The upper molar had been extracted a few years ago. The molar behind it had started to tip forward and he really missed it when chewing his favorite food….Prime Rib a J&W Cafeteria.
On the x-ray of the area you can see how the molar behind was starting to tip forward. You can also see the sinus cavity slowly coming down. In a few more years I suspect there would be very little height of bone. Then it would be very difficult to replace his missing molar with a mini dental implant or even a regular conventional implant.
One of my biggest objections to using a regular
implant is the two piece design. Anything that is made of two pieces is never going to be as strong as something that is one solid piece. Thus a 2.5mm mini dental implant is just as strong as a larger two piece 3.75mm implant.
I was asked to try out a different kind of regular implant. An OCO Biomedical solid one piece regular size implant. To replace this missing molar I would have used 2 Intra Lock Mini Dental Implants from Shatkin FIRST.
Since there was not 8mm of height available to place the regular implant I decided to do a sinus lift by tenting the membrane with some Foundation collagen material. The concept is to carefully penetrate the bone and then widen it just enough to place some of the Foundation material in to push the sinus membrane up and then insert the implant. Over time the body will fill bone in around the tip of the implant in the sinus cavity.
OCO Biomedical 4.0mm parallel pin in place to check spacing for final implant placement. Notice the lack of blood as the placement protocol is similar to that of placing a mini dental implant. NO FLAP, one pilot bit. There is one additional step…the final sizing bit.
After the Foundation bone grafting material was packed into the socket the OCO Biomedical ISI 4.0mm implant was used to push to material up into the sinus under the sinus membrane.
OCO Biomedical ISI regular implant in place ready to replace the missing upper molar. I will have the dental lab make a all porcelain crown to replace his missing molar. Once again notice the lack of a surgical flap, lack of blood, bruising of the tissue, no stitches or suture. Really very minimal surgery…very similar to the placement protocol of a mini dental implant.
In the end I think there is a place for either type of implant (regular or mini dental implant). They both work and they both work well. It really to me is what the dentist feels works best in his/her hands and what the patients desires are. Cost certainly is an issue with the mini dental implant being more cost effective. If I had to to this case over again I would have a hard time choosing the best option for my patient. Its all on what you like to do and what you are good at. My final thoughts are that there are so many patients that have missing teeth we should encourage dentists to get trained in placing implants…mini dental implant are a great way to start.
Paresh B Patel Dentist Mooresville NC