.

    minis are not implants and you put yourself at risk if informed consent on the nature of these devices are not explained to your patients.

  38. domis says:

    A little deviation from the minis – about the solid one piece vs. two-pieces external or internal hex connections. Clinically, the latter do encounter fractures but those with internal cone attachments are quite free from that, and the reason given is because the fit between the abutment and implant is so good that it becomes effectively a one-piece. Examples are the Bicon and the Ankylos systems.

  39. Tom Bunin says:

    I have a patient who was referred to me with a condition known as Oral-Buccal Dyskinesia. She has a full upper denture and a lower over denture on five IMTEC fixtures. Due to the incoordination of her tongue and cheecks, she is not able to get the lower prosthesis in place without tearing up the o-rings. I’m considering fabricating a bar that can be fixed over the existing IMTEC fixtures and incorporating either two ERA or Locator attachements on it for a new over denture. However, if placing two additional fixtures distal to the already placed IMEC fixtures is not contra-indicated physiologically nor neurologically, how do you feel about the long term sucess of a fixed hybrid prosthesis?

  40. Todd Shatkin, DDS says:

    Dear Friends,
    I am sorry I have not logged on to this forum in a while. There has been much discussion since my last post. I have submitted an article for publication which has been accepted and will be published soon about the success of the MDI for use with all different types of restorations. Whether or not we call it an implant or something else, it is indeed an implant screw which is being placed in a non-surgical manner. When you talk about fracture or tensile strength, it is important to note that a 1.8mm MDI implant is made of Titanium Alloy not CP Titanium. This dramatically strengthens the product. It is 62% stronger then CP titanium. Many companies are moving to this alloy because of the tensile strength. Now what this means is that a 1.8mm MDI is comparable in strength to a 3.3 mm conventional screw implant. The 2.4mm Max thread is then comparable in strength to a 4.0mm implant. Now you will understand why the MDI’s are very strong, seldom fracture and hold up well under loads similar to conventional implants. We have assisted hundreds of dentists with surgical stents and fixed and removable restorations using my now patented protocal F.I.R.S.T. (Fabricated Implant Restoration and Surgical Techniques).

  41. Anonymous says:

    I just viewed Gordon Christensen’s DVD on mini-implants. He uses mostly 1.8 – 2,4 mm diameter mini-implants for ‘long term’ placement. He presents many clinincal cases ranging from supporting bridges, connecting bridges between implants and natural teeth, supporting RPDs and overdentures and so on. He is usually at the leading edge in clinical dentistry.

  42. Judy Perine says:

    I recently underwent an attempt to have locator implants in my top jaw which was unsuccessful due to lack of bone. I have been advised that bone grafing is an option for me. I have worn dentures for 40 years and experiencing difficulty keeping the upper denture secure when eating. I had new dentures made in May of 2006. I am 58 years old and healthy. What would be your advice concerning the bone grafting? How long would you expect all of this process to take? Could the implants be done at same time as the grafts? I have been advised that the implant with the bar will be best for me so that they can bring the upper front teeth forward to fill my face and provide a normal bite. My natural bottom teeth were in front of my top and has created a definite problem with dentures, especially in the last few years. How many implants should I expect to have with the bar? It was determined that I will need a graft for all implants involving the top jaw.

    I am moving forward with having 2 locator implants on the bottom jaw since my doctor has no reason to expect problems their. Would appreciate any suggestions you may have to offer based on the little bit of info I have given. Thank You!

  43. Peter Staubli says:

    Dear Judy

    We can not help you with the grafting, however if you want a bar to be placed you should have at least 2 implants preferably 4 with an extension to receive a locking attachment to prevent lift off of the denture.

    Such attachment are the SwissLoc or the Lew attachment. A retentive clip such as a Plastic Hader or Gold Clip such as a CM or Ackermann rider would assist in retaining the denture with a click in sound.

    Sincerely Peter

  44. Walter J Kucaba, DDS, MS says:

    In 2001 I was walking through the convention center at an implant conference in Boston when the light came on. All of this wonderful conventional implant technology and surgeries to create the ideal placement site would only help about 20 percent of my patients. I then saw a booth with mini implants. I took the information, spent time with Dr. Victor Sendex and the rest is history. The important thing is not which system but that fact that they are a vital part of contemporary implant dentisry. Unfortunately they are looked on as conventional implants were in the early 1980’s. I have used several different systems and find the MDL system by Inter-Loc to suit my needs the best. They make 3 reduced diameter implants (Mini’s). A 2.0, 2.5 and a 3.0. I have used them for denture retention both maxillary and manibular, to gain additional retention with removable partials, Single and multiple units for crown and bridge and finally for transitional stabilization during the intergration period of conventional implants. I like the most of you was concerned about the long term prognosis. So I stretched the envelope and now feel very confident on what I can achieve with these implant. These implants have help many people who could not other wise afforded or were not candidates for conventional implants. They are great for bailing out conventional prosthetics when a mishap occurs. You all know the patient who comes in on Thursday and needs something done by Saturday. To get a better idea as to the use of these implants check out my website I will be lecturing on the uses of mini implants on 8 June 2007 at The University of Texas- Health Science Center at Houston. These reduced diameter implants have become the Duct Tape of implant dentistry and I could not practice without them.

  45. dr lopez says:

    Dear mini implantologists, I think we are to worried about what is an implant and what is not. If you go back to its origins from france, dr refael chercheve would have called it an implant. Mini implants in some instances are transitional and in others for long term use. drs. we have thousands of cases to proove it.

  46. Ken Clifford, DDS says:

    I attended Dr. Shatkin’s course in March in Las Vegas. It was very interesting and informative. You would be surprised at the number of dentists who are already using mini implants successfully for a wide range of applications. I just reviewed my records for the past 3 years. I have placed 222 mini implants so far, with 16 failed implants, but zero failed cases. In every case I was able to go back and replace the failed implant with a new one in a better location. Most of the failures were in the first year, very few lately. I admit I’ve gotten much better at finding the correct placement position and angle with experience. I also highly recommend the IMTEC training courses at the University of Oklahoma (two day seminars, hands on). There IS more than one protocal which works – I have adapted elements from several which I observed at the live demonstrations. Remember, every case and patient is different. Please do not allow the negative press from places on this website and others to deter you from finding out what is truly best for your patients. Of course no one has 10 year results from using minis for fixed applications – how can they for at least the next 10 years? Ultimate success requires that time span for evaluation, but in the meantime I am a happy camper providing a much needed, less expensive procedure for the many fixed income patients I serve, and at least for now (and I believe, for many years to come), they are FAR better off than before we treated. Best wishes to all, specialist and generalist alike!

  47. Xe says:

    Has anyone heard about the new Sweden&Martina 2.5 mini’s?Plus, i cant understand how can it be that a mini that is at least 1 mm narrower to a regular implant is such an indication for immediate loading.I mean it is smaller narrower, yet more stable???an anyone help me here?

  48. Dr Richard says:

    My partner and I have been discussing the use of “mini implants” in restorative dentistry. He believes that integration is just as, if not more, predictable as conventional, larger diameter implants. I am under the assumption that immediate loads will decrease the success of integration. Can anyone shed some light on the matter

  49. Dr Richard says:

    My partner and I have been discussing the use of “mini implants” in restorative dentistry. He believes that integration is just as, if not more, predictable as conventional, larger diameter implants. I am under the assumption that immediate loads will decrease the success of integration. Can anyone shed some light on the matter

  50. steven says:

    Dear Sir ! If you place the implant in bone with adecvate dimensions you’ll have great success !
    Before placing the implant rthink about the revascularisation of the site. I prefere to place MDI in stead conventional implants accompanied by boneaugmentation.

  51. Steve says:

    What do you think about using imtec mini implant for permanent replacement of a single maxillary tooth?

  52. Walter J. Kucaba, DDS, MS, says:

    Mini implants are at the same stage of developement that conventional implants were in the 80’s. I have been doing mini’s for 6 years the reason being I realized that conventional implants can only help about 20% of my patient population. Like conventional implants I started slow and went to Victor Sendex’s course where I saw the true potential for these implants. Like with all implants you need to work back from the prosthetics. I have used 3 systems and have found that Intra-Locks MDL(2.0 and 2.5) and Milo(3.0) provide me with the versality to do single units, partial denture retention and the old stand by full denture retention. They are also most useful in the bail out case. Mini implants are the DUCT TAPE of implant dentistry. They have helped me salvage cases that I could have not done any other way and not have the patient declair bankrupcy. Intra-Lock is the only system that has looked beyond denture retention. The prosthetic elements will allow you to do cases that you may have not gotten to due because of the limitations of conventional implant size. Check out my website to see what I mean. Get over it! Mini implants are not just transitional and are here to stay! The secret is knowing the anatomy of where you are using them which I fortunately learned with my conventional implant experience. Like with conventional implants if you don’t have the experience they can ruin you day!

  53. Scott Noren DDS says:

    Correct me if I’m wrong. Dr. Shatkin wrote me by email and also stated in his Compendium article a failure rate of about 6% but also excluded 22 patients from the study. I find 6% quite high first of all and second, there is hearsay that the real failure rate seen overall has been more like 22%. Here’s my spiel. If you go to 4 years of Oral Surgery residency, why would you think that you should do “everything” with a basic dental degree only. As things progress, we will see more lawsuits like the one out west I was told about. The one involving a general dentist with a cone beam ct who missed a cancer and, because he is not a radiologist, it AIN’T gonna cut it that he was “only doing dental stuff” and not responsible for whatever else was on the CT. Line your pockets as you will, but eventually, good implant dentistry prevails with those qualified to do it. I’m sure there’s a lot of stuff out there that people will “get away with” that is substandard and make good money doing it. Not for me. Sounds rough but it’s the truth.

  54. TL Jeffrey says:

    I’m in the process of getting full dentures with mini implants. I have my upper and lower implants in place and my immediate dentures. While it’s certainly not fun having your “old” teeth pulled, the process so far has been much less traumatic and much faster than I expected. If you are considering mini implants, do your homework, educate yourself about the procedure, and then find a dentist that you feel confident in. has been a tremendous help for me in educating myself and in finding a great dentist. It’s nice to have teeth!

  55. Alex says:

    I agree, this site is a valuable source of information regarding dental implants. Had it not been for OsseoNews I wouldn’t have known there are many prominent dentists who have had considerable experience doing mini implants and are quite willing and confident in them in the right circumstances.

    I am an “old guy” with limited resources. Given that, and the state of bone available, I think I’m a perfect candidate. I’ve been to two local implantologists who don’t even want to discuss minis and, if they do, thoroughly trash them. Within the next few months I hope to find someone local who will objectively consider my situation.

    By the way, how many implants do you have in each arch?

  56. Benjamin D. Oppenheimer D.D.S. says:

    Patients should not be dissuaded from some of the arguments from dentists here. MDIs are great for stabilizing dentures and replacing missing teeth. Also the ability to easily remove/replace the MDIs in the case of a failure allows for near 100% Case success (different from implant success). Much different from conventional implants and it’s really the goal anyway.

  57. Ken Clifford, DDS says:

    Alex – TLJ has five upper minis (will be six when bone finishes healing) and four lowers. Holding quite nicely at this point. We still have some issues with aesthetics but that will be addressed and cured with his final denture. Hope TLJ doesn’t have problems with me identifying myself as his dentist – he is a great patient with a terrific attitude about the whole process! And Ben – thanks for your contributions also. Hope to see you in Las Vegas in January!

  58. Francis says:

    I’m a patient at a clinic where I am getting full upper and lower dentures, following removal of about ten teeth. I have mandibular tori(bone segments on lower jaw) that will cause lower dentures to fit poorly unless the tori are removed. I think tori are present in about 10% of the population.

    Currently the clinic does not approve the use of implants. However the proceedure to remove the tori is approved.

    It seems to me that keeping the tori, and instead, using mini implants for my lower dentures would be the best approach. This has the added advantage of stabilization of the lower dentures plus seems a less invasive surgical proceedure.

    (Dental practioners at the clinic have indicated to me that they surely would like mini implants to be acceptable at the clinic as an option for patients who want to stablize lower dentures. They believe a request by me, the patient, to the clinic to formally request mini implants for my needs may facilitate future use of implants.)

    My question is:
    Are mini implants the better alternative to surgical removal of mandibular tori for lower dentures? If so, are there web-published articles that I can copy and submit with my request to the clinic?

  59. Bruce McKelvy says:

    It is probably a good idea to have the tori removed or at least modified so that a denture will fit properly. Mini implants are a great idea for the mandible. Intralock makes some which are slightly larger in diameter than Imtec. I have not seen a failure in the mandibular arch (anterior portion).

  60. John Egan says:

    i am a University lecturer and have experience with other implant overdenture systems but not minis. Has there been any recent clinical trials that have been published/

  61. Richard Hughes, DDS, FAAID, FAAIP, DABOI says:

    To Keith and other medical tourist: I have encountered this in my office and find that medical tourist want the world for next to nothing. You get what you pay for. You went cheap for half the treatment and even got sick. I can understant if one coners the earth for necessary treatment, but elective treatment that you could of obtained down the street in you home country. I do not get it.

  62. Keith Roberts says:

    Just to fill-in Richard Hughes’ helpful comments. I spent much more going to Thailand than I would have done `going local`. I went there for expertise not cheapness. (My partner says that that remark is like a red rag to a bull.)
    I only wish that Dr Hughes or someone could guide me in my choice as most web sites are pitifully inadequate in providing technical information.
    Regards to all and a Very Happy Christmas to all who think that way.

    Keith Roberts


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