ANSWERS TO QUERIES:- MINIMIZED DENTAL IMPLANTS: THE COMING WORKHORSE IN IMPLANT DENTISTRY

These reasons can be readily addressed when the facts are laid down clearly:-

(1) Mini- implants are made of titanium alloy, i.e. is size for size, 1.6 times stronger than commercially pure titanium. The diameter of mini- implants range between 2.0mm to 3.0mm. Mini- implants are actually less prone to fracture because it is solid.

Conventional implants are more prone to fracture because they consist of 2 pieces with a connecting screw in between. If a conventional implant is 4.0mm in diameter and the connecting screw is 2.0mm in diameter. The thickness of the remaining wall of the implant fixture is only 1mm. Compare this to the mini implant which is 2.5mm in diameter or thickness, which is stronger? The mini- implant…… believe it or not is stronger than the conventional implant! It is less prone to fracture than the conventional implant.

(2) Additionally, the 2 piece conventional implant is connected by a screw which has a tendency to come loose and even fracture. Also, there is a microgap between the 2 pieces of the conventional implant which harbour microorganisms that causes bone resorption and sometimes implantitis. Such a chronic source of pathogens in the body may cause coronary artery disease with the accompanying sequelae.

(3) Just because mini implants were designed to be transitionals should not mean that they cannot be used permanently. Many mini- implants have been used for crowns and bridges in the last 10 years successfully. The concept that an implant root should imitate the root size of the tooth it is replacing is largely an assumption by the pioneers of implantology. The basis should have been a study of how much osseointegrated surface is required to withstand the masticatory forces of a particular tooth. It should be reasonable to assume that the surface area of osseointegration may be less than the surface area of the periodontal ligament of the tooth to be replaced , since osseointegration square mm to square mm is much stronger a bond than the bond of the periodontal ligament, although without the shock-absorbing ability of the periodontal ligament. It is much more easier to extract a tooth than an osseointgrated implant. In fact, you cannot extract an osseointgrated implant. It is reasonable again, therefore, to assume that an implant that is half the size of a tooth root will give sufficient surface area of osseointegration to carry the tooth and its masticatory functions.

(4) Titanium osseointegrates, and if mini- implants are made out of the same stuff as conventional implants, they osseointegrate.

(5) The whole world of surgery is moving relentlessly towards minimal invasiveness as shown by the rapid change towards laporoscopy and closed surgery as far as possible. 

by Dr. Chow Kai Foo
BDS Singapore; FDSRCS England
Cert. of Oral Implantology University of Frankfurt Germany
FICD; Academy of Medicine; National Specialist Register

President of the Malaysian Oral Implant Association 2009-2011
Currently Advisor to the Malaysian Oral Implant Association