Narrow Diameter Implants for Long Term Use: What does this really mean?

Good insight will look into it for mandible thanks

I have been placing mini dental implants to stabilize lower dentures for a while. I have many cases going on 10 - 12 years now. Case selection is a key element to success.

I get this question all the time even from experienced docs.. They are approved for long term or on going term. They are even approved for fixed applications again , on ongoing basis. It's not hard to find the approval. I had one doc who was spreading to some patients I have treated that these minis weren't approved ...etc.. It is frustrating to deal with a few angry patients because of some uninformed or intentionally idiotic docs.

My goodness, on top of FDA's approval ( which doesn't mean much other than legal standpoint when in trouble ), you now need it to say it " osteointegrate"? You feel cautious towards using bigger implants? Why not ? because FDA said it " osteointegrates"? Some of these knowledges come from experiences and some from what we already know.. Just because you haven't been doing these procedures for the past decade, doesn't mean that a patient has to get denied or fed with speculation without valid experience or studies.I hear more and more from some docs that " according to countless studies, these mini implants fail a lot more than .... " And yet if you search for any articles that demonstrate such large failure rate of minis, you won't find any.. You will , however, find many that state " mini implants could be used as an effective solutions for ...etc " in conclusion.. although there is always a disclaimer at the end saying " further research is needed...." Minis work just as well as reg implants if treated right and right patients get trated with them. Blinded hatred or suspicion towards these merit no one. Especially not patients who could get implant tx and start chewing finally without blowing $ 20000 per arch.

Based on your statements, not blind hatred or suspicion, I personally feel that the minis are not the same as a regular implant due to lack of proven osteointegration and I feel that the patient should not be "denied" this information when selecting treatment.. They have a limited application and should be used judiciously. Your reply seems to me to be very colorful yet defensive.

I didn't know informinig others can be viewed as being defensive. There are many out there who make lots of statement about minis ( or anything ), when they haven't done any tx using minis. You don't happen to be one of them, are you?

I honestly don't think my comments have been understood about osteointegration and I feel that you are too busy defending your position . I have not found it necessary to use minis since the patients I treat are grafted and more conventional implants are placed which osteointegrate. The original question posted is what is meant by long term use and approval. I brought up the point that it is doubtful these implants osteointegrate that and that the 510 approval is based on the fact that similar implants are in the market place and do no harm. That's all.

Hooray.. finally some one says it right.

I am curious, CRS: how exactly do you define osseointegration (mathematically/scientifically speaking)?

Good question, now this is way above my paygrade but here goes. When I state osteointegration I mean that there is a direct connection between the implant and bone with no connective tissue in between sort of like an anklylosis vs a fibrous union. So basically the implant is fused to the bone, no movement. I believe that while the osteointegration process is occuring there should not be any micromovement. An implant is most stable at initial placement mechanically and this changes over at 6-8 weeks when the stability is gained by bony ingrowth. I'm totally going with clinical parameters since I only read research. Now I have a question since some minis have osteoconcuctive surfaces could they integrate faster since they have a smaller osteotomy and more surface area? The problem I feel with an exposed and immediately loaded mini is that there will be micromovement to give a fibrous union. So my discussion is that if there are published studies on minis osteointegrating will this violate the FDA approval? I really don't know I'm relying on my experience with fractures and orthognathic surgery.