Mini‐Implants,Mega Solutions: A Case Series

Dental implants have evolved as a standard of care for replacement of missing teeth. Though this treatment modality promises a high level of patient satisfaction and success, it cannot be performed in all cases. Apart from medically compromised patients, implant use is also restricted whenever there is limited available bone volume at the edentulous site. An example includes the mandibular incisor, the maxillary lateral incisor region, and other sites with reduced interdental spacing and atrophic edentulous maxillary and mandibular ridges. Bone volume at some of these sites can be increased by suitable augmentation procedure for placement of a regular diameter implant (3.75 to 4.2 mm). But many a times such procedure cannot be undertaken either due to financial constraint, risk of subjecting the patient to additional surgical procedure, added time factor, or guarded prognosis of the grafted site. In such cases, mini‐implants can be used. In this case series, mini‐implants (2.5 to 3 mm) were used to replace teeth in all mouth quadrants and to retain a mandibular overdenture in a compromised case. The implants served well at all the sites with minimal bone loss and a high level of patient satisfaction. Mini‐implants hold the potential to serve as an alternate to regular diameter implants in certain situations. Preferably they should be used in multiples to retain fixed dental prostheses and might serve as an efficient, low‐cost solution for retaining overdentures in selected cases.     

Patient satisfaction with mini‐implant stabilised full dentures. A 1‐year prospective study

The purpose of this study was to evaluate patient‐centred outcomes with regard to function and comfort after placement of mini‐implants for stabilisation of complete dentures. The trial was designed as a prospective cohort of 12‐months duration and involved 21 subjects in the age of 50–90 years having a full denture in the maxilla or the mandible with poor stability during function. Flapless installation of 2–4 narrow‐body Dentatus Atlas^® implants was performed and retention for the existing denture was obtained by the use of a silicone‐based soft lining material (Tuf‐Link^®). Patients' judgement of perceived satisfaction with function and comfort of the dentures was recorded at baseline, 1‐ and 12‐months post‐treatment using 10‐centimetre visual analogue scales (VAS) and a questionnaire. Clinical examination of the conditions of the peri‐implant soft tissues was performed at 12 months. Nineteen of the 21 patients were available for the 12‐month follow‐up examination. The two drop‐out subjects lost all implants within 1 month and rejected retreatment. Further six subjects lost 1–2 implants, but were sucessfully retreated by insertion of new implants. Overall satisfaction, chewing and speaking comfort were all markedly improved from pre‐treatment median VAS scores of around 4–5 to median scores of 9·0–10 (10 = optimal) at the final examination. The prevalence of positive answers to questions regarding stability/function of the denture increased significantly to almost 100% for all questions. Treatment involving maxillary dentures and the use of short implants (7–10 mm) was associated with an increased risk of implant failure. The results indicate that placement of mini‐implants as retentive elements for full dentures with poor functional stability has a marked positive impact on the patients' perception of oral function and comfort as well as security in social life.     

Clinical outcomes and cost effectiveness of computer‐guided versus conventional implant‐retained hybrid prostheses: A long‐term retrospective analysis of treatment protocols

1 Background

Computer‐guided systems were developed to facilitate implant placement at optimal positions in relation to the future prosthesis. However, the time, cost and, technique sensitivity involved with computer‐guided surgery impedes its routine practice. The aim of this study is to evaluate survival rates and complications associated with computer‐guided versus conventional implant placement in implant‐retained hybrid prostheses. Furthermore, long‐term economic efficiency of this approach was assessed.

2 Methods

Patients were stratified according to implant placement protocol into a test group, using computer‐guided placement, and a control group, using traditional placement. Calibrated radiographs were used to measure bone loss around implants. Furthermore, the costs of the initial treatment and prosthetic complications, if any, were standardized and analyzed.

3 Results

Forty‐five patients (149 implants in the test group and 111 implants in the control group) with a minimum follow‐up of 5 years, and a mean follow‐up of 9.6 years, were included in the study. While no significant difference was found between both groups in terms of biologic and technical complications, lower incidence of implant loss was observed in the test group (P < 0.001). A statistically significant difference in favor of the non‐guided implant placement group was found for the initial cost (P < 0.05) but not for the prosthetic complications and total cost (P > 0.05).

4 Conclusions

Computer‐guided implant placement for an implant‐supported hybrid prosthesis is a valid, reliable alternative to the traditional approach for implant placement and immediate loading. Computer‐guided implant placement showed higher implant survival rates and comparable long‐term cost to non‐guided implant placement.