When it comes to getting a tooth implant, a cheaper and quicker procedure may well be a tempting option but not necessarily a suitable one for most people.

Dental implants are usually performed when patients request the replacement of a missing tooth, either to improve their appearance or so they can eat and chew properly.

The surgical procedure involves drilling a cylindrical or screw-shaped implant made of titanium or titanium alloy into the jaw or upper bone.

This provides a foundation for the long-term support of the replacement tooth that is attached to the screw.

While conventional implants have been the method of choice for most dental implants, mini-implants have recently presented themselves as a viable alternative.

Compared to conventional dental implants, which use screws between 7mm and 8mm in diameter, mini-implants use screws that are less than 3mm.

The question is: Are they as safe and as good?

Dr Wong Keng Mun, president of the Prosthodontic Society of Singapore, felt that while mini-implants generally cost less than conventional ones, patients should consider the long-term pros and cons of each procedure before deciding on one.

He said: "The advantages of mini-implants are that they are more suitable for people with a narrow bone structure. As it is a flapless procedure, patients' gums need not be cut open.

"However, in the long run, it tends to be more difficult to maintain as it can be quite hard to clean and might loosen after awhile as the screws used are small and not bio-mechanically strong enough."

As a mini-implant screw is smaller, it creates a space between the implant and the crown, where food is easily trapped, leading to problems such as bad breath.

The tooth might also become loose and fall off if the patient eats food that is too hard, requiring a repeat implant procedure.

The recovery process, however, is quicker than for conventional implants, with most patients being able to resume eating on the same day.

Dr Wong said: "Some people might opt for mini-implants because they think they're less expensive.

"In reality, however, conventional implants do not cost that much more, considering the long-term advantages."

Government hospitals for example, charge about $3,000 for conventional implants, compared to the $2,000 that patients usually pay for mini-implants.

SUCCESS RATES

What might also make conventional implants a better alternative are the new technologies being developed to make the surgical procedure more accurate and aesthetically-pleasing.

Specialists at the National Dental Centre (NDC) put success rates of conventional implants at between 85 per cent to 95 per cent, five years after the surgery.

According to Dr Wong, new dental CT scans have been developed to provide dentists with three-dimensional images of a patient's bone structure, enabling them to determine more accurately the best size of implant to use.

Nerve injury in the jawbone is also minimised as dentists can better pinpoint the place where the screw will enter.

Aesthetically, conventional implants also produce nicer restoration work.

That said, the choice of mini-implants or conventional ones depends on each patient's specifica- tions, as each has different requirements. Thus, getting a second opinion on an initial diagnosis is ideal.

An NDC spokesman advised: "Successful implant treatment requires a thorough understanding of the individual oral condition of each patient, careful evaluation of the patients' desires, meticulous planning from the assessment of the implant site to the selection of the implant system, and finally the design of the replacement tooth.

"Patients should also be aware that there are alternatives to implant therapy and the dental surgeon should discuss and explore these adequately before the decision-making."

Who is suitable for a tooth implant?

• Patients must be medically healthy and able to undergo minor surgery.

• Patients must not be smokers, have uncontrolled diabetes or an impaired healing capacity. The bone underneath the missing tooth must have enough thickness and height.

• Implants must not encroach on the surrounding nerves.

• Having healthy gums is essential. - TODAY/ar