engleski

Use of mini dental implants as retentive elements for complete removable prosthesis

Use of dental implants of smaller diameters in various forms has been present for almost 20 years. In general, these implants are 2.75-3.30 mm in diameter, and they are frequently used in cases of limited bone volume. Mini dental implants (MDIs) are even smaller, with diameters ranging from just 1.8 to 2.4 mm. In the beginning, the main usage of MDIs was only to serve as the helping and provisional instrument for insertion of provisional restorations during the osseointegration phase of conventional larger diameter endosseous implants and for orthodontic purposes. In the course of time, it was observed that these implants integrated very well clinically and were difficult to remove. It became clear that they could also provide satisfactory prosthodontic rehabilitation effect especially for the retention of complete removable prostheses. The advantage in use of MDIs is that it is the minimally invasive, single-stage placement procedure. Compared with MDIs, the insertion procedure for conventional implants (diameter 3.5 mm and wider) is aggressive surgical procedure, which requires a mucoperiosteal flap operation and full-depth bone preparation (osteotomy). Therefore, the need of recovery time during tissue regeneration, vascular function restoration, and osseointegration are present. Minimally invasive technique of MDIs insertion consists of turning of the implant into the bone through a starting opening, but not a prepared bone site. Therefore, there is no bone damage or bone wound during implantation. Bleeding and postoperative discomfort are reduced, and most importantly, healing time is shortened. So, such implant can be practically loaded immediately, with no need for waiting for osseointegration, and which is often very important, at low cost. The MDIs do not pretend to be substitute for conventional implants, because wider diameter implants present several advantages, such as improved prosthetic stability, reduced screw loosening, reduced implant fracture, and more favorable force distribution in qualitatively and quantitatively poor bone. The MDIs are suitable for use in conditions with lack of adequate bone tissue for conventional implant placement, especially in patients with narrow alveolar ridges as there is no need for relying on grafting techniques. They are also very suitable for single-tooth replacement with restricted space (lower incisors), but the most effective prosthodontic use of MDIs is definitely for the retention and stabilization of complete dentures, especially mandibular ones. In this way, the problems, such as lack of retention and stability, decrease in function, and difficulties in speech and soft tissue sensitivity, are solved. Also, classical implant therapy is very expensive, so it is another reason that would often deter patients from accepting implant treatment, and MDIs are significantly more affordable when compared with conventional implants costs. Regarding to less surgically intensive treatment and good osseointegration of MDIs (that was confirmed with the long-term studies of success and survival rates of MDIs under load in masticatory function), this type of implant presents the opportunity to provide patients with cheaper, less complicated, and less surgically intensive treatment in a high number of cases thus providing predictable and financially feasible prosthetic treatment solutions.

prosthodontics; prostheses; mini dental implants; overdentures

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