Concerns also have been raised about whether general dentists who adoptmini implants receive sufficient implant training. Though mini-implantcompanies provide weekend training sessions, AAID believes such instructionfalls short of what dentists must know before adding implants to theirpractices.

"Dentists need to be well versed in implant dentistry before using miniimplants," said Kim Gowey, DDS, a past AAID president. "Without extensiveimplant knowledge, they will not know proper surgical techniques and all thebasics about bone healing critical for implant success. If you want topractice implant dentistry, there are no shortcuts for gaining the necessaryknowledge and training."

In a plenary-session presentation at the recent AAID annual scientificmeeting, Todd Shatkin, DDS said mini implants are half the diameter oftraditional implants -- almost toothpick size -- and the insertion procedureis less invasive and half the cost of traditional implants. "Mini implantsmade from titanium alloys are strong enough to withstand normal chewing forceand can be used confidently for immediate-load, long-term restorations," saidShatkin. He added that he now uses mini implants for stabilizing dentures,single-tooth implants and even full-arch restorations.

"The FDA has approved some mini implant systems for long-term use, andpatients can have a denture stabilized in about an hour or get a single-toothimplant in 30 minutes," Shatkin said. He reported findings from his Feb. 2007article published in Compendium Dental Journal showing his overall successrate with mini implants was 95 percent. He noted implants are now widelyaccepted in the dental profession for denture stabilization and crown andbridge applications.

For stabilizing dentures, Shatkin explained that four mini implants areinserted in the front of the patent's lower jaw. It requires mild anesthesia.The dentist adjusts the denture to snap on to the implants and secure it.Denture wearers also can remove the prosthesis for cleaning and snap it backin place.

Concerns About Inadequate Research

Italian dental researcher and practitioner Matteo Chiapasco, MD presenteda more conservative view to AAID meeting attendees, stressing there isinadequate scientific literature supporting long-term use of mini implants andno well-defined protocols to determine clinical situations for which theyshould be indicated.

"Adopting any procedure without sufficient research would bring us awayfrom practicing evidence-based dentistry and back to the '70s and '80s whendecisions were made from clinical experimentation," said Gowey.

According AAID President Jaime Lozada, DDS, there is concurrence for usingmini implants to stabilize a denture and for insertion in tight spaces betweenteeth, but many implant dentists do not use them for single tooth or multipleimplant placements. "For placing implants in an extraction site, in mostcases, it's in the patient's best interest to use a traditional implant tohelp preserve the bone and promote better osseointegration," he said.

Olivia Palmer, DMD, an AAID Fellow practicing in Charleston, SC, believesmini-implants aren't designed to support normal-size crowns for single-toothimplants. "The chewing force applied from a crown could overwhelm a miniimplant and put way too much pressure on the bone. This can lead to bone lossand eventual implant failure," she said.

AAID Credentialing Program Offers Rigorous Implant Training

For general dentists and specialists alike, the AAID credentialing programis an excellent investment in the future as the popularity and success ofimplants continues to rise.

The exam for the Associate Fellow credential consists of a written testand an oral examination, which includes defense of three clinical cases thatthe candidate completed. Applicants must be licensed dentists who have atleast 300 hours of postdoctoral or continuing education in implant dentistry,divided between the sciences related to implant dentistry (such as anatomy,immunology and pharmacology) and clinical implant education. Candidates mustpass the written exam before applying to take the oral/case part, and bothmust be completed successfully within four years.

About AAID

AAID can help consumers find a local credentialed implant dentist athttp://www.aaid.com. AAID is based in Chicago and has more than 3,500members. It is the first organization dedicated to maintaining the higheststandards of implant dentistry by supporting research and education to advancecomprehensive implant knowledge.

SOURCE American Academy of Implant Dentistry