Upper Roundhouse Using Mini Dental Implants: Is this a Reasonable Treatment?

Try not to go there it will cause you major issues later ,life is too short use standard narrower implants or even though I do not do it all on Four. Peter

dear Dr you really have provided no information as to how this treatment plan was derived.A proper discussion cannot really ensue until you do. For me narrow implants is common place in my office.. even for fixed uppers.So I will not discard the proposed plan on principle.However there are NUMEROUS factors to consider before this can be embarked upon ,and if you are going down the "mini" road especially MDI narrow implants that are one piece and force immediate load ...you need to consider very carefully what you are dealing with. I am suspecting a lack of experience due to the semantics of this question,which is ok.... but I caution you that using mini and indeed narrow diameter implants for fixed cases in the maxilla ,has a boat load of surgical and prosthetic biomechanics to consider ...narrow implants and especially MDI 's in a case like this are by no means an easy option.

I have seen this work on a most rare occasion. I would not do it!

Doing full round house fixed partials require the implants be placed so that the abutments can be CHANGED/MODIFIED/WAXED etc to DRAW!! Way easier with a 2 piece implant than a single. Also, you'll drive yourself into nutsville trying to fabricate a ceramic fixed prosthesis ahead of time... so this forces you to place the implants and then construct the prosthesis -unless as suggested you do an "all on four"... My best advice is contact your local NobelBiocare Rep. Most likely he'll have an upcoming lecture that he can get you into and you'll be able to see what if any advantage this may have for your patient. THEN go back to the drawing board and make a decision. Hope that helps.

I have done Mini's since 1999 and I shy away from teh maxilla due to the large trabeculae in teh maxilla versus the mandible. Even if you get some to intergrate I am sure some will not and it could be a nightmare. DO NOT DO IT!

I have seen articles (Japan) using 14 mini's for a roundhouse. I don't see the advantage to this technique when bone spreading osteotomes, grafting and 2.5mm and 3.0 implants are available. Build some engineering into the procedure.

If you do this you are INSANE!!! Stay away from this as it is not if it fails but when it fails (and it will fail miserably).

Always the contrarian, the answer to this lies in some very simple engineering principles. It's all about SURFACE AREA. If you use a sufficient number of small diameter implants, preferably with a more aggressive thread profile (i.e. Intra-Lock 2.5mm MDL), there is no reason why you cannot succeed. Against a full denture; absolutely. Against a natural dentition; with proper engineering, a high success rate (published). Against a natural dentition with insufficient number of implants or parafunction; this is a recipe for failure. In more narrow ridges, larger implant diameters can actually cause dehisences in bone, making these case more prone to failure. The use of narrow diameter implants should be used on a case-by-case basis, with all risk factors considered. With this approach, small diameter implants can be a valuable adjunct to an implant practice where finances or inability to graft are important parameters. RJM

Dear Dr, I have been through these so called MDIs for the Maxilla and Mandible, let me apprise you with my experience. For Maxilla these are an outright failure and as for as the mandible is concerned is also no success, it is the patient only who has to suffer because of the inadequacies of the MDIs as well of the Dr practising it. Hope you understand ? I cannot advise you but would definitely recomend to refrain from the so called MDIs, these in actual are an absolute time wastage factor if implemented on a patient without proper scrutiny and planning. Regards and wish that you take care of the patient/s in an appropriate manner. Sanjiv Kapur

The small diameter implants are not an easy way to go. I use them when the bone will not allow me to place larger diameter implants. Consider using a combination of small diameter implants where the bone will not allow wider ones to be used. Place the wider implants where you can. They can be splinted together, but your lab needs to have the knowledge of how to do so. Not all labs can do this or will be willing to attempt it. Plan the case with great care and consideration of the forces that these implants will need to resist. Allow time for the small diameter implants to integrate. A passive fitting overdenture will work. I allow 8-12 weeks minimum befor loading small diameter implants in the maxilla. Unless they are protected by adjacent teeth I do not do immediate loading. Immediate load can work but why risk it for the sake of saving a few weeks?

Hello Why do you wanna try anything like this on a patient who already lost all the teeth? Just buy cheaper implants available in the market, if expenses are the main problems. Or just mix both mini & regular implants according to the available bone. Best of luck

Minis that are all splinted together will hold up fixed restoration. You have to put enough of them like Dr. MIller mentioned above. If you are experienced, when you place the minis you will know lots of times that whether they will be successful or not. Some patients have poorer bone quality than others ( again,like mentioned above, some have larger trabecular patterns ). Another with minis with fixed rpundhouse is esthetics. It could be hard to make them look natural since there is no emergence profile and no hiding of junction between implants and gingival tissue. Best way is to approach it with the use of both minis and reg. sized implants in maxilla. While bigger ones integrate, minis hold up, then fine. Include them in final prosthesis. If they fail, just use inegrated implants.

Is it reasonable? Absolutely not !!!!!!!! I would bet the Owner of MDI, would even agree. Bv

I dont recommend using MDI alone...u need at least 10 implant or more to support fix at maxilla.. Use regular size implants and splint MDI for immediate provisonal.. you can try Replant it is cost effective and very succesfull system... Good luck

In my hands, aside from ortho anchorage, temporization is the only indication for that type of product . Bv