Mini Dental Implants

Osseonews: Dr. Shatkin you have been at the cutting edge in mini-dental implants. What do you think is the most significant advantage to the mini-implant?

Dr. Shatkin: The most significant advantage of the mini-implant is that it is a simple procedure for the doctor and patient, it is cost effective and requires no flap or suturing in most cases. Furthermore, the mini-implant can be restored with a permanent crown or bridge restoration at the time of placement if the F.I.R.S.T. procedure is utilized.

Osseonews: Could you describe the placement and exactly what makes it so simple?

Dr. Shatkin: You place a surgical guide stent with a titanium tube that guides the site and angulation of the pilot drill. An additional Pilot Drill guide is used to angle the drill in the proper direction. The implant is inserted through the tube as well. This ensures perfect placement. The stent is removed for the final torquing of the implant. No need to lay a flap or used guide pins. The stent is made on diagnostic casts. I have developed and patented a system for this called the Fabricated Implant Restoration and Surgical Technique (FIRST).

Osseonews: Could you describe the protocol for restoring a mini-dental implant with a crown?

Dr. Shatkin: The laboratory uses the same guide stent to make the crown. The path of insertion of the crown is along the same axis as the implant. The laboratory makes the crown to insert exactly in line with the implant. Essentially all you have to do is remove the stent and do the final torquing of the implant and then insert the crown. In less than 30 minutes a single implant and lab fabricated fixed crown can be completed and cemented permanently. In about an hour a 3 unit case can be finished and in 3 hours, an experienced implant dentist can place and restore an entire arch of implants and crowns.

Osseonews: Could you describe the configuration of the mini-dental implants.

Dr. Shatkin: The mini-implants are 2.0 - 2.5 mm in diameter and come in 10,11.5, 13, 15 and 18mm lengths. The 13mm and 15mm are the most commonly used. There are two styles of implant configuration. The mini-implant has a ball head, a square polished neck and a polished collar.

Osseonews: What is the orientation of the correctly inserted mini-implant?

Dr. Shatkin: The ball should be set about 3-4mm above the gingival tissue.

Osseonews: What are the indications for selecting the mini-dental implant?

Dr. Shatkin: We have used the mini-implants to support single crowns, fixed partial dentures and overdentures. There are few contraindications for selecting a mini-implant. For example if you are placing an implant immediately after an extraction, the mini-implant may be too narrow for predictable healing. You might select a wider conventional implant for that kind of a situation.

Osseonews: Do you feel that most general dentists could be comfortable placing and restoring the mini-implants?

Dr. Shatkin: Absolutely. I am a general dentist and I have placed and restored thousands of mini-implants. As long as you have the proper training and background, you should be able to place and restore these.

OsseoNews: Do you have a formula or system for deciding how many mini-implants to place. For example, in a square maxillary arch how many would you place to replace #7-8-9-10?

Dr. Shatkin: In general we use 1 mini per anterior tooth and 2 mini’s for each molar. For example for replacing #7-10 we would use four Mini’s. For replacing A maxillary canine we would use a 2.5mm mini.

OsseoNews: What is the proper or ideal alignment of the mini-implant? Long axis of the tooth replaced? What would be the alignment planned for an mini to replace #8? Through long axis of the cingulum of the prior natural tooth?

Dr. Shatkin: We place an mini to replace a maxillary central incisor on the available bone bissecting the buccal and lingual plates. Occasionally we use a custom abutment to angle the implant lingually.

OsseoNews: What kind of abutment interface do you have for cementing a crown or fixed partial denture. The most commonly displayed mini has a ball at the coronal end and a square neck directly subjacent.

Dr. Shatkin: We cement the crown directly to the ball and square on the implant. The crown is like a pontic with a cylindrical hole under it. We use a resin cement.

OsseoNews: For a maxillary overdenture do you use mini’s to support a bar or would you use free-standing. How many for each.

Dr. Shatkin: We generally do not use a bar but prefer free standing mini’s. We use 6-8 mini’s with the o-balls to support a maxillary complete overdenture with o-rings.

* Todd Shatkin Says: December 19th, 2007 at 10:03 pm Dear Friends and Readers, I have not posted in a while but I want you all to know that Samuel Shatkin FIRST, LLC Laboratory is offering the Intra-Lock MDL (Indicated for Long Term Use). This product in my opinion and the opinion of many dentists who have switched to the MDL is a superior product to a 1.8 mm design. They are significantly stronger then a 1.8 mm because they are available in a 2.0 and a 2.5 mm design. There is also the MILO implant which is a 3.0 mm implant. The patented delivery system allows an easier placement with or without the use of the surgical motor. After placing well over 5000 mini implants I can honestly say this system is superior to any other mini implant system I have used. For more information on the MDL mini implant system please feel free to contact Jay Moore at Samuel Shatkin FIRST, LLC 888-4Shatkin or visit www.shatkinfirst.com

p.s. Of course Samuel Shatkin, DDS, MD continues to assist dentists in treatment planning cases, fabrication of surgical stents for crowns, bridges and dentures using the mini implants and also provides a full service laboratory offering all aspects of crown and bridge and denture lab requirements.