What is the Minimally Invasive Implantation Method (MIMI)?

by Dental-Pedia
What is the Minimally Invasive Method of Implantation- MIMI - Dental Implantation

In medicine, minimally invasive generally describes surgical procedures that cause little or no damage to the skin and soft tissues. These surgical methods using the keyhole method, such as those used for heart valve, stent, gallbladder, appendix, and knee joint operations, have long been standard in surgery, as smaller or no incisions lead to less pain after the operation and the patient recovers more quickly and can resume his or her usual daily routine more quickly. 

The minimally invasive implantation method (MIMI) is becoming increasingly popular in implantology as an alternative for conventional implantation methods. The MIMI method has been established for over 25 years and incorporates modern findings in bone physiology and innovative high-quality prosthetics (dental prostheses). In this article, we provide an overview of the minimally invasive implantation method and its advantages. 

What is the Minimally Invasive Method of Implantation - MIMI? 

The Minimally Invasive Method of Implantation (MIMI) is done without incisions and sutures and a treatment time of about 8 to 10 weeks. An implant placement using the MIMI procedure is completed in a few minutes in just one session. Openings of the oral mucosa (gums) are usually not required, which also eliminates the need for sutures and suture removal a week later in another session. 

For you as a patient, implantation according to the MIMI procedure also offers the possibility of using implants even if the bone supply is already very much reduced due to bone loss (atrophy). Specifically, a horizontal bone supply (width) of 3 mm and a vertical supply (height) of 4 mm in the upper jaw and 6 mm in the lower jaw is sufficient for a MIMI implantation. Extensive, expensive, and painful bone augmentation can be dispensed with in many cases. 

This gives prosthesis wearers with removable dentures completely new perspectives, because implant-supported dentures can also be used in cases of bone loss without extensive and painful bone augmentation. 

Before the MIMI Surgery

You will certainly be interested to know how an implantation using the MIMI procedure proceeds. A MIMI implantation is quite unspectacular, and you will hardly feel anything from this short procedure. 

Anamnesis and initial consultation

At the beginning of every treatment, there is always an individual consultation. Your dentist will inform you in detail about implants and other alternative therapies, such as bridges or partial dentures. In the subsequent case history, your dentist will ask about your general illnesses and complaints in the mouth/jaw area to determine whether there are any contraindications that make implant placement unsuitable in general or at the current time. In the treatment room, the dentist will check the neighboring teeth and the antagonist, i.e., the tooth opposite in the other jaw. He will use an X-ray (two-dimensional) and, if necessary, a DVT (three-dimensional X-ray) to assess the condition of the jawbone. This is crucial for the healing and subsequent durability of the implant. 

Preparation before the dental implant surgery

Most implantologists will give your patient an ibuprofen 600 immediately before the the dental implant procedure; other strengths are also possible. For the first few hours after surgery, you should have a pain reliever at home, ideally also ibuprofen, to take as needed. Although the periosteum is not detached or greatly injured during the MIMI procedure, it is stretched by the implant and produces pain. You probably know how sensitive periosteum is from a shin injury - here the periosteum is virtually unprotected under the epidermis and even small injuries are extremely painful.

The doctor decides whether antibiotics are necessary after the operation. Many prescribe amoxicillin/clavulanic acid 875 mg/125 mg. Incidentally, medications containing amoxicillin/clavulanic acid are better tolerated if food is consumed at the same time.

Preparation before the dental implant surgery - MIMI Surgery

During the MIMI Surgery

The dental implant procedure itself takes only a few minutes and is usually performed under local anesthesia. A normal tooth extraction is a more extensive procedure with more possibilities of complications. In most cases, patients operated on MIMI resume their usual rhythm of life the very next day. 

Incidentally, medications containing amoxicillin/clavulanic acid are better tolerated if food is consumed at the same time. 
After anesthesia, without systematic opening of the gums, a small-sized bone shaft is drilled, through which the slightly conical implant is condensed with controlled force. Since the diameter of the implant is larger than the hole, the surrounding peri-implant bone is laterally compacted and the implant is firmly attached to the bone virtually from the start. The technical term for this is "primary stable”. 

After the MIMI Implantation - minimally invasive dental implant surgery

After the MIMI Implantation 

After the MIMI implantation, you should take it easy for the rest of the day. Take the painkillers and, if necessary, antibiotics, as prescribed and instructed by your dentist. However, you can usually resume your daily routine the very next day. 

Dental Implants are placed with primary stability 

Implants are not yet firm because they have not yet grown in. As with all titanium and ceramic implants, the strength initially decreases over the next 3 weeks. By day 21, stability drops to about 40% of what it was immediately after implant placement. Only after about 3 months is the implant fully ingrown and can be loaded like a real tooth. This is the case with every implant and is related to bone remodeling, which constantly ensures renewal of the bone substance. 

Do not overload the implant 

In the first 8 weeks after implantation, your assistance is particularly important for successful ingrowth. Implants should never be loaded laterally. Axial loads in the longitudinal direction (towards the jawbone), on the other hand, have no negative influence on ingrowth
Please note that depending on the implant placed, a post of up to approx. 8 mm may protrude from the mucosa. You should not play with it with your tongue or even press against it from the side, as this can lead to loosening of the implant. 

Frequently Asked Questions about MIMI

Is the insertion of an implant painful? 

No! The vast majority of MIMI patients report a completely painless treatment. Swelling and severe pain, which can last for several days after the procedure, as is known from conventional implant procedures, are practically non-existent with MIMI and most patients can resume their normal daily routine the following day. Taking antibiotics for several days is prescribed by your dental practice. 

How long does it take to insert an implant? 

The actual insertion takes only a few minutes per implant. You know the local anesthesia from other normal dental treatments, such as fillings, root canal treatments, or the removal of teeth. Immediately afterwards, or sometimes weeks later, impressions of the oral situation are taken for the tooth replacement. In order to show the public that high-quality premium implants can be placed in any practice without much technical effort, the developer of the MIMI system implanted two patients in a normal commercial aircraft - it is not necessary to turn the treatment room into a sterile operating room for a minimally invasive insertion. In the case of a tooth extraction, the opening might be many times larger than the hole in the MIMI procedure. 

Does the health insurance cover the costs of a dental implant? 

The statutory health insurance companies pay a fixed allowance per tooth gap, so you receive the same allowance for an implant restoration as for a bridge or denture restoration. For privately insured persons, the subsidy depends on your chosen tariff. However, many dentists offer instalment options, so sometimes a dental implant including a crown doesn't cost much more than a cell phone plan, but it significantly improves your quality of life. 

What is the lifespan of implants? 

An implant is designed to last your lifetime. Regular prophylaxis sessions and follow-up visits to your practice (2-3/year) are recommended. Should the denture or the dental crown ever become damaged, it can be easily repaired or replaced. 

How safe is the MIMI procedure? 

The procedure has been established and scientifically validated for over 30 years - countless international studies prove this. Your dental practice can provide you with an overview of the current studies if you are interested. 

When is the best time for implantation? 

If you have to have a tooth extracted, the optimal time for implantation is often immediately in the same session as the extraction! This means that you only receive a local anaesthetic, save yourself a second appointment months later, and do not leave the dental practice with a gap between your teeth, but with a temporary denture over the implant. The finished denture can be inserted just 2-4 months later. From a medical point of view, there is a lot to be said for so-called immediate implantation. It is almost the only way to ensure that both hard and soft tissue are kept in place as they were at the time of extraction. The longer one waits after an extraction until the implant is inserted, the more the bone degrades. 

Up to what age can dental implants be placed? 

Radio, television, and print media reported extensively on Germany's oldest implant patient, Gerda B., from Munich, who had her prosthesis fixed with four implants in just 20 minutes in 2012 at the age of 99. Since the procedure was minimally invasive according to the MIMI protocol, the stress for Mrs. B. was also minimal. Only you decide up to what age you would like to enjoy your life without worries - from the implantological point of view, there are no upper restrictions, only lower ones. Before the completion of bone growth (16 to 18 years of age), the indication is rather limited.

Why is a smaller amount of bone sufficient with MIMI than with the conventional procedure? 

With the minimally invasive method of Implantation- MIMI you work with nature and not against it! With KIV, the conventional implantology procedure, only cylindrical drills are used, which extract relatively extensive bone material. The MIMI procedure, on the other hand, is completely different: here, conical triangular drills are used, even or especially with narrow jawbones, which compress the bone laterally and remove very little bone substance.

What materials are used for dental implants and can an implant be rejected by the body? 

Titanium grade 4 (99% titanium content, cold-formed and therefore more stable than titanium grade 4) is considered to be biocompatible without any known body defence reactions, which is why many implants are made of this material. If titanium intolerance is suspected, any general practitioner can send blood samples to special diagnostic laboratories (e.g. www.imd-berlin.de). Ceramic implants are available as an alternative to titanium implants. Your dental team will be happy to advise you whether these implants are indicated for you. 

Is it necessary to replace every single lost tooth with an implant? 

Nature has provided 18 roots for 14 teeth in the lower jaw and 22 roots in the upper jaw (not counting the wisdom teeth). An implant is an artificial tooth root and every implantologist should try to replace every missing tooth with an implant. The consensus conference on implantology (Professional Association of Oral Surgeons (BDO), Federal Association of Implant Dentists in Europe (BDIZ EDI), German Society for Oral and Maxillofacial Surgery (DGMKG), German Society for Dental, Oral and Maxillofacial Implantology (DGI), German Society for Dental Implantology (DGZI) clearly recommends that every tooth should be fitted with an implant.

The minimum number is...

In the upper jaw for a fixed restoration: 8 abutments
In the upper jaw for a removable denture: 6 abutments
In the lower jaw for a fixed denture: 6 abutments
In the lower jaw for a removable denture: 4 abutments
However, in the case of a so-called locator restoration for removable dentures, practice has shown that half of these abutments can be sufficient.

Is a three-dimensional X-ray image (DVT, 3D X-ray) required for every dental implantation? 

A 3D X-ray (DVT) is now listed by many implantologists as a basic requirement for implant placement. Various reasons are cited for this, including a more accurate treatment and cost plan (HKP) or a prerequisite for minimally invasive implantation, as this is the only way to accurately depict the hard and soft tissue structures. But reality shows that this is not the case.The 3D image is calculated by computer from a large number of 2D projections created by a circulating projector and receptor. Each manufacturer uses its own algorithms for this, which lead to different results, as the devices allow parameters such as mAs, KV, voxel size, number of frames to be changed, the exact effects of which are unclear to many operators. Specific protocols for defined indications, which currently do not exist, would be very helpful. Depending on the setting of these parameters, the DVT can turn out very differently and is therefore unsuitable as an exact diagnostic. 

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