Zest SaturnO-rings for Mini Dental Implants ~ Upgrade your Snap in Dentures

/in , /by

After the hundreds of mini dental implants I have placed to secure upper and lower dentures I would have thought there could be a better snap for the O-ball attachment.  Saturno rings pivot

 

But thanks to Paul Zuest there is one now, the SaturnO-ring.  Released in late October it offers up to 30' of angle correction.  The standard o-rings that come with most mini dental implants(Intra Lock, IMTEC MDI, OCO Biomedical) offer around 5' .

Saturno rings 30 correction

 

 

 

 

 

It has a TiN coated race that allows the rubberTiN race

 o-ring to rotate freely inside the metal housing. 

Wow…great engineering and a great idea… I wish I had though of that. 

Picture on right shows the race pivoted up inside the housing.

 

Zest offers a standard size Saturno for a 2.25mm Ball and a Micro size Saturno for a 1.8mm Ball attachment. 

Saturno rings

Saturno rings micro

 

 

 Standard on left and

Micro on right

 

 

 

There is also a neat little o-ring tool so when you need to replace those worn out black rings you don't damage them with a sharp dental instrument getting them in the metal housing. 

O ring tool 

I had just the case to try out these new Zest SaturnO-rings.  My patient had 6 mini dental implants (Intra Lock) placed in the upper jaw to secure in his full upper denture plate.  As much as we tired to make it easy for him to remove it was just too tight.  He struggled to get it in or out.  Some of the issue I am certain was the divergent angles of the mini dental implants.  I fitted him with one of his bag full of old dentures with a lab processed Molloplast soft liner over the 6 mini dental implants.

Molloplast liner He was comfortable with that molloplast liner and it did provide some grab on the mini dental implants but of course I wanted to give the SaturnO-rings a try. 

I reamed out his horseshoe upper denture, taking away the old standard housings. 

Upper denture reamed out 

In the mouth were fitted 6 micro housings, they were picked up inside the upper denture with some self cure pink acrylic.  They worked great!  I thought I was done.  But darn it, he still could not get that thing in and out like he wanted to a few days into it.    Poor guy was just getting older and I wanted to make him happy.  I think most of it was he just wanted to feel like he could accomplish this task for himself. 

So I reamed them out again and decided to try the idea of using the larger SaturnO-ring on the mini implants to give him some retention but  not quite as much. 

Saturno and standard

The SaturnO rings snapped over the 1.8mm ball like I expected and had less retention.  There were 3 mini implants that touched each other with the housings  so I placed 3 standard housings for those areas. 

 

 

We picked them up just like normal.  Less retention…yes.  Enough retention?  Charlie said two thumbs up.  He was able for the first time now to put them in and out….without a Mirror!  Even I was impressed.  He was smiling ear to ear. 

CharlieWpostSaturno

 

 

 

 

 

 

 

 

 

 

 

 

 

Thanks to some clever engineering at Zest Anchors we as have another choice to make patients lives better with mini dental implants. 

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants SaturnO rings for Intra Lock IMTEC OCO Biomedical

ACE Surgical Mini Dental Implant with a Zest Locator for the Upper Denture Plate

/in , /by

Does your upper denture gag you?  Does it feel like a big bulky piece of plastic?  Do you not taste your food anymore?  Do you talk funny or don't sound like yourself anymore? 

These are all the things my patient told me yes to.  That is a lot of yes answers to have on one patient.  Usually I don't get that many issues with the upper denture.  But when we do have someone that just simply can not wear the upper full denture plate its a huge problem; both for function and esthetics. 

Relined upper denture

 

Upper denture prior to placing 4 Mini Dental Implants with a Zest Locator attachment (different than a o-ball and ring snap typically used on mini dental implants).

 

 

Locator

 

 

 

 

Zest Locator attachment.  It has a flat surface to make inserting the snap easier on the patient than the o-ball and ring.  It also has different nylon rings that can be swapped out by the dentist to offer the patient levels of retention…..so if the denture is not tight enough a more retentive ring can be placed.  This feature is not available on the o-ball mini dental implant.

 

4 minis in place upper

 

4 ACE Surgical Secure Mini Dental Implants with Locator attachments.

 

 

Marked inside upper denture

 

Upper denture marked for location of the ACE Secure Mini Dental Implant.

 

 

 

 

 

 

Space for locator mini implant  Space created for the Zest Locator 'snaps' that will be fitted inside the existing upper denture.  In a few weeks I will make the upper denture into a horseshoe shape so he can: 'Talk better, taste his food better and gag much less'

Black housing in denture

 

Snaps picked up in the upper denture.  These rings will be replaced with more retentive rings after the implants heal into the bone.  But even today the denture is tight and my patient is impressed with how much hold he has now.

 

 

 

 

Robert ratner post

 

Final Pan X-ray of the ACE Surgical Mini Dental Implants with a Zest Locator Attachment. 

 

 

In the end I am impressed with the Locator attachment.  A bit more skill required to place these mini dental implants than a o-ball type.  This is mostly due to the protocol of using a 2.3mm in the front and having to place a 3.25mm in the back.  My preference would have been to just use 6 2.3mm minis and give the patient a few extra implants.  But as with any product it is up to the dentist to determine what he/she feels is best for the patient.  This case could have been done and been successful with any mini dental implant, IMTEC MDI, Intra-Lock, OCO Biomedical mini or micro. 

Paresh B Patel DDS  Dentist Mooresville NC

ACE Surgical Mini Dental Implant

Mini Dental Implants are not FDA approved to use for crowns…or are they?

/in , /by

Where is this coming from?  Why would we as dentists want to misinform the very patients that seek our help?  If we don't know the answer its best to tell the patient I don't know.  We should say, if you are considering getting this procedure with mini dental implants you ought to seek out a dentist that does a lot of them.   I think it would be better to let our patients know the truth and let them make decisions for themselves on how they want their mouth taken care of.  In the end its their health, time and money….not ours. 

To answer the question do Mini Dental Implants have FDA approval to use long term for crowns or dentures… YES they are.Mdi approval_Page_3

 

Image of the 510(k) approval from the FDA, straight from their website stating in plain English that mini dental implants (IMTEC MDI) are approved to use for however the dentist sees fit; long term or short term.  IMTEC MDI is the substantial equivalent that most other, if not all other manufacturers have applied to get their FDA approvals. 

  Does being FDA approved mean anything?  Well it means something, but as with any medical device you have certain risks and benefits.  If we as dentists are going to try and take the position that traditional implants are FDA approved and minis are being used outside of their prescribed approval then that is just wrong and means nothing.  They are both approved to use in the mouth.  Do they both work…yes. Do they both have the potential to fail…yes. 

They both have about the same success rate (anywhere from 96-97% success).  You can make any study look good for the parameters you want it to….but in everyday wet fingered dental offices you will find this number to be correct.  A skilled traditional implant dentist and a skilled mini implant dentist will have around the same success ratios. If anyone tells you they have a huge failure rate with minis then they just have not got the proper training….just like if someone tells you that traditional have a huge failure rate in their hands….you may wish to see the help of someone else. 

Intra lock fda approval_Page_5

 

 

FDA 510(k) approval for a Intra Lock Mini Dental Implant Prosthetic Abutments in plain English showing approval for use in either upper or lower jaws for a removable (denture) or fixed (crowns and/or bridge) prosthesis. You can see all the other major brands, OCO Biomedical mini and micro, ACE Surgical Secure Mini, etc… have FDA approval on the FDA website.

 

 

 

 

 

Paresh B Patel DDS  Dentist Mooresville NC

Mini Dental Implants

Mini Dental Implants ~ 1/2 the Cost All the Benefits

/in , /by

Dr. Paresh B Patel's interview on Charlotte Today.  Click to watch patient comments on their experience with mini dental implants for an upper and lower full denture and mini dental implant for a fixed porcelain crown. 

 


 

Paresh B Patel DDS  Dentist Mooresville NC

Mini Dental Implants

No Bone for Dental Implants ~ Would Mini Dental Implants work?

/in , /by

One of the main reasons patients don't move forward with dental implant treatment is lack of bone.  This lack of adequate bone can be in the width or height dimensions. 

Thin ridge

Cone Beam CT scan showing a lower mandibular ridge with severe resorption in both the vertical and horizontal dimensions.  The ridge of bone is only 1.2mm wide at the top and stays that way for 9mm until you get to the wider bone near the chin. 

In this case we had no choice but to flatten the ridge to make room for the smallest mini dental implant we have (1.8mm wide).  Once that was done there was only 11mm of height left to place the mini implant in the lower jaw. 

Lower ridge 
 
The mouth has a very specialized kind of bone, its called alveolar bone.  This alveolar bone is not found anywhere else in the body.  Its purpose is to hold the roots of your tooth the the base of the jaws.  Once teeth are lost this bone just melts away or is resorbed by the body.  If you have a loose or ill fitting denture or partial the constant rubbing and moving will cause this bone loss to accelerate.  Even in areas of one missing tooth the alveolar bone melts away.  Without a tooth root over time the bone will be lost.  The good news is that any dental implant, mini or traditional conventional will help to keep this bone from melting away any further.  Bone loss for implants

This picture shows how substantial bone loss can be from missing lower jaw tooth molars.  The ridge of bone is thin and is vertically deficient.  Options could be to do a block onlay graft of bone or to consider using mini dental implants.  One of the benefits of mini dental implants is that we can sometimes avoid this additional surgical procedure. 

Large bone defect Area where a tremendous amount of bone has been lost in the lower jaw.  A large defect that would require bone grafting to place traditional size dental implants. 

So what should you do if there is no bone left for a dental implant?  The most elegant solution is to repair the missing bone and gum to gain the height and width that was once there.  This requires the experience and high degree of surgical skill of an experienced Oral Surgeon, Periodontist or a well trained General Dentist who does this kind of surgery on a daily basis.  We refer this kind of treatment to a highly skilled dentist in our area. 

But with every procedure there are some drawbacks.  For this kind of bone grafting or repair the potential hazards are:  prolonged healing time, additional surgery, additional temporary dentures to fit over the repaired bone while it heals, potential morbidity and expense.  There could be additional pain and discomfort or injury to the nerve.  Mini Dental Implants are an alternative to consider to bone grafting or bone augmentation.  The patient not only saves on the cost of the bone grafting (anywhere from $3000 to $6000) but we can use the mini dental implant almost immediately.

Thin ridge that needs grafting

This picture shows how thin a ridge can get.  It would be very difficult to place a traditional implant here without doing a surgical bone grafting procedure. 

 

 

Mini implant placed

 

Here we have placed a mini dental implant without any bone augmentation procedures.

 

 

 

Mini implants thin bone Mini implants thin bone 2

 

Intra Lock Mini Dental Implants in thin bone.  Here I used a 2.0mm Intra Lock mini; however just about any mini dental implant would work….other minis I use include OCO Biomedical mini or OCO Biomedical micro, IMTEC MDI, ACE Surgical Secure Mini Prep or Hiossen.

 

 

 

Crowns on minis

 

Porcelain Crowns on the top of the mini dental implants cemented in place.

 

 

 

Thin bone and nerve

 

This x-ray shows a 2.0mm wide mini dental implant.  Notice how thin the bone is…it is at most 4mm wide.  A traditional regular implant would not fit without bone augmentation(repair) surgery. The pink shows where the nerve bundle exits out of the jaw into the gum tissue. 

Frequently Asked Questions on Mini Dental Implants ~ Do They Work?

/in , /by

Mini Dental Implants ~ Are they bad? Do they work? Can you unscrew them with your fingers? Do the break? Can you use a mini implant on the upper arch?  And many more……

I get lots of questions from Dentists and Patients alike on Mini Dental Implants.  The short answer is if used and placed properly Mini Dental Implants will work to solve the patients request….to have a 2nd chance for teeth.  A mini dental implant just does it a different way.  Do I think mini implants will replace traditional regular conventional implants?  No….mini dental implants offer the patient another choice.  There will always be a need for regular implants.

Do Mini Dental Implants Work?

Yes…they can replace missing teeth in the upper and lower jaws with porcelain crowns or bridges.  They can hold in upper or lower dentures with a o-ball and a snap fitted into the denture.  Mini Dental Implants have a history of working well for over 15 years.

My Dentist tells me that I should not get Mini Dental Implants; what should I do?

There is lots of confusion on this subject of mini dental implants vs. regular traditional implants.  There should not be.  They both work and they both work well.  It's more of an issue of choice for the patient.  If a patient does not choose regular traditional implants they should not be told to just go home; they should have been offered mini dental implants.  With 40 – 50 Million Americans without teeth, implant treatment should not be only for the rich.  Mini Dental Implants offer what was once not possible for most patients.  With only 3% of Americans with Dental Implants we as Dentists have so much work to do.   It would take us our entire careers to help everyone live a better life with dental implants. 

Mini Dental Implants do integrate (bond) to the bone. 

They are approved to use in the USA by the FDA for long term use anywhere in the mouth.

I can tell you that my success after placing over 1500 mini implants is the same as regular conventional dental implants.  I encourage patients who have reservations to make a consultation with a skilled Dentists (Oral Surgeon, Periodontists, or General Dentist) who places traditional implants and a Dentist who places mini dental implants.  I would ask each one to see examples of their final results and how many implants they have placed.  With that information I think patients are well equiped to make a choice that is appropriate for them. 

Mini Dental Implants are so small, will they holdup in my mouth?  I was told they would break.

Mini Dental Implants are made from titanium alloy.  This alloy is 1.6 x stronger than CP(Commercially Pure) Titanium.  Most mini dental implants are between 2.0mm and 3.0mm in size and fracture LESS because they are SOLID.  A regular conventional implant is two pieces that is held together with a screw.  If the traditional implant on average is 4.0mm wide and the screw hole in the center is 2.0mm wide then the outer wall of the implant is at most 1.0mm.  Because of the one piece design the mini dental implant will fracture less than a regular traditional implant.

Do Mini Dental Implants integrate or bond to the bone?  I was told they do not.

All the mini dental implants we use are made from the same Titanium alloy used in making the larger regular style traditional implant.  The surface coatings are the exact same, so if titanium integrates (bonds) with the bone, the same will happen with a mini dental implant.  Studies now show this to be true.

Paresh B Patel DDS  Dentist Mooresville NC

Mini Dental Implants

 

Mini Dental Implants to replace a Missing Front Upper Tooth

/in , /by

Our next patient was missing one of his front teeth….well actually he is missing a few of his teeth.  However our plan is to replace these missing upper teeth with mini dental implants and crowns a few at a time as he can afford to do so. 

Missing teeth

 

 

 

 

 

He has an upper plastic partial denture plate.  We will remove the plastic denture teeth as the crowns and mini dental implants are added.

Minis in 2

 

Mini Dental Implants in place ready for impression to send to First Impressions Dental Lab for Porcelain Crowns.

 

 

Minis in

 

Mini Dental Implants Day of Placement…..notice no gum incision or bleeding in area of placement.  Minimal surgery for faster healing and less patient discomfort. 

 

 

 

Paresh B Patel DDS  Mini Dental Implants

Dentist Mooresville NC

Upper Partial or Mini Dental Implant Bridge?

/in , /by

It seems here lately we have had a lot of patients come in that are unhappy, frustrated and just don't like their partial dentures.  They specifically want to just get rid of it and replace it with some mini dental implants and a set of porcelain crowns or porcelain bridges. 

Existing upper partial

 

Photo of my patients existing upper partial denture that replaces most of her upper front teeth.  I did not think it looked all that bad for being 7 years old….she just did not like it.  The way it kept her from tasting her food, the way she talked with it, the bulk of metal as she put it on the roof of her mouth.  She also did not like the lower but wanted to start with replacing the top partial plate with mini dental implants and a bridge.

 

Ridge before mini

 

Like most patients that seem to find me…she had what looked at initial glance good bone.  However on the x-ray it was mostly tissue.  It had just been too long since the teeth had been extracted and the bone had just melted away.  Without roots the body over time just starts taking away the bone.  If an ill fitting partial sits and rubs on the bone year after year it accelerates the process of bone resorption.

 

So we went over the options as usual of traditional implants and some bone augmentation or I could use what bone she had, place at least 6 minis and make her a 8 tooth bridge to replace her missing teeth. 

Partial

 

I used her existing upper partial denture plate as a guide on where I could place the mini dental implants.  I drilled a hole in the center of each tooth, placed in back in her mouth and with a marking stick located the ideal place for the mini implant. 

 

 

 

Of course in her mouth most of the 'ideal' locations had less than ideal bone. 

 

Post mini

 

 Photo of 6 mini dental implants placed day of.  You can see 2 areas where we tried to get the last 2 mini dental implants in but found poor bone.  These areas will just fill back in with gum tissue. 

 

 

A impression was taken of the mini dental implants and off to First Impressions Dental Lab for them to make the 8 tooth porcelain bridge.  In three weeks her mini dental implant bridge will be back and I will post the photos.

Paresh B Patel DDS mini dental implant dentist

Dentist Mooresville NC

Mini Dental Implants to Secure a Lower Partial

/in , /by

The uses for a mini dental implant never stop amazing me.  Today we had a fella come in who had broken his lower little front tooth.  Broken lower front tooth

 

Clinical photo of the broken lower front tooth….it was broken below the level of the gum tissue.

 

 

 

So I decided to extract the root tip for him with some peritomes to save as much bone on the lip side as possible to hold our ?????  You guessed it, a mini dental implant.

Mini in place

 

Picture of extracted root tip and the Intra Lock MILO 3.0 x 15mm mini dental implant in the socket where the root was. 

 

 

 

 

 

 Housing check

Picture of the mini dental implant 'snap' in place over the o-ball.  This is what will fit inside his partial denture to hold this side of the lower partial. 

 

 

 

Impression cap

 

Picture of the impression metal cap fitted over the mini dental implant.  This will be picked up in our impression so the lab can place a replica of the implant before the pour the stone model.  Once that is done they can process the 'snap' under the replacement denture tooth. 

 

 

Imprssion

 

Impression of mini dental implant and partial to be sent to First Impressions Dental Lab to add a snap and a tooth. 

 

 

 

 

 

Final xray

 

Final x-ray of mini dental implant in place where the root tip was…day of placement. 

 

 

 

 

 

 

 

 

 

 

Our goal is to add a few more mini dental implants over time and then get rid of his lower partial denture for either a full set of fixed crowns or a secure lower denture.  At the end of the procedure our patient commented on how quick and painless the entire process had been.  It nice that such new products exist for us as dentists to offer such a non invasive, non surgical approach to dental implants.

Paresh B Patel DDS  mini dental implants 

Dentist Mooresville NC

Mini Dental Implants ~ Extractions ~ Immediate Placement and Saving the Bone

/in , /by

Another good use for mini dental implants is when we have a failing bridge or a tooth that has had a failing root canal treatment.  Our next case is a patient that came to see us after having pain with her temporary bridge.  Her old bridge she told me was wobbling around and her dentist told her the post was weak and he needed to make the bridge longer…..only if we had met sooner that might not have been what she had chose to do. G8PBAUAAQB92

Failing RCT bridge

 

We can see on this x-ray (this is the x-ray she brought from her previous dentist before he removed the bridge and made it one tooth longer)the decay under the post that continues down the root on the tooth that has had the root canal treatment.  The root canal tooth was very mobile (as in when I took the bridge off to assess the teeth I could move the root in the bone. 

 

We covered all the options with the patient from a new bridge(her previous dentist has already made the decision to make a longer bridge for her that went to the canine tooth in front of the root canal tooth).  I told her I thought it would not be a good idea to keep the root canal tooth since is was already mobile. 

We talked about 2 traditional implants, or a few minis and single crowns on her natural teeth. 

Extraction

 

She decided to let me extract the Root canal tooth.  There was enough destruction of bone on the cheek side that I explained to her that I would place some socket preservation material (a freezed dried mixture of bone) in the hole where the root was to help her body fill in that hole with good live bone so we could come back in 12 weeks and place a mini dental implant.

 

 

Bone graft

Here we have the socket preservation material in the extraction site.  Its easy to see how plump the ridge looks.  It will stay that way without caving in and will give us lots of good bone to put a mini dental implant. 

 

 

 

Mini dental implants secure prep

2 Mini Dental Implants in place to hold a molar size crown.  The mini dental implants will be shaped to allow room for her teeth to come together.  We will place a Porcelain crown over the mini dental implants. 

 

 

 

X ray mini dental implants X-ray of the two mini dental implants in place. 
The ghost image of where the root was will fill in with bone and in about 12 weeks we will add in another mini dental implant to support a crown. 

 

 

 

 

I will continue the post with the pictures of the crowns when we get the final mini dental implant in place and the crowns back from the lab. 

Paresh B Patel DDS  mini dental implants

Dentist Mooresville NC