Mini dental implants
Encyclopedia
Mini dental implants are small diameter dental implants.

Dental implants may be split into two separate categories based on the diameter of the device. Small diameter dental implants, most often referred to as ‘Mini Implants’, are those with a diameter less than three millimeters (3mm.) Likewise, standard or conventional implants are those implants larger than 3mm in diameter, but most commonly 4- 5mm. As a rule of thumb, Mini Dental Implants are at least half the price of conventional implants and sometimes a quarter of the price of conventional implants.

Mini dental implants, or MDI's, are sometimes referred to as SDI's (small diameter implants), as well as NDI's (narrow body implants). Although mini dental implant is actually a trade name
Trade name
A trade name, also known as a trading name or a business name, is the name which a business trades under for commercial purposes, although its registered, legal name, used for contracts and other formal situations, may be another....

 for the most widely used small diameter implant, the 3M™ ESPE™ MDI Mini Dental Implant, the dental industry
Dental laboratory
Dental laboratories manufacture or customize a variety of products to assist in the provision of oral health care by a licensed dentist. These products include crowns, bridges, dentures and other dental products...

 has adopted the term to describe this class of implants. Some small diameter implants are used as anchors in orthodontic
Orthodontics
Orthodontics, orthodontia, or orthodonture is the first specialty of dentistry that is concerned with the study and treatment of malocclusions , which may be a result of tooth irregularity, disproportionate jaw relationships, or both...

 cases and are called TADs, or temporary attachment devices. One example of a TAD is the Unitek™ Temporary Anchorage Device System. These differ from the more common mini dental implant
Dental implant
A dental implant is a "root" device, usually made of titanium, used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth....

s in that they are removed after they are no longer needed and orthodontic treatment is completed.

Mini Dental Implants are constructed of various titanium alloys. The same applies to traditional implants.

Design

Currently, mini dental implants have a diameter of 1.8mm to 2.9mm and are offered in various lengths. It is important to note that the pull out strength of an implant has been shown to be based on its length rather than its diameter. Multiple tip, thread, body and head designs are available across the category as well. Most tip designs are sharp or slightly blunted to provide self tapping ability of the implant through the medullary bone. Some blunted designs taut a compression of the bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...

 as an advantage. Thread designs vary from thin to thick and thread spacing is also variable. The design variations allow for use of the implants in the different densities of bone (D1-very dense, D2, and D3-soft) found throughout the mouth
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....

. The body connects the tip with the prosthetic head and can be a parallel sided cylinder
Cylinder
Cylinder most commonly refers to:* Cylinder , a three-dimensional geometric shapeCylinder may also refer to:-Science and technology:* Cylinder , the space in which a piston travels in an engine...

 or a progressively tapered cone
Cone
A cone is a basic geometrical shape; see cone .Cone may also refer to:-Mathematics:*Cone , a family of morphisms resembling a geometric cone...

. The aforementioned design elements contribute to enhancing initial stability. The choice depends again on the bone density encountered in the desired implant location. For one piece dental implants such the minis, the concept of initial (mechanical) stability is paramount for success. This is based on mechanical retention of the implant in the bone (See the osseointegration
Osseointegration
Osseointegration derives from the Greek osteon, bone, and the Latin integrare, to make whole. The term refers to the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant...

 page), as well as the strength of the implant. There can be statistically significant differences in the strength of the implant. According to Binon, adequate mechanical characteristics are needed for an implant to resist functional occlusal loads.

The prosthetic head allows the dental prosthesis
Prosthesis
In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...

 to connect to the implant and anchor it to the bone. It also connects to the implant driver during placement. Square, rectangular, or o-ball heads are common and connect easily to a simple set of corresponding drivers. Fixed crowns
Crown (dentistry)
A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant. Crowns are often needed when a large cavity threatens the ongoing health of a tooth. They are typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which...

 or bridges
Bridge (dentistry)
A bridge, also known as a fixed partial denture, is a dental restoration used to replace a missing tooth by joining permanently to adjacent teeth or dental implants....

 can be cemented directly to the square or cubic head of the mini. Subsequently, a sphere was milled into the square portion of the head allowing for a more elegant restorative solution. This ‘o-ball’ design became a popular solution to secure loose dentures
Dentures
Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental...

. Other standard prosthetic options for removable and fixed solutions do exist and custom options are available from various dental labs.

Uses

Mini dental implants are extremely valuable for endentulous patients that have loose lower dentures
Dentures
Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental...

 and want an easy solution to secure them in place. Most denture patients have highly resorbed jawbone
Jawbone
Jawbone can refer to the following:* Mandible, the lower jaw bone* Maxilla, the upper jaw bone of humans* Jawbone , a musical instrument made from the jawbone of a donkey, horse, or zebra* Jawbone , blues musician Bob Zabor...

s (Mandible and/or maxillary bones) and bone augmentation, aka bone graft, is required for a standard dental implant solution. Moreover, health status of many senior citizens contraindicates invasive dental treatment, such as a conventional implant. In contrast to conventional implants, a survey of 200 clinicians indicated that a flap procedure was mostly (80% of the time) unnecessary for placing MDI's. Healing time is decreased, as the ability to avoid flap surgery aids in healing (the periosteum is left undisturbed) and immediate satisfaction achieved with this minimally invasive approach. The shorter treatment time translates to lower costs as well; an important factor because implants are not typically covered by dental insurance
Dental insurance
Dental insurance is a type of health insurance designed to pay a portion of the costs associated with dental care. There are several different types of individual, family, or group dental insurance plans grouped into three primary categories: Indemnity which allows you to see any dentist you want...

 programs.

Although not as widely utilized, many MDIs are FDA
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...

 approved to be used for fixed crown
Crown (dentistry)
A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant. Crowns are often needed when a large cavity threatens the ongoing health of a tooth. They are typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which...

 and bridge
Bridge (dentistry)
A bridge, also known as a fixed partial denture, is a dental restoration used to replace a missing tooth by joining permanently to adjacent teeth or dental implants....

 installations as well. Proper case selection is critical but the available literature has demonstrated success that rivals standard implants. This means if you are missing a tooth or multiple teeth, a mini implant may be placed and a crown fabricated to cement on to the head of the implant.

Another important indication for Mini Dental Implants is the transitional stabilization indication. In this instance, Mini Dental Implants are used to give temporary support to the denture while the conventional implants and bone graft are healing.

Procedure

Mini dental implants are placed in a flapless and minimally invasive procedure
Minimally invasive procedure
There are three main categories which describe the invasiveness of surgical procedures. These are: non-invasive procedures, minimally invasive procedures, and invasive procedures ....

 under local anesthetic
Local anesthetic
A local anesthetic is a drug that causes reversible local anesthesia, generally for the aim of having local analgesic effect, that is, inducing absence of pain sensation, although other local senses are often affected as well...

. This is in sharp contrast to conventional implants, which are often placed in a procedure requiring a flap, bone graft, and/or significant healing time. In the United States, using mini dental implants to secure a lower full denture is a generally accepted indication. A number of mini dental implants are placed in the mandible and these implants will be used to secure the denture (as opposed to adhesive materials or other methods of stabalizing the denture). For most types of mini dental implants, a small hole will need to be drilled before inserting the implant.
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