Dentists have struggled over the years to treat this condition employing a number of techniques. Removable partial dentures, conventional fixed partial dentures, Maryland Bridges and conventional dental implants are employed with varying degrees of success and patient satisfaction. This article will focus on the benefits of using Mini Dental Implants with fixed crowns to treat such conditions.
Patients with congenitally missing maxillary incisors are often treated in their childhood. Orthodontics is typically employed and completed resulting in an unavoidable facial concave defect in the maxilla and converging adjacent root tips. Accordingly, this space is lacking both in buccal-lingual and a mesio-distal dimensions. The facial concavity may be treated successfully by block only grafting with fixation but the adjacent roots remain problematic. Also, the block grafting requires multiple surgeries, donor site morbidity and considering the patient age and growth potential may be premature. This procedure is best treated by a practitioner with significant skill usually requiring referral.
This complicated treatment also increases the treatment cost. When compounded by subsequent implant placement, second stage surgeries and restorative visits, the teenage patient and parent will most certainly object and begin looking for an alternative. Although we are justified to charge for our time and efforts, implant alternatives do exist that are predictable and cost effective.
Mini Implants have been demonstrated to function well in fixed applications. The MDI has allowed us to offer a more affordable solution to patients. The price of the implant parts are reasonable, often under $100. Conventional crown fabrication or CAD/CAM may be utilized without expensive abutments or transfer pieces.
Placement of the MDI is completed following the same general protocol as used for denture stabilization. A Max thread MDI is utilized to achieve initial stability and a longer implant is recommended. Using the same concepts for placement of large diameter implants, appropriate radiographs and surgical/restorative guides are prepared. Placement is accomplished with the use of surgical guides and guide tool devices. Temporaries are fabricated with resin. Impressions may be made at the time of placement or may be reserved for a post operative appointment following osseointegration. Temporary crowns are cemented. Final crowns placed.
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