Mini Implants for Lower Denture: How Long Do I Need to Wait After Extraction?

Consider having mini implants in the first bicuspid region (solid cortical bone)on either side, to stabilize your immediate prosthesis at the time the six extractions are done. The remaining mini implants can be placed and loaded after the extraction sites have formed cortical bone. Good Luck! Theodore M Grossman D.M.D.

This is a question I get in nearly every presentation I give on mini implants to other dentists. Mini implants require solid mature bone to function properly. The most important concept here is ‘initial stability” or how tightly the implant is locked in the bone during the surgical appointment. This is critical with all one piece implants, that is implants that already have the abutment end already attached to the screw part. The abutment end of the mini implants (MDI) sticks thru the gums and into the mouth and has a ball shaped attachment on top. This cannot be removed and reattached later. So, because the implant has the abutment end already attached it will be used immediately and needs initial stability in the bone. This is harder to achieve when teeth are to be removed. For one thing, the tooth extraction leaves a hole that is larger than the diameter of the MDI. A longer implant will need to be used. Secondly, the socket where the tooth is extracted will need to be carefully cleaned out to eliminate any bacteria that will cause implant failure due to infection. Thirdly, to place the implant at just the right position so that the ball end is at the right position AFTER the gums and bone heal is tricky. Ultimately, the answer is that it can be done but usually it works out better to wait or what i do with patients just like this is a combination of MDIs and standard implants. This is the strategy:I’ll have an immediate denture made for the patient ahead of time. I take out all the remaining teeth and put in 2 mini implants in the front and 2 standard implants toward the back. The minis function to hold the denture temporarily while the gums and bone heal and the standard implants heal to the bone. I can decide to keep the MDIs if they work as a final implant or remove them and have only the larger implants snap in to the denture if not.hope this helps.Dr. Ben Benjamin D. Oppenheimer, DDS