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How Many Mini Implants are Needed for My Mandible?

Question:

Barb asks:

I had 4 mini implant screws placed in my mandible about 3 weeks ago. My dentist said during the surgery that my bone was soft and he could not get a good lock so we needed to wait about 6 weeks before we finish the job.

About 3 weeks post surgery, one of the central implants became infected and had to be removed. Now my dentist says I need to wait 2 more months before he re-inserts a new screw and attempts to seat the lower denture. I am asking him to please try to use just the 3 mini implant secure screws and go ahead and seat the denture. I desperately need my lower plate to hold my top denture in. He refused to consider doing that. He says the standard is 4 mini screws and he is not willing to deviate from that. I am concerned that there may be a problem when he inserts the other screw, because I have diabetes and am glad to have the other 3 screws doing great. Should I see if another implant dentist will finish the job just using 3 screws? Is 4 minis really necessary?

Answer:
Answered by: Dr. Benjamin D. Oppenheimer

Amherst, NY

Hi Barb,

Your dentist is probably looking out for your best interests. Mini implants require a certain amount of stability in the bone to be functional. If that stability is not achieved during the surgical visit, we rely on the body’s ability to heal to the implants and cause the minis to become solidly attached to the bone. This healing process can take 3-6 months.

Four minis is not a magic number but it is recommended based upon certain biomechanics in implant dentistry. Your dentist may want to wait to snap the minis to the denture because of the soft bone encountered initially and the need for healing to occur before securing the implants to the denture, not the fact that he doesn't want to use remaining three. This is a prudent measure and may save you additional surgeries to correct more failed implants. If you insist on having him secure the denture prematurely, you may be responsible for more implant failures.



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