Mini Dental Implants: With Collar or Without Collar?

Dr. A, The collar is used to allow for attached gingiva, so whether you use the collared or classic implant the amount of attached gingiva should be your main determination on how much of the implant head is above tissue. The collar on the MDI is 2.5mm, so if you have less than 2.5mm of attached gingiva, you are going to take up more space in the denture possibly. The Classic style or non-collared would be ideal in a patient with very little attached gingiva. With this being said, your pre-op planning is very important. You will want to examine the exesting denture thouroughly if you plan on using it and you will want to know what your tissue situation is. Hope you find this helpful. JP

use only the collar implants for fixed restorations as fabrication of crowns direct to the implant is more difficult with the implants that have no collar. I agree with Jerry for over dentures, you can mix them on the same case so why not get both.

Are you using these mini implants for definitive restorations? There intention is really as a temporary/interim fix. My advice would be to use regular 3.5mm or greater width implants. That way your angulation issues can be solved easily. It should be easy to select the proper size from your cone beam or CT study of the implant site.

Dear Dr G. To bring you up to date with modern day implantology, mini and midi implants have been used as permanent implants for some time now. Implantologists who do not use these type of implants in CERTAIN RESTRICTED circumstances are depriving their patients of the optimum treatment modality.

In total agreement with Dr. A, I have placed quite a few for denture stabilization and I can't recall needing the collarless version. That is, all my patients had 2.5mm of tissue or more. If having enough room in the prosthesis is an issue use the smaller MH2 housings.

Also in agreement with Dr. A. The polished collar is to traverse the attached gingiva. If it more vertical clearance that you are looking for, consider using the Atlas System that does not require a housing that takes up room in the denture base. I have used this very successfully over the years for denture stabilization. Also, consider the lack of vertical dimension present. Possibly new dentures are needed prior to implant stabilization to provide more 'pink acrylic' to house the implant's retentive system. Dr. G's comment on 'temporary/interim fix' is approximately 10 years out dated. GIVEN THE CORRECT DIAGNOSIS OF THE RECEPTOR SITE BONE, narrow diameter implants (those less than 3mm in diameter) not only are FDA approved for definitive restorations (since 2004) but provide numerous treatment options for patinets who have limited bone. Many patients can now be helped that were unable to receive implant treatment in the past.

I have been using 3M ESPE mini implants in the UK for the last five years, and it is only in the last two months that I have had to order the collarless implants. This was patient dictated as the clinical conditions, small bone reception sites and very thin gingvae, made their choice over the collared variety. A useful tip for any one considering the MINI implant route is that once collar disappears into the soft tissue, the implant is normally in place.

Check out the Inclusive mini implants from Glidewell. They are 100% compatible with 3M, however the square used for insertion is shorter; this means the housings are smaller (3.5mm) and you do not need as much room in the denture - or you need to remove less.

Dave- Do you work for Glidewell or our you a private dentist?

I'm glad to see some people here are presenting some facts about small diameter implant. here and even on other implant related websites have so many uninformed ( not willing to be informed sometimes with their knowlegede about reg. implant ) tend to bash the mini implant. It';s true that many of us went a bit crazy about minis when they came out on their denture stablization concept and for some minis didn't perform as they expected. In my hands, they perfomred fine and I continue to use them as additional option. there are about 55 articles about minis if you do search on pubmed. Not all of them are peer reviewed ones and some, because of the fact, feel a bit hesitant about using them. I perfectly understand that as well but what gets me going is that some like Dr.G above, who doesn't really know or hasn't placed any minis gives out advices about minis to others who has already placed or about to place them. Let's read a bit here before we speak!!

I have placed standard diameter implants for 25 years with excellent success. I started to use NDI'S about 2 years ago in situations where the bucco-lingual dimension of bone is too narrow for standard diameters. I have also used NDI'S where the interdental space is limited. The protocol is different in that less bone preparation is required since the narrow implant acts as the final drill. I suggest taking a course even if you are an experienced surgeon. Long term clinical trials with good scientific protocols are not available yet but there is certainly a place for NDI'S in all implant practices. I have used NDI'S for denture stabilization, as transitional implants to help stabilize provisional restorations and to support crowns when replacing incisors. At this point I would not use an NDI to replace a posterior tooth or to support a fixed prosthesis.

I have been placing conventional implants for 15 years and have never placed a mini. I was schlepped by my boss to Dr Shatkin's mini implant course in vegas last week and I must say I was very impressed with the presentations and it seems like a lot of the guys have been placing these with great success, including immediate load for posterior teeth. I think it is important to keep an open mind about these as there definitely seems to be a place for them in clinical practice and with time we might find that our preconceptions of their inferiority prove to be wrong. 20 years ago a lot of people were saying that conventional implants were crap and that they don't work.