Mini-Dental Implants- Securing loose Dentures and More!
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By Dr. Jeff Shnall
General, Implant & Cosmetic Dentistry
Note: You can listen to this information if you prefer on my Dental Podcast by clicking on this link:
I am sure many of you have heard of dental implants, which have been available in North America for over 20 years, but perhaps fewer of you have heard of mini dental implants.
In this article we will explain what mini dental implants are, their uses, how they differ from regular sized dental implants and some of their advantages and disadvantages compared to regular sized dental implants.
I am Dr. Jeff Shnall and I am a general dentist in Toronto, Canada. I have been placing both regular and mini implants for several years.
First let’s describe what a mini dental implant is. Picture a small to medium length common screw you would find in a hardware store. A mini implant looks much like that screw, with threads running down it’s length. The mini implant has a small round ball on its top, at the end where you would normally place the screw driver.
Mini implants come in a variety of lengths but by definition, they must have a diameter of 3mm or less to be considered mini. Anything wider is considered a standard or regular sized implant. There length ranges from approximately 12mm to 18mm (approximately 1/2 inch to 13/4 inches).
How are mini implants used in dentistry?
One of the most popular uses of mini implants is to help hold full and partial dentures securely in the mouth.
Some of you reading this article may wear a denture or have a family member who does. Many people do quite well with full upper dentures. These are dentures that replace all the upper teeth. A full upper denture fits up against the roof of the mouth and gums and a suction cup effect can hold a full upper denture firmly in place . Picture the way a wet suction cup can stick against a glass surface or a wall. It is the exact same effect that can hold a full upper denture in a person’s mouth.
However, in the lower jaw it is very difficult to achieve a suction like grip between a full lower denture and the lower gums . Many patients who wear full lower dentures have to learn to live with a denture that is not firmly attached to their lower gums. Many full lower dentures just sit on top of the gums and some patients have suffered the embarrassment of having their lower denture falling out of their mouth while they speak, sneeze, laugh or eat.
Why do patients have such a difficult time with lower dentures?
After a tooth is extracted there is a gradual loss of bone in the site where the tooth was pulled. There is significant bone loss in the first 12 months after a tooth is extracted, and this loss will gradually continue at a slower rate after that for years to come. So if a patient loses all the teeth in their lower jaw, they will lose a large amount of the bone that would normally support a denture. In many cases the bone loss will eventually become so severe that their denture will simply sit on a flat lower jaw bone, without any bone ridge to retain their denture.
Patients can also lose a large amount of bone in their upper jaw and many of these patients need or want the extra grip and stability for their upper dentures that mini implants can provide.
So, this is where mini implants come into the picture. If a patient is suffering with a loose full lower denture, ideally six mini implants can be placed in the lower jaw. They are usually placed in the front area of the jaw, where the patient’s six lower front teeth used to be. In the upper jaw ideally eight mini implants are required to stabilize a complete upper denture.
AFTER – 4 MINI IMPLANTS PLACED BY DR. SHNALL
. Once mini implants are placed in the upper or lower jaw all you will see the small ball top of the implant poking through the gums, sitting just above the gum line, however the rest of the implant is buried beneath the gums, anchored to the bone and out of view.
Once the implants are in place, attachments can be placed into the patient’s existing denture, allowing the denture to be snapped into the mouth, onto the implants. The goal is to have the patient able to have their denture secured to the mini implants the same day they are placed. So, now the lower or upper denture sits firmly in the mouth and the patient can eat and talk with confidence.
Mini implants can also be placed into the upper or lower jaw to retain a partial denture, which is a denture that patients wear if they are missing only some of their teeth.
The advantage of a mini implant in this situation is that one or two mini implants can be placed to allow a partial denture to be held in, instead of relying on partial denture clasps, which can sometimes be unsightly, can break, or loosen over time. So if you wear a partial denture, mini implants might be something worth looking into.
How are mini implants placed?
Mini implants are generally simpler and quicker to place than traditional dental implants.
First, if you are nervous about the procedure can give you medication before the procedure such as a sedative pill, or we could use laughing gas to relax you during the appointment. See Episode 2 of the Dental Health Podcast: “ Taking the Fear Out of Dentistry” for more in depth information on this topic.
Freezing is given in the site of the proposed minis.
At each implant site I prepare a small channel or space. This is quick and painless.
I then place the mini implant. Because it is shaped like a screw, it threads itself into the bone of the jaw the same way that a screw is threaded into a piece of wood. Again, this is painless. And that’s it. It’s done. Several mini implants can be placed quickly in this manner. This may not sound pleasant but the procedure is very straight forward and the results are well worth it.
After the mini’s are placed I will do one of the following.: I may place special attachments into the patient’s denture that will allow the denture to snap onto the mini implants. However, sometimes we wait for several weeks to let the mini’s become more firmly anchored to the bone before placing permanent attachments in the denture. In this situation, I will place a soft liner in the denture where the minis are located . The soft liner will grip the round ball shaped tops of the mini implants, and will help keep the denture stable while we are waiting for the implants to become permanently anchored to the bone.
After the appointment, there may be some discomfort that is very manageable with medication such as Advil or Toradol. In my experience patients will often feel fine the day after the implants are placed and usually by that time will usually not require further pain medication.
|The full lower denture is very secure|
How do Mini Implants Compare to Standard Sized Dental Implants?
- Like regular implants, mini implants are approved by the FDA and Health Canada for long term use for tooth replacement and to anchor dentures.
- Both are available in a threaded design
- Both can be used to anchor full and partial dentures in much the same way.
- Both mini and regular sized implants preserve bone, preventing the loss of bone that normally will occur anywhere in the jaw that a tooth is extracted. When you chew on a dental implant, the implant transmits forces to the surrounding bone. This stimulates the bone and actually prevents it from shrinking
- Both mini and standard dental implants are made from titanium, a metal with very unique properties. When you place a titanium implant in bone, over the twelve week period that follows, your body will produce new bone that attaches itself direct to the implant, locking it in. For some reason, our bodies treat titanium as if it is self. This property of titanium is unique and doesn’t occur with almost any other metal.
- mini implants, just like regular implants can be used to replace one or several missing teeth with a permanently cemented crown or bridge, except at a lower cost than traditional implants.
Both regular sized and mini implants both have their place in dentistry and both can improve the quality of life of our patients.
. Lets’s discuss some of the advantages and disadvantages of minis and when I would use them and when I wouldn’t.
Advantages of mini implants over regular sized implants
- A denture can often be anchored or attached to mini implants the day the minis are placed to give your denture support immediately. This can be done with regular sized implants as well but at a much higher cost for parts and a higher fee for the placement of regular implants.as compared to minis.
- Mini’s can be quicker and simpler to place than traditional implants and can often be placed non surgically,that is, no scalpels and no stitches.
- Because mini implants are simpler to place, they can be placed at a lower cost than a regular sized implant, thus mini implants can be more economical for patients to consider if they need denture stabilization
- Because mini’s are narrower, they can be placed in jaws that have thinner amounts of bone than may not be wide enough to support regular sized implants.
Disadvantages of mini implants over standard implants:
- mini implants are not suitable to replace single teeth in the upper back molar areas of the jaw. The bone is not dense or hard enough to give the mini implant the strong, tight grip in the bone that it needs the day it is placed to be successful.
- Mini implants have a more limited role than regular sized implants in dentistry. Because they are smaller than regular implants they are generally only strong enough to support removable dentures and not a full set of upper or lower teeth that are cemented or screwed into the implants. This is in contrast to regular sized implants, where 5 to 8 regular sized implants can be used to support a set of teeth that is permanently placed in the mouth that cannot be removed by the patient.
My office can help arrange financing for our patients, so a miserably loose lower denture can be converted into a stable denture secured by mini implants for a fee that can suit most budgets.
Mini implants can improve health and quality of life. People who have loose upper
and /or lower dentures will often seek out foods that are softer and easier to chew, resulting in their diet having fewer coarser grains and vegetables. This means their diet will be lower in fibre. Dietray fibre has been shown to be important in preventing colon cancer, heart disease, diabetes and other illnesses. A diet with softer and more processed foods can lead to many health problems such as those that I just mentioned. Placing regular or mini implants can bring huge relief to these patients, who will be able to chew with greater ease, won’t have to limit their diet to softer foods, and feel more comfortable and confident about their denture.
Both regular and mini implants have their place in dentistry, and are well worth looking into if you are missing teeth.
If mini implants interest you what is the next step?