What do you do when there is a small space between lower front teeth and you need a mini dental implant? There are lots of choices out there, IMTEC MDI, Intra Lock, OCO Biomedical, HiOssen…all these companies make a nice mini dental implant.
In this case I decided to try the Ace Surgical miniMarkMini Prep Implant. It is 2.3mm in diameter and comes in various lengths. The tooth in the center of the photograph was not restorable and had 360 degrees of decay.
X ray of lower incisor that will be extracted and a Ace Surgical miniMark mini prep implant will be placed.
Following our standard protocol of extracting teeth with periotomes or Golden Misch forceps the tooth was removed with little trauma to the gum and bone. You will notice in subsequent pictures the lack of blood or having to cut the gum to place the mini dental implant for the final crown.
Mini Mark mini prep implant in its sterile container.
To place the mini mark implant the step drill was used to make a initial entry point to the bone. Due to the adjacent teeth a drill extender was used to 'get around' those teeth and into the bone. The mini mark placement kit does not include this drill extender. Make certain you have one on hand or consider a different implant placement kit.
mini Mark mini prep implant is now in the extraction site and fully seated using the contrangle implant motor and drill extender.
I could not find on the distributors web page (Henry Schein Dental Supply) the restorative components for this mini implant system.
Most other mini dental implant manufacturers offer:
temporary crown copings and/or comfort caps
This could be a limitation for easeof use for the miniMark mini prep system.
But we are not so easily frustrated and decided to come up with our own solution…not as easy as other mini dental implants but will work.
I decided to take an ION crown form one size smaller than needed to fashion my 'own temporary coping.'
The Dr. Patel miniMark temporary coping in place. I cemented in over the miniMark mini prep with Temp Bond Clear and teased it on and off during the setting phase. Notice how nice we were able to get the ION crown to fit around the gum and miniMark mini prep implant. This could have also been done with Jet Arcylic as it will bond to the ION crown forms. The key is to create a coping that will form the gum tissue during the healing phase.
A few dabs of bonding agent, some composite was placed over the ion crown and a temporary crown that could come on and off was fabricated. The patient will return in 12 weeks for a tissue and implant assessment.
Final X-ray of the miniMark mini prep implant in the extraction site for a lower incisor crown. There needs to be at minimum 3mm past the apex of the root that was extracted to provide stability and enough bone to secure the dental implant.
I think the mini Mark implant will work just fine. What the General Dentist will need to assess is what kind of cases would he/she like to do? If doing more than just a 2.3mm implant then one must consider a different implant system. If doing a Locator style overdenture and a small implant here and there only then the ACE Surgical miniMark system will work.
My challenge to General Dentists is why limit yourself to this? There are several mini dental implant systems that allow you to move forward in your implant choices, styles, features and sizes. You can get the proper training and open up a world of possibilities to improve your patients lives and make dentistry exciting everyday.
There are several good mini dental implant courses out there; find out which one is for you and get started. As they say: 'The hardest part of getting started is…..getting started'
Paresh B Patel DDS
Can dental implants be affordable? My next patient wanted to get rid of his dentures and have a fixed set of crowns or a full arch roundhouse bridge on dental implants. He brought his treatment plan for 8 dental implants and a set of 12 porcelain crowns…..total cost a bit north of $28,000. With mini dental implants we could reduce that cost and still have a well engineered bridge.
He had a nice ridge of bone to work with. It would not need any pre surgery to accommodate dental implants. With some planning with Jon Younce CDT at First Impressions Dental Lab a logical progression treatment plan was formulated that was restorative driven.
His pan x-ray also showed good bone with the sinus cavity totally dropped down where the back teeth were in the upper jaw. There was also a retained set of root tips that would need to be removed on the upper right.
Using his upper denture as a guide I made holes in the center of each back tooth and the lingual of the front teeth to ensure the mini dental implants would line up correctly for the final roundhouse full arch bridge.
10 ACE Surgical Mini Prep 2.3mm implants were placed in the upper arch. They were placed as parallel as possible to allow for proper draw of the final roundhouse full arch bridge.
His denture was soft lined to fit over the ACE Surgical Mini Dental Implants.
A regular crown and bridge impression was taken of the 10 ACE Surgical Mini Dental Implants. No additional impression copings or lab analogs were used. With mini dental implants we can create a more efficient and cost effective solution for patients by reducing parts and pieces that are normally required with traditional dental implants.
A standard crown and bridge model was poured in Pol-u-rock by the lab and a set of trial resin crowns were made to let the patient 'test drive' the crowns.
Lab fabricated resin temporary crowns ready to try in and have the patient give us his feedback on esthetics, function, comfort and color.
It was decided after a few days that the temporary crowns were too long. The patient also had Bell's Palsy and we decided to try and correct the slant. This photograph shows one side of the temporary crowns shortened to the new lenght for the lab to see our corrections. I shapedthe other side and let the patient go home to 'test drive' them again for final approval.
Reshaped temps and final photos for the lab to duplicate the arcylic temps in porcelain for the full arch bridge
Final porcelain bridge back from the lab. It is in three sections.
Final porcelain bridge cemented over 10 ACE Surgical Mini Prep Mini Dental Implants.
Full smile with the bridge in place.
Final pan x-ray with the 10 Ace Surgical Mini Dental Implants with the 12 units of bridge work cemented over them. Our plan is to do a lower mini dental implant overdenture that will be converted to a bridge over time as $$ can be invested.
Paresh B Patel Mini Dental Implants Charlotte Hickory Lenoir NC