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Mini Dental Implants for Missing Laterals

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One of the most prevalent dental conditions is missing upper laterals (about 10% of the population is missing these teeth from birth).  IMG_7519

Some of the time, even with orthodontics, there is not enough space to restore the missing teeth with traditional implants (implants with a diameter greater than 3.0 mm).IMG_7522

Most of the patients I have seen either have some sort of removable appliance or a orthodontic retainer with the two missing teeth on it.  The issue is that these teens don't really care to wear their retainer. 

Another solution, the bonded bridge, seems to fail.  While the bonded bridge works well on missing lowers, the clinical data shows that bonded bridges to replace missing upper laterals fail quite often because the central and canine tooth both move to different degrees under chewing function. 

One solution that works well in my hands is a technique that Dr. Todd Shatkin taught me….use mini dental implants.  The Intra Lock or IMTEC Mini Dental Implant can be threaded in between the canine and central.  This mini implant can then hold a crown in place that the patient does not remove.  

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This photograph shows a Intra Lock 2.5 x 18mm mini dental implant to replace missing laterals.

 

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www.dentalminiimplant.com

 

One Mini Implant for Each Root?

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At the last Annual meeting for Mini Implant Dentists a friend of mine, Dr. Steve Brown, showed several of his cases where he used one mini dental implant for each root on a missing tooth.  Of course I thought, huh?  Not a bad idea, but is there really space?  Tennis Ball

To confirm I spoke with Valdi at Sam Shatkin's FIRST Labs.  Valdi is the master lab tech at the Lab and he said, 'No problem, Dr. Brown has been doing that for years.'  So with that information in hand I had to give it a try.

So, having the sink or swim kind of attitude, I enlisted the help of a friend and long time patient of mine.  He had a missing upper molar that he desperately wanted back, not to mention he had been bugging me to death about it.

So with the big day here and multiple sizes of Intra Lock mini dental implants in stock, we got John numb with 1/2 a carpule of Lidocaine…not a lot really.  Just enough to get the gum tissue numb.

We made one pilot hole and placed a 2.0 x 11mm mini….and then another pilot hole was made carefully.  One more mini was tightened into place…..was there space for one more?  I looked over at the assistant, she nodded her head in approval.   The patient was just sitting there just like the guy in the cartoon….'A bit wider Mr. Sprinkle, I need to see if this tennis ball, I mean this last mini implant can be fit in' I said. 

So there it was, 3 mini dental implants all snug in place ready to support a molar crown!

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An Itero impression was taken and its off to Shatkin FIRST Lab for a PFM Mini Implant Crown.  IMG_7539