DENTAL CARE

Jeffrey Gross, DDS, FAGD

Q: Am I a Candidate for Mini-Implants? A: There was a folk song that was popular many years ago that was entitled “If I Had A Hammer”. The lyrics began with “If I had a hammer, I’d hammer in the morning, I’d hammer in the evening, All over this land….” I thought of this song as I saw an ad in the paper for the use of mini-implants. The ad seemed to imply that instead of using conventional (whatever that may mean) implants, anyone can use mini-implants and get all the same results. The ad said that these mini-implants were easier to place, took less time, involved faster healing, and were half the cost. Let’s take a few minutes to learn together about this subject.

Mini-Implants are pretty self descriptive. They are miniature versions of their big brother. We all like small. We like items to be petire. Our phones have become miniature computers. There is even a brand of car that is becoming more popular call the Mini Cooper. In an era of super-sizing, being smaller and more compact is still a very positive attribute to have. So it sounds like smaller, miniature implants are the new and improved implant. We have moved forward to this compact era. I can use a mini-implant wherever I previously used a conventional implant. Just like the song says: I would hammer in the morning…….” I would use my hammer everywhere and all the time.

The ad went on to say that healing is faster and the teeth can go in faster and the results are immediate. We all want this. Right? As with many things in life, if something was really true then everyone would be doing that thing. We need to talk about this. The biggest advantage to mini-implants is their size. The biggest disadvantage to mini-implants is their size! That’s right, the best thing about them is actually the worst thing about them. Many years ago a wise oral surgeon told me that he always over-engineered his implant cases. He used the biggest and most implants wherever he possibly could. The reason was very simple. Implants serve as a foundation for teeth in the mouth. When we build a house, for example, do you ever hear that the contractor uses mini-supports? Where we need to use studs every sixteen inches, do we put them every three feet? Of course not. We need to construct a structure that is solid and will endure the weight and other forces that may be put on it. So I will ask you: Why do we think that we can skimp on support for teeth? We chew meat…. we chew bread... we chew nuts. These and many other foods put many heavy forces on our teeth. We need support. We were given at least twenty eight teeth. Why do we need so many? Let us develop a few big teeth on some small roots and that’s it. These mini roots would make it easier to brush and floss. Our dental cleanings would go faster as there are fewer and smaller roots to develop tartar to clean. The answer is obvious. It wouldn’t work. From a structural standpoint it is faulty. We need enough teeth and large enough roots to handle all the forces of chewing. People with a full compliment of teeth and a healthy supporting gums and bone, can exert the greatest biting forces. These forces are needed to properly eat our food and allow us to be nutritionally fit.

Where we have the greatest forces, we need the biggest implants to support these tremendous forces. Back teeth is NOT an area where we use mini-implants. The biting and chewing forces of our large molars will overload a miniature implant. You can’t put a top heavy crown on a little tiny implant and expect the support to last. This will overload the situation and cause the implant to fail. I have written extensively on how detrimental to natural teeth excessive biting and grinding can be. In the case of an undersized implant, even normal biting is too much.

So after all is said, where would I use a miniimplant. I have used them for years, but the need to pick and choose the right candidate is important. I would not use my hammer to hammer all over the land. Mini-Implants are best used to support a denture that already has a reduced biting force. It should bite against another denture, not against natural teeth. This will produce excessive forces for the mini-implant. Because they are smaller in diameter, one needs more of them to support a denture. Where I could use 2 normal size implants, with min-implants, I need at least double that. You still need to evaluate the patient and the remaining bone to place these properly. I have seen too many inexperienced dentists place mini-implants in the wrong area or missed the bone because they used shortcuts in their techniques. When I teach my students, I emphasize proper preparation before ever beginning any treatment

So yes, mini-implants are a valuable adjunct to all the other tools and techniques that I have. Proper preparation and planning is crucial as with all things in life. If you ever wondered if you are a candidate for mini-implants or any other type of implant, please call me at 440.951.7856. I will be more than happy to talk to you and advise you to the best of my ability. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile

34586 Lakeshore Boulevard

(¼ mile west of Route 91 on Lakeshore Boulevard)

Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com