Immediate Loading With Mini DentalImplants in the Fully Edentulous Mandible

Mi-Ra Ahn, DDS,* Kyung-Mi An, DDS,† Jung-Hwan Choi, DDS,‡ and Dong-Seok Sohn DDS, PhD§

Successful oral rehabilitation withdental implants for partially orfully edentulous patients has been

reported.1–3 Regardless of this success, a3- to 6-month healing period is usuallyrequired to get osseointegration, de-pending on bone quality. In this period,premature loading to the dental implantsis prohibited to allow for osseointegra-tion.4,5 In addition, no removable pros-thesis is used as long as possible be-cause premature loading can disturb thehealing at the site of guided bone regen-eration or bone graft.6

However, patients often complainof diet difficulties and unaesthetic ap-pearances during the healing period be-tween implant placement and final pros-thesis because they cannot wear adenture. To solve these patients’ com-plaints, provisional mini dental implantscan be placed between final implants orat the site of bone grafts. Provisionalmini dental implants provide immediateoverdenture or fixed prosthesis supportafter final implant placement. This tech-nique requires minimal additional timeand is economic because the patients’old dentures are used as immediate tem-porary prostheses.

The purpose of this article is toevaluate the efficacy of 27 provisionalmini dental implants, which wereloaded immediately for 11 patients.

MATERIALS AND METHODS

Twenty-five mini dental implants(IMTEC Corp., OK) and two minidrive-lock implants (Intra-Lock Inter-national Inc., FL) were placed in thefully edentulous mandible of 11 pa-tients (4 men and 7 women) ranging inage from 41 to 73 years (average, 52.9years) from April 2002 to September2003. The diameter of the mini dentalimplant was 1.8 mm. The diameter oftwo mini drive lock implants was 2.0mm. The length of mini dental im-plants that were placed is 13 to 18 mm(average: 15 mm) (Table 1).

Surgical Procedure

All final and provisional mini den-tal implants were placed in the mandibleunder local anesthesia. Crestal incisionwas made to expose the bone. A 1.2-mmpilot was the only drill for osteotomy ofthe implant site to place provisionalmini dental implants. External irrigationwith normal saline was supplied.

The osteotomy of mini dental im-plant was at least 2 mm away from thesite of the final implant site to preventthe final implant from early bone re-

sorption. The depth of the osteotomywas limited to half of the implantlength to get the primary stability ofmini dental implants.

Mini implants were self-tapped andplaced with a finger driver manually.The final seating of mini implants wasperformed with a ratchet. Mini implantswere unscrewed in approximately 180°to 360° counterclockwise direction inthe very dense bone (type I density) andrescrewed to a final position. This self-advancing step was repeated severaltimes to prevent mini dental implantsfrom fracture in the very dense bone.Two to four implants were placed de-pending on the type of prosthesis. Twoimplants were placed for an implant-supported overdenture, and three to fourimplants were placed for a fixed pros-thesis (nontissue support type).

The incision was sutured in a stan-dard manner. A sterile rubber dam waspunched out with a rubber dam puncherand placed over the surgical site to pre-vent the suture area from sticking to theself-curing rebase materials (TokusoRebase; Tokuyama Dental Corp., To-kyo, Japan) or self-curing pattern resin

*Resident, Department of Oral and Maxillofacial Surgery,Daegu Catholic University, Daegu, Republic of Korea.†Resident, Department of Oral and Maxillofacial Surgery,Daegu Catholic University, Daegu, Republic of Korea.‡Resident, Department of Oral and Maxillofacial Surgery,Daegu Catholic University, Daegu, Republic of Korea.§Associate Professor, Chair. Department of Oral &Maxillofacial Surgery, Daegu Catholic University, Daegu,Republic of Korea.

ISSN 1056-6163/04/01304-367Implant DentistryVolume 13 • Number 4Copyright © 2004 by Lippincott Williams & Wilkins

DOI: 10.1097/01.id.0000148560.65514.3d

The use of immediate loadedprostheses is not recommended forat least 2 weeks to prevent implantsfrom premature loading. In addition,immediate removable prostheses arenegated for at least 4 weeks at thesite of guided bone regeneration orbone graft. However, patients areoften not pleased with limited dietsand the unaesthetic appearance dur-ing the healing period without a den-ture between implant placement andfinal prosthesis. Mini dental im-plants provide stable and esthetic

temporary prostheses immediatelyafter implant placement and bonegrafts. The use of mini dental im-plants is simple and cost effectivebecause the patient’s old denture isused as a provisional prosthesis.This article shows the success of 27mini dental implants that wereplaced for 11 mandibular fully eden-tulous patients. (Implant Dent 2004;13:367–372)Key Words: loading, dental im-plants, temporary prosthesis

IMPLANT DENTISTRY / VOLUME 13, NUMBER 4 2004 367

(GC Corp., Tokyo, Japan). The O-ringand metal housing were seated on theO-ball head of the implant for animplant-supported overdenture. The pa-tients’ old dentures were prepared tomake the space for the O-ring and metalhousing (or square head of the mini den-tal implant for a fixed prosthesis). Self-curing rebase materials or self-curingpattern resin was added to the tissue sideof the newly adapted denture and placedon the O-ball head of the mini dentalimplants (or square head of the minidental implant for a fixed prosthesis).Excessive rebasing material wastrimmed, and the newly adapted denturedid not make any premature pressure tothe final implants or the site of bonegrafting. After the curing of the rebasingmaterial, the occlusion and retention ofthe temporary prosthesis were checkedand the denture was delivered to thepatient on the surgical day.

CASE REPORTSCase No. 6: Immediate RemovableProsthesis Using Two Mini Dental Implants

A 49-year-old male patient hadused his old ceramic metal bridge as aremovable prosthesis. When this bridgewas removed, soft tissue was overgrownand a concavity of extraction defect wasseen (Fig. 1A, B). An extraction bonydefect was seen in the computed tomo-gram (Fig. 1C). An overdenture that wassupposed to be supported by two minidental implants and bone graft wasplanned.

After removal of this ceramic metalbridge, a transitional full denture wasdelivered to allow for healing of soft

tissue at the extraction socket. Implantsurgery was performed 4 weeks later.Two final implants (Endopore; InnovaCorp., Toronto, Ontario, Canada) wereplaced in both mandibular canine areas.The osteotomy for mini dental implantswas performed between two final im-plants. The osteotomy was prepared 2mm away from these implants. Allograft(irradiated cancellous bone and marrow;Rocky Mountain Tissue Bank, Aurora,IL) was grafted in the extraction defect(Fig. 1D). His old denture was modifiedand adapted to the O-ball head of themini dental implants (Fig. 1E, F). Nopremature pressure to the site of thebone graft and the final implants wasverified. The retention and support ofthis prosthesis was more favorable thanthe old denture. Mini dental implantswere removed and the uncovering of thefinal implants was performed after a5-month healing period. Favorable boneregeneration and no bone resorptionaround the mini implants were seen(Fig. 1G). The denture was newlyadapted for overdenture abutments (Lo-cator; Innova Corp.) that were placed inthe final implants on the uncovering dayfor continuous denture use.

A final prosthesis using twoZAAG locator attachments (Zest An-chors Inc., CA) was delivered 6 weekslater (Fig. 1H). This patient was verysatisfied with the immediate provi-sional removable prosthesis supportedby mini dental implants because hehad used his denture from the firstsurgical day to the day of the finalimplant-supported prosthesis.

Case No. 10: Immediate Fixed ProsthesisUsing Four Mini Dental Implants

This 41-year-old male patient pre-sented with a fully edentulous maxillaand mandible (Fig. 2A). Transitionalmaxillary and mandibular full den-tures were fabricated and deliveredbefore implant surgery. The patientwanted an immediate prosthesis af-ter placement of full implants. Bonegrafting was performed in the bilat-eral posterior extraction defects afterthe placement of full implants andsimultaneous four mini dental im-plants (Fig. 2B, C). His old denturewas modified and adapted to thehead of provisional mini dental im-plants. The fixed prosthesis was ce-mented in the square head of themini dental implants in the mandibleon the surgical day (Fig. 2D). Thetissue side of the provisional fixedprosthesis was reduced to avoid pre-mature pressure to the site of bonegrafting and final implants in bothposterior areas. The uncovering offinal implants was performed after a5-month healing period. Good boneregeneration and osseointegration ofthe final implants were seen (Fig.2E). No permanent implants showedfailure. A final implant-supportedfixed prosthesis was cemented 6weeks later (Fig. 2F, G).

RESULTS

Twenty-seven provisional minidental implants were placed in the ante-rior mandible, and 26 mini implants re-mained stable and functioned from thefirst surgical day to the uncovering dayof the final implants. One mini implantwas fractured during placement. The av-erage functioning time was approxi-mately 21 weeks. All patients weresatisfied with immediate implant-supported overdentures or fixed pros-theses supported by mini implantsthroughout the healing period in themandible. Mini implants did not dis-turb the osseointegration of the finalimplants and bone regeneration at thesite of bone grafting. All patients re-ported no pain or discomfort withthese immediate temporary prosthe-ses. No bone resorption was observedat the exposure of final implants.

Table 1. Average Diameter, Length, and Loading Period of Mini-implants in CurrentStudy

CaseNo.

Age(yrs)/Sex

No. ofMI

Type ofProsthesis

Diameter(mm)

Length(mm)

Date ofInsertion

Date ofRemoval

Loading Period(week)

1 73/F 2 R 1.8 13 5/17/2001 11/14/2001 162 63/M 2 R 1.8 15 6/20/2001 1/11/2002 293 47/F 2 R 1.8 15 4/30/2002 10/5/2002 174 66/F 2 R 1.8 15 6/17/2002 10/21/2002 185 47/M 2 R 1.8 15 11/22/2002 2/19/2003 126 49/M 2 R 1.8 15 11/13/2002 6/25/2003 367 65/F 2 R 1.8 15 2/24/2003 8/4/2003 248 52/F 3 F 1.8 15 4/23/2003 9/5/2003 189 56/F 2 R 1.8 18 4/18/2003 11/4/2003 27

10 41/M 4 F 1.8 13 5/9/2003 10/29/2003 1411 43/F 4 F 1.9 15 9/17/2003 2/13/2004 20Average 52.9 1.82 14.9 21.2MI, mini implant; R, removable type; F, fixed type.

368 IMMEDIATE LOADING WITH MINI DENTAL IMPLANTS IN THE FULLY EDENTULOUS MANDIBLE

DISCUSSION

The loading of implants should beavoided until completion of implant os-seointegration.2,3,7 In addition, traumacaused by immediate loading to the siteof a bone graft can cause failure of boneregeneration. Also, patients may have alimited diet and limited social activity inthe absence of a temporary prosthesisduring the healing period.

The use of provisional mini dentalimplants offers many advantages to bothpatients and surgeons. The use of minidental implants provides patients with

an immediate removable denture orfixed prosthesis after implant place-ment.8,9 This immediate temporary pros-thesis using provisional mini implantscan solve speech problems, unaestheticappearance, and mastication problemsduring the healing period.10,11 In addi-tion, mini implants do not disturb theosseointegration of final implants andthe regeneration of a bone graft.8–12 Minidental implants are cost effective be-cause the patients’ original denture ismodified and used as a provisional pros-thesis. The surgical time for the place-

ment of mini implants is minimal. Twomini implants are necessary for an im-mediate implant-supported overdenturein the mandible. Three to four mini im-plants are required for an immediatefixed prosthesis in the mandible.

For the sake of initial stability ofmini implants, the depth of osteotomyshould not be drilled to the length of themini implants. The depth of the osteot-omy should be limited to the half-lengthof mini implants, which will be placedin the anterior mandible because miniimplants are self-tapped for the final po-sition with primary mechanical reten-tion. Mini implants should be placedwith a finger wrench and ratchet manu-ally to verify initial stability.

Bone density is one of the majordetermining factors for the high successrate of mini implants.13,14 The high suc-cess rate of provisional mini implantswas reported in the anterior mandible,but in the maxilla, the high loss of pro-visional mini implants has been report-ed.8,10,12 A lower degree of removaltorque of transitional implants was re-quired in the maxilla than the mandiblebecause of poor bone density.13

Bone resorption around mini den-tal implants is possible at the site ofpoor bone density. Provisional minidental implants should be placed atleast 2 mm away from permanent im-plants to prevent bone resorption at thesite of a final implant.14,15

When provisional mini implantscannot advance within very densebone, the implants should be un-screwed 180° to 360° at the site ofvery dense bone, and then manual ad-vancement of mini implants is re-peated to prevent the fracture of theprovisional mini implant. This proce-dure is repeated until final seating ofmini implants. The fracture of onemini implant that was described in thisarticle happened because of forcefuladvancement without the repeated un-screwing and advancement of the miniimplant in very dense bone.

The use of titanium alloy-basedmini implants may be more advanta-geous than commercially puretitanium-based provisional mini im-plants to reduce bending or fracture ofthe implants during the insertion andfunction of the provisional implants.14

Fig. 1. (A) Intraoral view of the healed socket after removal of a ceramic metal bridge. (B) Fixedprosthesis that the patient used as a removable prosthesis. (C) Large bony defect in theextraction site. (D) Bone graft and two mini implants and final implants. (E) Modified old dentureO-ring and metal housing were placed. (F) Postoperative panoramic radiograph. (G) Goodbone regeneration and no bone resorption at mini implant sites after 5 months of loading. (H)Final overdenture using two Locator attachments (Innova Corp., Toronto, Canada).

IMPLANT DENTISTRY / VOLUME 13, NUMBER 4 2004 369

CONCLUSION

An immediate temporary remov-able or fixed prosthesis supported bymini implants in the mandible is veryadvantageous. This prosthesis does notdisturb either osseointegration of finalimplants or the healing of bone grafts. Inaddition, mini implant-supported pros-theses provide immediate masticationand esthetics for patients during thehealing period. Two mini implants arerecommended for overdentures butthree to four mini implants are requiredfor a fixed prosthesis in the mandible.

Disclosure

None of the authors have any fi-nancial interest in the mini implantsmentioned in this article.

REFERENCES

1. Adell R. Tissue integrated prosthe-ses in clinical dentistry. Int Dent J. 1985;35:259–65.

2. Albrektsson T, Zarb GA, Worthing-ton P, et al. The long-term efficacy of cur-rently used dental implants: a review andproposed criteria of success. Int J OralMaxillofac Implants. 1986;1:11–25.

3. Jemt T, Lekholm U. Oral implant treat-ment in posterior partially edentulous jaws: afive-year follow follow-up report. Int J OralMaxillofac Implants. 1993;8:635–640.

4. Branemark PI. Osseointegration andits experimental background. J ProsthetDent. 1983;50:399–410.

5. Lagawa Y, Ishikawa Y, Nikai H, et al.Interface histology of unloaded and earlyloaded partially stabilized Zirconia endos-seous implants in initial bone healing. JProsthet Dent. 1993;69:599–607.

6. Nevins M, Mellonig JT. ImplantTherapy: Clinical Approaches and Evi-dence of Success, vol II. QuintessenceBooks; 1998:91–97.

7. Piattelli A, Corigliano M, Scarano A,et al. Immediate loading of titaniumplasma-sprayed implants: an histologicanalysis in monkeys. J Periodontol. 1998;69:321–327.

8. Krennmair G, Weinlander M,Schmindinger S. Provisional implants foranchoring removable interim prostheses inedentulous jaws: a clinical study. Int J OralMaxillofac Implants. 2003;18:582–588.

9. Ravasini T. Immediate provisionalimplants as abutments for an overdenturein the mandibular edentulous jaw: casepresentation. Pract Proced Aesthet Dent.2002;14:673–677.

10. Leshem D, Mazor Z, Leshem R, etal. A simple technique for fabrication of im-mediate interim removable prosthesis sup-ported by transitional implants. ImplantDent. 2003;12:227–231.

11. Nagata M, Nagaoka S, Mukunoki O.The efficacy of transitional implants placedsimultaneously with implant fixtures. Com-pend Contin Educ Dent. 1999;20:975–978.

12. Khoury F, Happe A. Interim im-

plants in extensive bone transplantationprocedure: results of a clinical study. Im-plantology. 2000;9:375–387.

13. Simon H, Caputo A. Removal torqueof immediately loaded transitional endosse-ous implants in human subjects. Int J OralMaxillofac Implants. 2002;17:839–845.

14. Sohn DS. Color Atlas, ImmediateLoading With Temporary Implants.Jiseong Publication Co; 2002:116–118.

15. Froum S, Emtiaz S, Bloom M, et al.The use of transitional implants for imme-diate fixed temporary prostheses in casesof implant restorations. Pract PeriodontAesthet Dent. 1998;10:737–746.

Reprint requests and correspondence to:Dong-Seok Sohn, DDS, PhDDepartment of Oral & Maxillofacial SurgeryDaegu Catholic University Hospital3056–6 Daemyung 4-DongNam-Gu, Daegu, Republic of Korea 705-034Phone: (53)650-4288Fax: (53)622-7067E-mail: dssohn@cu.ac.kr

Fig. 2. (A) Preoperative panoramic photograph showing fully edentulous jaws and bonydefects in extraction sockets. (B) Bone grafting in the bilateral posterior extraction defects. (C)Postoperative panoramic radiograph. Four mini dental implants in the mandible and fiveprovisional implants were placed. (D) Immediate provisional fixed prosthesis cemented to minidental implants. Note the relief of the tissue side to avoid premature pressure to the site of thebone graft and final implants.

Fig. 2. (E) Good bone regeneration in theprevious extraction defect. (F) Intraoral viewof the final implant-supported prosthesis. (G)Panoramic radiograph after cementation ofthe final prosthesis.

370 IMMEDIATE LOADING WITH MINI DENTAL IMPLANTS IN THE FULLY EDENTULOUS MANDIBLE

Abstract Translations [German, Spanish, Portugese, Japanese]

AUTOR(EN): Mi-Ra Ahn, DDS*, Kyung-MiAn, DDS**, Jung-Hwan Choi, DDS***,Dong-Seok Sohn, DDS, PhD****. * Assisten-zarzt, Abteilung fur Gesichts- und Kieferchiru-rgie, Katholische Universitat von Daegu, Re-publik Korea. ** Assistenzarzt, Abteilung furGesichts- und Kieferchirurgie, KatholischeUniversitat von Daegu, Republik Korea. ***Assistenzarzt, Abteilung fur Gesichts- undKieferchirurgie, Katholische Universitat vonDaegu, Republik Korea. **** A.O. Professor,Leiter der Abteilung fur Gesichts- und Kiefer-chirurgie, Katholische Universitat von Daegu,Republik Korea. Schriftverkehr: Dong-SeokSohn, DDS, PhD, Abteilung fur Gesichts- undKieferchirurgie (Dept. of Oral & Maxillofa-cial Surgery), Klinik der Katholischen Univer-sitat Daegu (Daegu Catholic University Hos-pital), 3056 - 6 Daemyung 4-Dong, Nam-Gu,Daegu, Republik Korea (Republic of Korea),705 –034. Telefon: (53) 650 –4288, Fax: (53)622 –7067. eMail: dssohn@cu.ac.kr

Unmittelbare Belastung mit Mini-Zahnimplantaten im vollkommen zahnlosen Unterk-iefer

ZUSAMMENFASSUNG: Der Einsatz einer unmittelbar belasteten Prothetik sollte fru-hestens zwei Wochen nach dem Ersteingriff erfolgen, um die Implantate vor vorzeitigerBelastung zu schutzen. Au�erdem sind sofort entfernbare Prothesen fruhestens vierWochen nach der Behandlung im Bereich einer gestutzten Knochengewebsregenerationoder Knochentransplantation zulassig. Demgegenuber stehen die Patienten, die haufig mitden Einschrankungen bezuglich Ernahrung und unasthetischer Optik wahrend des Hei-lungsprozesses unzufrieden sind, wenn ihnen keine Ubergangslosung zwischen Implan-tateinsatz und letztendlicher Protheseanpassung zur Verfugung steht. Mini-Zahnimplantate bieten hier eine stabile und asthetische Prothesenlosung zumvorubergehenden Einsatz sofort nach unmittelbarem Implantierungs- oder Transplan-tierungseingriff. Mini-Zahnimplantate sind leicht anzuwenden und, da die alte Prothesedes Patienten als Provisorium genutzt werden kann, erweist sich diese Losung auch alskostengunstig. Der vorliegende Artikel beschreibt den erfolgreichen Behandlungsverlauffur insgesamt 11 Patienten, bei denen im vollkommen zahnlosen Unterkiefer 27 Mini-Zahnimplantate eingesetzt wurden.

SCHLUSSELWORTER: Belastung, Zahnimplantate, provisorische Prothese

AUTOR(ES): Mi-Ra Ahn, DDS*, Kyung-MiAn, DDS**, Jung-Hwan Choi, DDS***,Dong-Seok Sohn, DDS, PhD****. *Residente,Departamento de Cirugıa Oral y Maxilofacial,Daegu Catholic University, Daegu, Republicade Corea. *Residente, Departamento de Ciru-gıa Oral y Maxilofacial, Daegu Catholic Uni-versity, Daegu, Republica de Corea. *Resi-dente, Departamento de Cirugıa Oral yMaxilofacial, Daegu Catholic University,Daegu, Republica de Corea. **Profesor Aso-ciado, Jefe, Departamento de Cirugıa Oral yMaxilofacial, Daegu Catholic University,Daegu, Republica de Corea. Correspondenciaa: Dong-Seok Sohn, DDS, PhD, Dept. of Oral& Maxillofacial Surgery, Daegu Catholic Uni-versity Hospital, 3056–6 Daemyung 4-Dong,Nam-Gu, Daegu, Republic of Korea, 705–034.Telefono: (53) 650-4288, Fax: (53) 622-7067.Correo electronico: dssohn@cu.ac.kr

Carga inmediata con mini implantes dentales en la mandıbula totalmente edentulosa

ABSTRACTO: El uso de protesis cargadas inmediatamente no se recomienda durante porlo menos dos semanas para prevenir que los implantes sean cargados prematuramente.Ademas, las protesis removibles inmediatamente no se deben usar durante por lo menos4 semanas en el lugar de la regeneracion guiada o injerto del hueso. Sin embargo, lospacientes a menudo no estan satisfechos con dietas limitadas y una presentacion pocoestetica durante el perıodo de curacion sin una dentadura entre la colocacion del implantey la protesis final. Los mini implantes dentales proporcionan protesis temporarias establesy esteticas inmediatamente despues de la colocacion del implante e injertos de hueso. Eluso del mini implante dental es simple y de bajo costo porque la dentadura vieja delpaciente se puede usar como protesis provisoria. Este artıculo muestra el exito deveintisiete mini implantes dentales que fueron colocados en 11 pacientes con mandıbulastotalmente edentulosas.

PALABRAS CLAVES: carga, implantes dentales, protesis temporarias

IMPLANT DENTISTRY / VOLUME 13, NUMBER 4 2004 371

AUTORES: Mi-Ra Ahn, Cirurgiao-Dentista*,Kyung-Mi An, Cirurgiao-Dentista**, Jung-Hwan Choi, Cirurgiao-Dentista***, Dong-Seok Sohn, Cirurgiao-Dentista, PhD****.*Residente, Departamento de Cirurgia Oral eMaxilofacial, Universidade Catolica deDaegu, Daegu, Republica da Coreia. **Resi-dente, Departamento de Cirurgia Oral e Max-ilofacial, Universidade Catolica de Daegu,Daegu, Republica da Coreia. ***Residente,Departamento de Cirurgia Oral e Maxilofa-cial, Universidade Catolica de Daegu, Daegu,Republica da Coreia. ****Professor Asso-ciado, Chefe do Departamento de CirurgiaOral e Maxilofacial, Universidade CatolicadeDaegu, Daegu, Republica da Coreia. Cor-respondencia para: Dong-Seok Sohn, DDS,PhD, Dept. of Oral & Maxillofacial Surgery,Daegu Catholic University Hospital,3056–6 Daemyung 4-Dong, Nam-Gu, Daegu,Republic of Korea 705–034. Telefone: (53)650-4288, Fax: (53) 622-7067. E-mail:dssohn@cu.ac.kr

Carga Imediata com Miniimplantes Dentarios na Mandıbula Totalmente Desdentada

RESUMO: O uso de proteses carregadas imediatas nao e recomendado por pelo menosduas semanas a fim de impedir os implantes de carga prematura. Alem disso, protesesremovıveis imediatas sao negadas por pelo menos 4 semanas no local da regeneracaoossea guiada ou do enxerto osseo. Contudo, os pacientes frequentemente nao ficamsatisfeitos com dietas limitadas e aparencia nao estetica durante o perıodo de cura semuma dentadura entre a colocacao do implante e a protese final. Miniimplantes dentariosproporcionam proteses temporarias, estaveis e esteticas, imediatamente apos a colocacaodo implante e dos enxertos osseos. O uso de miniimplante dentario e simples e economicoporque a velha dentadura do paciente e usada como protese provisoria. Este artigo mostrao sucesso de vinte e sete miniimplantes dentarios que foram colocados para 11 pacientesmandibulares totalmente desdentados.

PALAVRAS-CHAVE: carga, implantes dentarios, protese temporaria.

372 ABSTRACT TRANSLATIONS