The International Academy of Mini Dental Implants would like to congratulate all the new Fellowship members!

Also, we would like to thank Intra-Lock International for sponsoring the reception after the Orlando lecture.

Dr. Todd Shatkin will be attending the AAID Conference in San Diego, Florida. He will be a roundtable speaker on Mini Implants on October 31, 2008 at 12pm. Dr. Shatkin will speak on mini implants throughout the conference, be sure to attend this implant information rich discussion! Check the AAID website for more information…

Dr. Shatkin will be holding a brief seminar in New York City on Thursday November 13th. Please visit MiniDentalImplants.com for more information…

We have a new AM Buffalo Segment Video from September 29th, 2008 on Denture Stabilization.

All questions answered in the YouTube video:

How long does the mini implant procedure take?

Is there any discomfort?

How much do mini implants cost?

After your procedure you can leave the office and eat a full meal feeling confident with your mini dental implants. You won’t have to worry about smiling, speaking, or eating anymore, mini implants are your solution! For more information please visit Mini Dental Implants for more information. Now, sit back and watch how easy it is to replace a few teeth.
Click here to watch at YouTube

January 29th, 2008 at 3:57 pm

Phil Cressman, Male, aged 62 with dental problems most of my life due to enamel problems (identical twin) I recently lost a tooth that was supporting a bridge and my dentist, Ontario, Canada recommended an implant. Since mini-implants are not normally done in Canada for tooth replacements (only denture stabalization) I contacted Dr. Tood Shatkin in Buffalo, NY. Had a visit for evaluation & Dr Shatkin recommended two implants to support a two tooth crown. Without going into costs as every case is different I do believe my treatment was about 50% the price of having conventional implants placed in Ontario. The really big savings is in terms of pain & suffering. When I returned for the implants Dr Shatkin was working for only about 30 minutes (aside from freezing etc) and the results were great. (Crown had been fabricated from moulds taken at the time of my first consultation.) Actually ate dinner a few hours later & only minor soreness for a few days. It has been only one week & I have to return for a check up but HIGHLY RECOMMEND at least looking into mini-implants as a potential alternative to conventional dental implants with associated surgery. (In my case a sinus lift would have been performed if conventional implants were to be used)

Thanks Phil for your expierience…

Dr. Shatkin

Osseonews: Since we last spoke, there have been some new developments with mini implants and with the F.I.R.S.T. (Fabricated Implant Restoration and Surgical Technique)* procedure that you developed can you tell us about this?

Todd Shatkin,DDS: Sure, the biggest thing is that my patent for F.I.R.S.T. was approved in late 2006 and that was very exciting. This is my unique technology and technique for guiding the accurate placement of Small Diameter Implants (SDI’s) allowing immediate placement of crowns at the same visit. This protocol is foolproof. It is simple, direct and absolutely predictable. The other major development is that we have authorized only one dental laboratory in the United States to use this technology which is Samuel Shatkin FIRST, LLC (Please see: www.shatkinfirst.com). As you know the art and science of dentistry is continuously evolving and we have to keep up with all the advances and this can be a challenge at times. We continue to improve our laboratory procedures to keep up with these changes. We now have over 1200 dentists who have used my patented F.I.R.S.T. technology with great success.

The feedback from the dentists who have used our system is very positive. The technology and the technique works and is very predictable. That’s it in a nutshell. We have taken two of the more difficult aspects of implant placement and made this whole process very user friendly. By using SDI’s, we eliminate the need in many cases for bone augmentation and sinus lift procedures. By having such an accurate and simple system for SDI placement, we eliminate many of the vagaries and potential for complications.

Osseonews: Dr. Shatkin what SDI system are you currently using and why?

Dr. Shatkin: The system I have switched over to is the MDL System which is manufactured and distributed by Intra-Lock Inc. and distributed by Samuel Shatkin FIRST, LLC. The MDL (Mini Drive Lock) so named because of the patented “Drive Lock” technology which I will discuss, is available in a 2.0mm, 2.5mm and the MILO mini implant at 3.0mm. These three diameters are all you need.

There are several advantages to these SDI’s over other systems that I have used in the past. One significant advantage is the fact that these are significantly stronger – as much as 30-40% stronger. This results in a much lower chance of fracture during or after placement. Another huge advantage is the “Drive Lock” system for delivery which allows the dentist to place the implant directly from the package to the bone in one fluid motion. I normally place these with the surgical motor which further simplifies the procedure.

Osseonews: Dr Shatkin, FDA approval is a big issue when it comes to implant dentistry. Can you tell me about the FDA with regard to these MDL small diameter implants?

Dr. Shatkin: Yes, the FDA has granted the MDL 510K clearance to market these as “Intended for Long Term Intra-bony applications”. This is the approval that the dentists need to feel good when placing MDL implants for both denture stabilization and crown and bridge fixed restorations using F.I.R.S.T. Technique.

Osseonews: Tell me about Shatkin FIRST Lab where is it and how does it operate?

Dr. Shatkin: The lab is in our medical/dental center in Amherst, NY. My father Samuel Shatkin, DDS, MD is a Plastic and Maxillofacial Surgeon with more then 50 years of clinical experience. He owns and operates the lab. There are many highly trained and experienced technicians working hard to produce the best restorations possible. Every case submitted by a dentist is personally reviewed and planned by my father or myself. We review the xrays and articulated study models to determine the appropriate placement positions and sizes of the implants to be placed. Once this is done and the case is planned and accepted we perform “model surgery” and place analogs in the models. Next under the guidance of licensed dentists the technicians make a surgical guide stent and the final restorations so that the dentist can place the mini implant and permanently cement the single or multiple crowns at the next visit. This is my patented F.I.R.S.T. Technique which has now been utilized for more then 4 years. In addition to this the laboratory is also a full service national dental lab and provides among other things, dentures, veneers, standard crown and bridge work, case planning and consulting etc. They have the latest in advanced porcelain technology including the newest Ivoclar emax frameworks.

Osseonews: What mini implant systems does Shatkin FIRST lab work with?

Dr. Shatkin: They work with any approved SDI system on the market. They are an authorized reseller of Intra-Lock, for the MDL and MILO SDI system. An advantage of this is that if the dentist wishes he can have the implants that are recommended by a consulting dentist (e.g., my father or me) shipped to them with their lab case so they are sure to have the needed appropriate implants in their inventory when the patient is in the chair. We were not able to offer this service previously. This upgraded service has been readily accepted by the clinicians and again, the feedback is very positive.

Osseonews: One question that has repeatedly come up is where are the studies in the peer-reviewed literature to support the long term use of SDI’s?

Dr. Shatkin: This is important. The largest study actually was published in the Feb, 2005 issue of Compendium. I was the primary author of this article which discussed results of over 2500 mini implants I placed during a 5 1/2 year period. Anyone desiring a reprint can contact Compendium or myself. The results were astonishing! We had over 97% success with minis for single and multiple crowns and bridge applications. This is indisputable long term success!

Osseonews: Could you please describe your patented, unique approach to the placement of the SDI’s using your surgical guide stent and flapless surgery.

Dr. Shatkin: Once Shatkin FIRST Lab sends you the surgical stent and finished restoration, the dentist, using the F.I.R.S.T. Pilot Drill Guide instrument places the stent in the mouth, then the drill guide into the titanium sleeve of the stent and using the pilot drill provided with the mini implant system drills through the drill guide into the bone about 8mm deep. Then the drill guide is removed and the mini implant is placed through the stent sleeve into the bone. I use the surgical motor now to place the MDL into position. This allows a very smooth and simple method of placement. Once the implant is down most of the way, the stent is removed and the mini implant is placed all the way into position. It is quite a simple process. Next the restoration is tried in place and any minor adjustments are made and the case is completed. The same process with the guide stent is used for crowns, bridges and denture cases.

Osseonews: Do you feel that general dentists can learn to place small diameter implants with the current training programs available? What do you recommend for training?

Well, as you know, I have been teaching SDI placement for the past 7 years and I have placed over 5000 SDI’s with amazing success. I am continuing to provide training programs throughout the country and abroad, and also in my Amherst, NY offices. General dentists can definitely leave one of these programs ready to place SDI’s. There are other programs out there which I’m sure are equally good for training. Anyone interested in taking one of my upcoming programs can contact me at tshatkin@minidentalimplants.com or 716-839-1700.

Osseonews: Is there an organization for dentists to belong to which focuses on mini implants?

Dr. Shatkin: Yes, a group of us have started the International Academy of Mini Dental Implants. This was our first year and our next annual meeting will be held in conjunction with our Las Vegas Mini Implant Symposium March 14 and 15, 2008. We have nearly 100 members of the Academy and it is growing fast. Anyone interested can contact me or go to www.IAOMDI.ORG and click on membership.

Osseonews: In your experience, is there less chance of complications when placing small diameter implants as opposed to conventional implants?

Dr. Shatkin: Definitely, I have been placing implants for the past 18 years and the SDI’s for the past 7. There is no question that there are far fewer complications with SDI’s. There is no cutting, no sutures, minimal postoperative pain or swelling and the procedure is accomplished in one treatment visit in most cases.

Osseonews: Do you see SDI’s replacing conventional implants with wider diameters?

Dr. Shatkin: What we are seeing is a shift from wider, conventional implants to narrower ones – sort of a downsizing in progress and the FDA is moving in the right direction by approving these systems. As we have discussed, implantology is still very much a developing science.

Osseonews: What do you see as the next major paradigm shift in implant dentistry?

Dr. Shatkin: Immediate loading. More and more cases will be brought into immediate function. We are seeing the wide scale success of this now with the SDI systems. And I predict this trend will be exploding as more SDI’s are placed and more and more dentists start placing them. Anyone performing implants should be seriously considering the use of SDI’s in their practice.

Osseonews: If you were treatment planning a mandibular overdenture, would you place 4 SDI’s — 2 in each of the #22 and 27 areas?

Dr. Shatkin: Normally yes we place these between the mental foramina so around 22, 24,25 and 27 areas – 4 SDI’s.

Osseonews: If you were treatment planning a maxillary overdenture, what SDI implant configuration would you use?

Dr. Shatkin: I usually place 4-6 SDI’s between the bicuspids. I try to avoid the posterior maxilla for overdentures. This traditionally has been one of the danger zones.

We are also having tremendous success using these for “roundhouse” – fixed bridge restorations using 10-12 minis in each arch. We have almost 100% success as do hundreds of dentists who have done this procedure using my F.I.R.S.T. Technique.

Osseonews: How would you replace a maxillary central incisor? Maxillary lateral incisor? Maxillary canine?

Dr. Shatkin: When replacing an incisor you want to use the longest mini implant possible as it is important for strength especially in the maxilla. We use the 2.5mm MDL or the 3.0mm MILO implant for these applications.

*F.I.R.S.T. Technique is Patented with the USPTO #7,108,511 and a registered Trademark, owned exclusively by Todd E. Shatkin, DDS all rights reserved.

emax is a registered Trademark of Ivoclar/Vivadent.

MDL and MILO are registered Trademarks of Intra-Lock International.

Patients often struggle with how to pay for needed dentistry. Very often replacing missing teeth is that last thing on their mind with all the other expenses in life. Well now that cost has dropped significantly! With the new MDL mini implants from Intra-Lock and distributed by Samuel Shatkin FIRST, LLC and the F.I.R.S.T. Technique developed by Dr. Todd Shatkin, a Western NY implant dentist, a patient can come to a dentist and have one or more teeth replaced in as little as one treatment visit! Yes F.I.R.S.T (Fabricated Implant Restoration and Surgical Technique, developed and patented (USPTO #7,108,511) by Todd Shatkin, DDS utilizes miniature dental implants to immediate stabilize a replacement tooth. The Authorized Laboratory (Samuel Shatkin FIRST, LLC) produces the restoration and a surgical guide stent for dentists all across the US and abroad. Then at a single treatment procedure the dentist places the MDL implant and finished crown or bridge restoration with permanent cement on top of the MDL (Mini Drive Lock Implant). This procedure is less then ½ the typical cost of replacing missing teeth with other style implants or fixed bridgework. It is also accomplished without the need to grind down healthy tooth enamel! As your dentist if you qualify for this simple innovative procedure. Don’t be fooled by other labs claiming to be authorized to use the Shatkin procedure. Only Samuel Shatkin FIRST, LLC Laboratory is an authorized lab. For more information Patients call 866-GET-MINI’s today and Dentists call 888-4SHATKIN.

Featuring New York implant doctor Todd Shatkin Implant placement and restorative needs might be one of the top requested categories that laboratories receive today. With the evolution of implantology during the last 25 to 30 years, Dr. Todd Shatkin has become a leader of these conservative techniques, not only in regard to placement but the overall process.

Dr. Jameson: First, let’s talk about the mini-implant. What is its most significant advantage as compared to the osseointegrated implants that have been on the market for the last 15 years?

Dr. Shatkin: Since I’ve been in practice for 16 years, I have seen most of the major companies manufacturing conventional-style implants and have used many of these systems. All of these have great research and great statistical studies to show their wonderful success. The problem is trying to get patients to accept these treatment modalities can be difficult. As we know, a single conventional implant typically takes seven office visits to complete, and usually five to seven months of treatment. Usually, it involves cutting the tissue, reflecting a flap, drilling holes, and then second-stage surgery. Many of the companies now are releasing single-stage products, which have helped the situation. But still, they require multiple-office visits and extensive treatment time frames. In addition, the cost is fairly expensive since it requires one to three specialists to be involved in the treatment. About six years ago, I became affiliated with Imtec. I had been using some of their conventional implants a few years earlier, but then started using these mini dental implants for lower-denture stabilization. Following this, I used them for upper dentures when we removed the hard, plastic palate and made a horseshoe-type palate with these mini-implants and O-ring keepers. These were extremely successful. I would say the greatest advantage is that mini-implants can be done in a nonsurgical manner by making a tiny pinhole in the gum, and threading the implants into the bone. They are self-tapping and self-threading so they engage the bone immediately. Dr. Victor Sendax developed this technique more than 20 years ago, and has patents on the protocol of this denture-stabilization procedure. What’s nice is that a patient can have the procedure performed in about an hour, go home to eat dinner, and awaken the next morning with virtually no discomfort. The cost is significantly less as well.

Dr. Jameson: What specific indicators need to be in place for a doctor to find a good candidate for this type of implant?

Dr. Shatkin: You can use mini-implants in almost any location. They come in various lengths and sizes. They also can be angled easily to find bone. So, when you look at an X-ray, sometimes it looks like a sinus may be low and you may not have sufficient room. But often there is palatal bone through the sinus since you’re looking at a two-dimensional view. If you go in one way and don’t find bone, you can angle them another way and find bone. So, even if it appears on an X-ray that a patient may not be a candidate, often these implants can be used because of their small diameter. A good candidate would have to have some bone. He or she needs to be a healthy individual who’s not on a tremendous amount of medication (although you could still treat patients with steroids and blood thinners to circumvent medication issues). Bone should be of average or better density. A low-bone density doesn’t work well with these immediate-load type implants. Fortunately, though, only about one to two percent of the population has low-bone density.

Dr. Jameson: In your experience with mini-implants, you have developed a technique for working with minimal patient appointments. You have coined this technique the F.I.R.S.T. procedure. Please explain this acronym, and how you use it in your practice.

Dr. Shatkin: After having tremendous success with mini-implants in stabilizing both upper and lower dentures, I started using them for abutments in fixed crown and bridge cases. For about two years, we did this before I developed the F.I.R.S.T. procedure. What we were doing was attaching natural teeth to these implants, or doing them free-standing for abutments. If patients didn’t want to have a partial denture, we could eliminate the partial by placing mini-implants and then putting on crowns and bridges. I found that we were loading mini-implants with temporary crowns and bridges, and then a couple weeks later, placing final crowns and bridges. We had 97 to 98 percent success with the mini-implants during a period of two to three years. After these results surfaced, I decided there should be a way to fabricate a custom final crown or bridge restoration and put it on these mini-implants the day of placement. This would be the ideal. A patient could have several missing teeth replaced in 30 minutes to one hour while having the crowns and implants placed in the same visit.

This is when I developed F.I.R.S.T. It stands for Fabricated Implant Restoration and Surgical Technique. This is similar in concept to the Invisalign approach in which a doctor would take polyvinyl or rubber-based impressions of the arches, a putty-bite registration, photographs and X-rays before sending them to Dr. Samuel Shatkin and me. We then review the models, X-rays, and records to determine with the referring doctor whether the case is acceptable or not for this type of treatment. If it is acceptable, we proceed to the laboratory where we do a mock surgery on the models, place mock analog implants in the models, and have the lab fabricate a surgical stent with titanium sleeves over the implants. Once this is completed, the actual crowns and bridges are fabricated on the models as if the implants are already in place in the patient’s mouth. Next, we return the case to the doctor so he or she can place the implants and cement the crown(s) or bridge(s) on the same visit. This is my patented procedure. We also utilize an instrument, the F.I.R.S.T. Pilot Drill Guide, which helps direct the pilot drill into the middle of the cylindrical titanium sleeve so that it locates the implant in the middle of the sleeve. The dentist places the implant in the mouth via the titanium sleeve in the stent, which stays in the mouth during placement. The stent then is removed and the crowns are cemented.

Dr. Jameson: That is an amazing development. What do you think is the next phase in the future of implant development?

Dr. Shatkin: I think you are seeing already the beginning stages of what will grow in popularity. I started promoting this procedure about two years ago. Other companies now are trying to do similar things. Time will tell whether they have unique ideas, or are just copying the technique I have described. As I see it, this is the future of dental implantology. A patient will be able to come for a consultation, and have impressions taken the same day. The next time you see them, they can have implants and crowns placed. I can’t imagine anything better. In fact, I have done this procedure on my father. Since I feel so strongly about it, my family members are having the procedure done in order to replace individual teeth.

Dr. Todd Shatkin lectures internationally on the subject of mini dental implants. He developed the F.I.R.S.T. technique (patent pending), and has placed thousands of these implants for use with dentures, crowns, and bridges. He has a private practice for cosmetic and implant dentistry in Amherst, N.Y. He can be contacted at the Aesthetic Associates Center for Plastic Surgery and Dentistry at (716) 839-1700, or at Samuel Shatkin FIRST, LLC Laboratories at (716) 839-2959.

Dr. John Jameson is chairman of the board of Jameson Management, Inc., an international dental consulting firm. Representing JMI, he writes for numerous dental publications and provides research for manufacturers and marketing companies. He also lectures worldwide on the leadership and integration of technology into the dental practice. Dr. Jameson manages the technology phase of the consulting program carried out by JMI consultants in the United States, Canada, and Europe. He may be reached at (877) 369-5558, or by visiting www.jamesonmanagement.com.

Milo™ Is a 3.0mm diameter implant with an O-ball abutment built into the implant body. It has strength characteristics that surpass normal diameter implants and it comes with a crown and bridge implant abutment so that the implant can be used for overdentures and crown and bridge restorations.

Results of Strength Testing…

YouTube Mini Implant Video

Dr. Shatkin: At our clinic, we use one mini implant per anterior tooth and two for molar teeth. We routinely replace #6 and 11 with a 2.5 mm mini implant.

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 a mini-implant to replace #8, through the long axis of the cingulum of the prior natural tooth? (This question is important since many of our online subscribers are lab owners.)

Dr. Shatkin: We place the mini implant central on the available bone bissecting the buccal and lingual plates. Occasionally we use a custom abutment to angle the implant lingually. Typically we use a surgical guide stent provided by Samuel Shatkin, DDS, MD and his laboratory.

OsseoNews: What kind of abutment interface do you have for cementing a crown or fixed partial denture? The most commonly displayed mini-implant 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: As you know, a real hot topic is maxillary overdentures.

In your Amherst practice, do you use the mini-implants to support a bar or would you use free-standing? Also, how many for each?

Dr. Shatkin: We customarily use 6-8 Mini’s with o-balls to support a full upper denture with o-rings. These procedures are great because they require no flap, no sutures, little post-op discomfort and immediate results the same day as placement. I have personally placed over 5,000 Mini’s in the past six years and have had 95% success.

OsseoNews: It appears to me that you’re on the cutting edge with your F.I.R.S.T. technique. I believe that immediate placement and immediate temporarization or permanent restoration is the key. With your system it appears the dental lab does most of the work. I really like your approach.

Dr. Shatkin: We assist dentists in treatment planning, selecting the appropriate implant for placement, occlusion analysis, etc. A dentist who’s been trained in one of my seminars sends us the polyvinyl impressions, a bite registration and a panoramic x-ray, along with details as to shade etc., and we do the rest. The F.I.R.S.T. technique and service to the industry is really taking off. With a minimum amount of promotion, we now have about 750 dentists regularly using our services and we are growing every day. There is a huge need for immediate implant and crown services from the dental profession. There has been a huge swing in favor of placing mini’s in the anterior mandible to support an overdenture, and I’ve enjoyed immense success with that service. However, I think that use of these devices in other treatment situations may represent the next stage in the evolution of the approach to implants. I encourage all dentists to begin providing

these simple, cost-effective methods of tooth replacement.

OsseoNews: You had a F.I.R.S.T. two-day seminar in Las Vegas last fall that from all reports was successful. Tell me about it and when another one’s planned.

Dr. Shatkin: We had over 75 doctors enroll in the course and the evaluations were extremely favorable. Most of those enrollees are now routinely accepting single tooth and crown/bridge cases utilizing the F.I.R.S.T. technique. We’re going to have another one in Baltimore on August 19/20. It will be a two-day symposium on the mini implant for use with denture stabilization as well as for use with single and multiple crowns and for full arch reconstruction. The course is August 19 and 20th and will be held at the Baltimore Marriott Waterfront. The enrollment fee is $1,295 and includes 14 hours AGD CE.

* 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.