Mini Implants

Recently there has been a resurgence in the use of mini-implants (1.8 2.4 mm in diameter). The implants were introduced in the form of temporary implants and are now used as a final solution for patients. This new idea is encouraged by some opinion leaders as an inexpensive solution for patients. My only experience with mini-implants has been the removal of mini-implants fractured, so the idea of taking one or two day course and begin to put these flaplessly left me scratching my head.

Keep an open mind, I read a recent article * in the Compendium. I would like to share my feelings after having examined the article. The article followed an impressive number of implants (2514) over a period of 5 years with an evaluation period averaged just under 3 years. The reported average survival rate was 94.2%. While impressive, it falls to about 3.5% shy of our survival at 10 years with standard and wide diameter implants. This represents an increase of over 100% failure rate. In addition, 20 implants fractured during installation and are not included in survival analysis. If they are included, which would increase the failure rate by an additional 0.8%. In addition, the authors oppose the introduction of the mini-implant type-4 bone and bone-D quantity. These criteria represent areas where most failures occur with standard implants. If I removed the implants and short implants placed in bone of poor quality and are immediately loaded mandibular implants, my survival rate climbs to 99.38% published ** This represents an increase of 500% rate failure using mini-implants.

After review, the article said that the average time of failure was about 6.4 months. Today, most standard implants are loaded at approximately 8 weeks. The data published with standard implants show that most failures occur during the period of 8 weeks after placement. This means that most failures occur with standard implants before making the denture, whereas most mini-implant failures may occur during or after manufacture of prostheses.

Several other interesting facts surface. Firstly, it took three years of experience with the placement MDI to achieve the success rates of over 90%. Second, mini-implants have been much more successful support fixed bridges, which is a costly restoration. Thirdly, mini-implants used to support existing prostheses had a survival rate of only 88%. Fourthly, a large number of mini-implants are available from the standard diameter implants. Fifthly, the implants in the posterior maxilla were 3.3 times more likely to fail. Sixth, the implant is made of cons-extraction and, therefore, should not be used for immediate placement. Finally, mini-implants placed to support the dentures were 4.3 times more likely to fail.

After reviewing this article, I still believe that the use of standard implants will my treatment of choice. Never forget that there are patients attached to these implants, and the best way to manage a complication is avoided in the first place.

I congratulate the authors for a publication well-written objective.

Mini Dental Implants * For long-term fixed and removable prostheses. Shatkin TE, et al. Compendium, Vol 28, No. 2 pp 92-99.

** An analysis of 5 years of life Table A Multi-Center Study Involving immediately loaded implants in the edentulous mandible. Testori T and Meltzer here. Clin Oral Implants Research, Vol.115, 2004.