Mono Implant Instrumentation
Good morning and welcome to the Shatkin F.I.R.S.T.® Monday morning minute.
Good morning. I’m Dr. Todd Shatkin and welcome to this Monday Morning Minute. Today I want to speak about the mono mini implants. They are wonderful and they make an exceptional option for you to use when you have enough bone to do this. In my opinion and I know I’ve been talking about the minis and the Milos and now the monos for some time. In my opinion, these mono I call them the mono mini implants because I’m going to explain why in a minute. But they are, in my opinion, better than the Milos. I know Dr. Gillespie may not like that because he’s a Milo man but I think we’re going to turn him into a mono man.
So I want to explain to you why I really love these mono implants. They can be treated like a mini implant. That’s why I call them the mono mini because what you have is a very, very narrow tip to these implants. So when it goes into the bone, it enters the bone just like a mini implant. But as it goes in, it widens out to a bigger flare toward the top. And that flare can depend on the diameter of the implants.
They start out at a 3.0, then they go to a 3.3, then a 3.75, a 4.2, and even a 4.75 implant. These are fantastic for areas especially in the upper anterior jawbone where the bone is a little bit thicker and you want a little more strength for a longer tooth. These mono implants are fantastic. The 30, the three three S are fantastic for anterior upper teeth. Also, they are bendable. And that’s an amazing feature because you can bend the implant once it’s in place. And it’s really become so wonderful to have that at your armamentarium to be able to reposition the angle of an implant that’s so thick but so strong. So it’s a really wonderful design.
Now I want to show you how we take the implant out of the package and into the patient’s mouth. There are a number of instrumentation that come with this small kit. The first thing you need to know about are these finger drivers. The finger driver goes over what we call a carrier. The carrier is what takes the implant out of the vial. Now, if you look closely, you’ll see there’s a carrier attached to the implant.
This carrier is only used for that purpose to carry the implant to the site and begin the process of placement. It is not meant to be used to place the entire implant. You take the implant out of the package, attach this finger driver and pull it out of the vial. You then go directly to the patient’s mouth after making your pilot hole. Now, the pilot hole, we typically use a 1.5 millimeter pilot hole. These are our gold pilot drills. Sometimes they’re silver, but they’re the D one five drill. These are reusable. You don’t have to throw these out after each use. Okay?
So you make your pilot hole with a 1.5 drill for the 30 or the three three implants. If you’re going up to a three seven five implant, you might go to a 2.0 drill. And then the four two, you might go to a 2.5, depending on the bone density. And you’ll figure that out. But once you make your pilot hole, you take this implant out of the vial. You carry it to the placement site and start to screw it in place with your fingers. Once you engage solid bone, you pull the finger driver off, and then you pull the carrier off.
If you try to place this implant too far with the carrier in place, the carrier will get very snug on the implant and it will be harder to remove. So again, you’re going to place the implant just a few turns until it engages good bone, take the finger driver off and pull the carrier off. It will come off with your fingers. Okay?
Next you have the option if you want to use a ratchet wrench or a contra angle driver to place it the rest of the way. There’s a ratchet driver in your kit that can be placed on the implant. And note that the ratchet driver has one red stripe, whereas the carriers have two red stripes. Don’t be confused because the carrier and this ratchet driver look very similar. You never want to throw away the ratchet driver that comes in the kit. Then you can go and take the finger wrench if you want to screw it in the rest of the way. Or you can take the ratchet wrench to screw it in the rest of the way. Okay? Those are options to do it by hand, okay? But you don’t want to attach the ratchet wrench to the carrier.
That’s a mistake that will make the carrier too hard to remove. And we’ve had doctors call and say they can’t get the carrier off it’s because you’re supposed to take that off with your fingers just after initial placement. Now, most doctors, like myself, will not use the ratchet and this driver. They will use the contra angle driver that goes onto your handpiece. Just like the way we place the mini implants and the same speed of 35 RPMs, same rules apply. You’re going to try to get past that 30 newton centimeter point. Once you get past the 30 newton centimeter point, you’ll push the button on the handpiece. You’ll go to 60. Same rules apply.
Like the minis, place it all the way in with the contra angle driver. You’ll get that feedback from the motor and you’re going to do everything the same as you do with a mini implant. Once the implant is fully in place, and what I mean fully in place, you want to bury that implant until the bottom of this abutment touches the tissue. You can go a little bit further if you like to. You can actually bury part of the abutment below the tissue if you need to reduce it a little bit by height.
You also can prep the top of the implant a little bit if you need to. Then if you need to bend the implant, put that driver on, put your ratchet wrench on, and you’re going to bend it. It’s as simple as that. Remember, when you do bend that implant, you only want to bend it one time in the direction you want to bend it in. So that not to weaken the collar on the implant. But these are bendable collars. So you can bend it up to 25 degrees and then just leave it like that.
Now, also, when you’re making your temporaries, use the large blockout shims over the abutment and then make your temporary over the top of that. After that, if you want to take the blockout shim out and cement it with temporary cement, you can however you want to retain that. Temporary is fine. We also do have some impression copings that we can sell you to go with these so they snap on the abutment, and then you can take your impression that way. But in my practice, I typically just take a direct impression of the implant itself without any copings.
The other thing I want to mention to you is at this time, we can make surgical guide stents for these implants, but we would recommend that you use the stent to make your pilot hole only and then take the stent out to place the implant because some of the larger implants won’t fit through the sleeve. But you can make your pilot hole up to a 2.5 millimeter pilot hole through the stent and then take it out and use the implant without the stent. All right, so I hope much of your questions have been answered today. I’m going to tell you right now, once you start using these, you are going to love them.
Every single dentist who started using our mono mini implants has loved them. So please give our office a call, talk to one of the sales associates, and they will tell you about our special offer of the mono implants, which is if you buy ten of them, you’ll get all the instrumentation free. So we’ll give you an assortment of implants and all the instrumentation you need to place them for free. It’s always good to be here. We’ll see you next Monday on the Monday Morning Minute.