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CATEGORY LINICAL

Miniature Implants A New Solution: from simple to complicated clinical situation

Dr Omid Allan

By Dr Omid Allan

M iniature implant is a new innovative system which o ers signi cant exibility to dentists in di erent clinical situation. eir narrow diameter and self advancing design can reduce or eliminate the need for extensive bone drilling and facilitate preservation of the natural tissues. Many of iatrogenic complications in dental implantation procedures are caused by bone drilling which not only risks invading the anatomic structures but also can destroy the remaining alveolar bone. Using Ultra narrow diameter Miniature implants which are inserted in the bone without extensive bone drilling, helps the clinician to be in control of the implant positioning and avoids many complications. One of the most common concerns of dentists who don’t have experience with the narrow diameter implants is that if the mini-implants with their reduced bone to-implant surface can stand the occlusal forces. A histomorphometric study published in International Journal of Implant Dentistry , presented that the osteointe gration parameters for Mini Implant of 1.8mm diameter and 10mm length is comparable to the same of an Ankylos 3.5mm diameter with 8mm length after 6 weeks of healing. 1 A systematic review of success and survival of Mini implants collected high success of 92% to 100% in several studies. 2,3,4 is is not much di erent from the data for conventional implants. Although the studies are mainly done on the use of mini-implants for stabilising removable dentures. e limitations in restoring mini implants are addressed with the new design and innovative form of the Miniature Implants. is new implant system stands out among all current implant systems for the bene ts they o er such as: a. Ultra-narrow and self-advancing form of the implant. b. Tissue level design which secures a more predictable long-term health of the peri-implant soft tissues.

mark the location of the implant sites. e implants are delivered with a disposable plastic cap which functions as a nger wrench. ey are hand inserted using the plastic caps. e implants are Miniature implants 2.8mm x 10mm and 2.4mm x 14mm.

c. Eliminating the possibility of micro-gap and micro-pumping e ect. d. External hex form of the implant which allow more exibility if restorative options. e simplicity and exibility in treatment which Miniature implants o er, can help restoring missing teeth of patients from simple cases to very complex situation. ere are three cases presented to demonstrate the treatment approach with Miniature implants. Case 1: e patient is a 71-year-old male com plaining of missing upper left premolar teeth. Patient is on daily low dose of Aspirin (Cartia) but has no history of a signi cant medical condition. Patient su ers from chronic bruxism and tooth wear which is believed that resulted in vertical root fracture of both upper left premolar teeth. e 1st upper left premolar tooth was extracted around four months earlier. e CBCT shows a buccal bone de ciency.

e implant insertion continues using a machine insertion tool once resistance to the nger torquing is felt. e procedure can be completed using a rachet till the implants are placed to their desired positions. e treated surface of the implants must be fully inserted in the alveolar bone. It’s recommended to further insert the implants by 1.5 to 2mm of the machined surface in the bone. is allows the treated implant surface to be subcrestal and secures subgingival positioning of the implant shoulder.

e treatment options for using two conventional implants or Miniature implants discussed and patient chose Miniature implants for their minimally invasive approach. e buccal bone de ciency in region of 1st upper left premolar would require lateral bone augmentation if a conventional implant were used. However, the palatal ridge of the site presents enough height for insertion of a Miniature implant with no bone drilling approach. A tissue punch (3.5mm) was used to

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