Abstract
Introduction: Over the last five years 3,276 implants have been placed at the University of Nevada Las Vegas School Of Dental Medicine. Of those, 55 have been small diameter implants (SDI), accounting for less than 2% of all dental implants. Nine SDI’s were placed for fixed restorations. This case report demonstrates the use of SDI’s for a fixed, splinted restoration, utilizing a surgical guide for both the osteotomies and implant placement. Methods: Two 2.0 mm × 15 mm SDI’s (Shatkin F.I.R.S.T.) were placed in the location of teeth #23 and #24. A surgical guide (Shatkin F.I.R.S.T Laboratory) was used for initial osteotomies to ensure proper angulation and for final placement of the SDI’s. A laboratory fabricated splinted acrylic temporary (Shatkin F.I.R.S.T.) was placed during the healing phase. Results: Both SDI’s displayed successful integration, based on the Health Scale for Dental Implants. The SDI’s displayed no mobility, no pain or tenderness upon function, <2 mm of radiographic bone loss from initial surgery, and no exudates. The final splinted Porcelain-Fused-to-Metal (PFM) restoration was fabricated using conventional crown and bridge techniques and was cemented using FujiCEM. Conclusion: SDI’s are indicated in cases where bucco-lingual bone width is limited and bone and soft tissue grafting are not possible. A surgical guide can be used to ensure proper placement and angulation of SDI’s. Placement of a single traditional implant with cantilever prosthesis has an increased chance of prosthesis failure in five years. SDI’s, in this application, have a success rate comparable to traditional implants. This case demonstrated a guided surgical technique for SDI’s without extensive bone or soft tissue grafting procedures.
Highlights
Over the last five years 3,276 implants have been placed at the University of Nevada Las Vegas School Of Dental Medicine
Based on success rates similar to larger diameter implants, uses for small diameter implants (SDI)’s can include single implant supported crowns, larger fixed prosthesis, orthodontic anchorage (TADs), implant-tooth-tissue supported removable partial dentures, and implant supported over dentures [4,5]
SDI’s are not applicable in all clinical situations, but can offer valuable treatment options for clinicians in fixed or removable situations. This clinical case highlights the replacement of two anterior mandibular teeth with two SDI’s and a splinted fixed prosthesis in which a “traditional” diameter implant was too large for the bone volume without extensive on lay grafting procedures
Summary
Two 2.0 mm × 15 mm SDI’s (Shatkin F.I.R.S.T.) were placed in the location of teeth #23 and #24. A surgical guide (Shatkin F.I.R.S.T Laboratory) was used for initial osteotomies to ensure proper angulation and for final placement of the SDI’s. A laboratory fabricated splinted acrylic temporary (Shatkin F.I.R.S.T.) was placed during the healing phase
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