Which is the best implant system a dentist should use?

Smaller diameter implants also known as SDIs, mini-implants, midi-implants, same day teeth, one visit implants or self-tapping implants have revolutionized dentistry in this field. 

Here are the main advantages of using the smaller diameter implants.

[1] Smaller diameter implants are also known as Mini implants, midi implants, same-day teeth implants and SDIs. Their characteristics are that they have a tapered design and being of smaller diameter, they are therefore self tapping. Self tapping means that the osteotomy hole does not have to be created to the size of the implant in order for the implant to be placed. These implants use the property of alveolar bone which is porous and elastic so to  enable self tapping dental implants to be placed easily and quickly. Often, all that is needed is for the initial pilot drill to just enter the cortical layer. Sometimes it is helpful to enter up to half way up to the depth of the implant but often you only need to go just into one quarter implant depth and the implant’s tapered design does the rest for you. 

2] Mini implants have an advantage in that the root portion of the implant and the abutment is not separate. This has the advantage in that no screw is necessary to hold the implant abutment onto the root form part of the dental implant. Any dentist who places implants knows about a common complication of conventional implants where the screw becomes loose or even breaks. This complication cannot therefore happen with smaller diameter implants which are a clear advantage. This also means that the implant can be prepared for a temporary crown or a permanent crown at the same visit as the implant is placed. This is in contrast to conventional dental implants away the patient needs to return to have the abutment placed first.

(3) Smaller diameter implants, as a one-piece system. This reduces the cost significantly because the implant system does not come as several components as in conventional systems. The conventional system will come as the root portion of the implant, the abutment portion of the implant, the attaching screw and a cover screw will also be necessary whilst everything is healing up. It is therefore not surprising therefore that the conventional implant will cost more than double than that of these type of implants.

[4] These implants are ideal for thin and atrophic all the ridges. This is for two reasons. The overall diameter of the implant is small and therefore it can be used in a smaller range of ridge size. The design of these implants in the way that they are self tapping and tapered means you that a small ridge can be expanded. Conventional implants in contrast cannot be used to expand a ridge. A conventional implant usually requires one and a half millimeter of alveolar bone from the buccal aspect and another one and half millimeters of bone from the lingual aspect. This often means that  a conventional implant will  typically be 5 mm in diameter and  We know that this arrangement is not commonly available so the patient has to go away empty handed or is subject to further costly and invasive surgery with bone grafting. However with a smaller diameter implant, let’s say you are using a 2.5 mm diameter implant. You can get away with having only 1 mm of bone on either side because the ridge will also be expanded. This means that you only need 4 mm of bone which is usually available in most patients.

5.  Smaller diameter dental implants do not require significant additional surgical skills that a general Dental practitioner does not already present. It is often stated that placing a smaller diameter implant is on par with trying to drill a post for a root treated tooth. In fact if you use a surgical guide, it is even easier than placing a post in a root treated tooth.

6.  Because a full mucoperiosteal flap is not required to be lifted, this has obvious advantages in that the procedure is  less time consuming, it is less costly, it is less invasive and will produce fewer post-operative complications. A patient will not require antibiotics or corticosteroids in addition. Many of our patients say that they did not even need to take any painkillers afterwards which goes to demonstrate how minimally invasive this technique is.

7.  Dental sutures are not required because a mucoperiosteal flap will not be raised. This saves on time and it produces less discomfort for the patient. A flap is not required because you will be using a transmucosal drilling technique where you drill directly through the gum overlying the cortical bone. This hardly causes any bleeding whatsoever.

8.  If you are using a one piece implant system, you can place a temporary crown out of occlusion straight away. This means that the patient does not need to wear a denture and once again it reduces the overall cost.

9.  Smaller diameter dental implants are perfect when the alveolar ridge is very thin. Studies have shown that when the alveolar ridge is even thinner than the diameter of the implant you are using, you can still have successful dental implants because the self-tapping nature of these implants causes an expansion of the alveolar bone.  These studies show that the dimensions of the alveolar ridge is increased when these implants are placed due to the elastic nature of the bone.

10.  Further studies long-term also show that these implants suffer from less crestal bone loss than conventional implants. Typically conventional implants will suffer from crestal bone loss up to the first thread but then can receive continuing bone resorption after that time as well.

11.  Due to the minimally invasive surgical technique, there are less surgical and post-operative problems for the patient. These implants are much quicker and therefore are ideal for patients who are elderly or when the medical history is compromised.

12.  The minimally invasive surgical technique that these implants are placed under, local anaesthetic quite comfortably is sufficient for the patient. The patient does not need to go under sedation or have heavy general anaesthesia.

13.  These implants expand and simultaneously compress the alveolar bone, so bone grafting is often not required. This dramatically cuts down on the surgical time, the cost and the number of visits required.

14.  Smaller diameter implants are also used for the immediate extraction placement technique. Certain strict guidelines have to be of course in place such as the distance of the implant from the edge of the tooth socket.

 Overall these smaller diameter implants are less costly, less invasive and much quicker to perform than conventional implants. For the dentist, they are a fantastic practice builder.