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MIMI®-Flapless - Minimally Invasive Method of Implantation

The periosteum-preserving Minimally Invasive Method of Implantation (MIMI®-Flapless), which is the method we prefer to apply, is not in contradiction with the conventional implantation method, but it compensates it.
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Minimally Invasive Method of Implantation- the MIMI® Insertion Protocol

Based on current findings on bone physiology, the MIMI® insertion protocol is a minimally invasive dental implantation procedure without incisions and sutures. In fact, the dogma of "healing by resting" has been refuted. As a matter of fact, bone needs loading, which increases bone mass, while inactivity or healing by resting causes bone mass loss. In addition, MIMI® differs from other insertion protocols in other aspects. Using CNIP-Navigation, drilling is performed at very low speed in the cortical bone and in the spongy bone, which avoids bone jaw perforation. CNIP in a sagittal/horizontal position can be compared with an endodontic treatment involving a manual preparation of the root canal, avoiding canal perforation. Like a treatment of a less dense nerve canal, for performing a cavity the Conical Triangular Drills are guided through the cortical bone (dense buccal and oral exterior walls) and allow in depth preparation of the spongy bone.

Conical Triangular Drills

With MIMI® insertion protocol, the Conical Triangular Drills allow bone to be removed and also "laterally condensed".
Champions-Implants recommends that you should drill at a maximum rotation speed of 250 min-1 in the cortical bone and at 70 min-1 max. in the spongy bone.

MIMI® Is Not Blind Work.

Dr. Armin Nedjat, the developer of Champions® implants, was focusing on minimally invasive insertion protocols and developed the standardized MIMI® procedure. For the last 15  years, this method has not only proven its worth in Germany but also in other countries in Europe as well as e.g. the United States and Asia.

You can find frequently asked questions on MIMI below:

1. What is the difference between MIMI® and the conventional implantation method?

"MIMI", the minimally invasive insertion protocol, is performed without raising a mucoperiosteal flap, without incisions, and without sutures. Drilling is performed with Conical Triangular Drills. Contrary to other insertion protocols, MIMI only requires 2 instead of 5 or 6 sessions.

Patients treated with MIMI® usually can resume their daily activities the next day. Without pain and swelling - because using MIMI®, the periosteum is protected to the maximum during surgical as well as during prosthetic procedures. In 98% of the cases, surgery requires neither an exposure of the implant nor a reopening of the gingiva. Immediately after implantation, you perform a "closed impression", same as for a dental preparation. Besides saving surgery sessions and time, do not forget the benefits for the patient: the patient practically does not feel any pain and in most cases, the final denture is done only 8–10 weeks after implantation. If the implant is immediately loaded, the final denture is done on the same day or only few days after implantation.

THE MIMI®-FLAPLESS ADVANTAGES AT A GLANCE:

  • Minimally Invasive Method of Implantation (MIMI®-Flapless)
  • No mucoperiosteal flap during surgery
  • No implant exposure
  • No subgingival impression for dentures

MIMI®-Flapless: die sanfte, „unblutige” Implantation MIMI®-Flapless: ohne Schmerzen und Schwellungen MIMI®-Flapless: maximal Periost-schonend MIMI®-Flapless: in rund 98 % keine Implantat-Freilegung oder Wiedereröffnung der Gingiva MIMI®-Flapless: enormer Zeitgewinn MIMI®-Flapless: keine Schmerzen und die Prothetik ist nach 8-10 Wochen definitiv eingesetzt

2. Does flapless surgery require a cone beam, planning software, and a 3D-drilling template?

A pre-operative cone beam is not necessary. It is not recommended that you should plan the length and diameter of an implant by means of a cone beam. Planning with a cone beam can lead to deviations of several millimeters between the planned and actually placed implant, leading to an incorrect evaluation. In addition, exposure to radiation is higher with a cone beam than with an OPTG or a dental film.

In my view a cone beam just for making drilling templates is contraindicated. You only need drilling templates with other implant systems when drilling at 400 min-1 or more with twist drills in the spongy bone.

In addition, serious studies are talking clear: a drilling template does not ensure a reliable treatment. It is the opposite: you don’t really see your surgical site, and you fully rely on the lab, which has manufactured this template.

For MIMI®-Flapless you do not need a planning software because one thing is fact: "the diameter of the implant that is to be placed is not determined by the width of the alveolar ridge, but instead by the primary stability of the intra-operatively inserted condensers!" Scientific studies have already confirmed this!

MIMI®-Flapless: DVT-Aufnahme nicht zwingend notwendig MIMI®-Flapless: Empfehlung ohne Bohrschablone MIMI®-Flapless: Eine Bohrschablone bietet weder dem Behandler noch dem Patienten mehr Sicherheit MIMI®-Flapless: Planungs-Software nicht empfehlenswert

3. Can you often avoid augmentations if you perform implantation using MIMI®-Flapless?

Yes, since more and more short implants (from a length of 6 mm) can be placed in the vertical dimension. With the MIMI®-Flapless II method (developed and performed by Dr. Ernst Fuchs-Schaller 1996), you can treat narrow alveolar ridges in the horizontal dimension. Statistical research has shown that the success rate is the same as for long implants. In addition, with less complications and resorptions, MIMI®-Flapless II does not require as many sessions and possible complications such as ineffective bone augmentations.

Durch das MIMI®-Flapless-Verfahren kann man vielfach auf Augmentationen verzichten

4. How long should you wait after a dental extraction until the bone is regenerated and you can place an implant?

From a medical-physiological and a patient-psychological point of view: 2–5 minutes after dental extraction!

The best moment for an implantation is right after the dental extraction! That is why the phrase “I don’t have many potential patients for implants” is not up-to-date anymore! To us as MIMI®-users science has proofed to be a success, based on studies:
“Immediate implantation is the method of choice to preserve the structure of hard and soft tissues!” Usually, patients are happy when they can choose the therapy themselves.

From a forensic point of view, patients should have enough time to take their decision, but you should at least offer them this solution. Immediate implantation (dental extraction and implantation in just one session) is not only a big chance for our clinics, but it has also proven to be beneficial for our patients too:
just one local anesthesia and only one surgery session! From a psychological point of view, it seems to be important for the patient: Get rid of the “sick tooth” and immediately get a “healthy root”!

MIMI®-Flapless: Implantation gleich im Anschluss an eine Zahnextraktion MIMI®-Flapless: Sofortimplantation das Mittel der Wahl MIMI®-Flapless: Riesen-Chance Sofortimplantation MIMI®-Flapless: Sofortimplantation maximal schonend MIMI®-Flapless Sofortimplantation: „Kranker Zahn raus, gesunde Wurzel rein”

5. I have never placed an implant before, but I would really like to start with MIMI®-Flapless implantation. What can I do?

For acquiring skills in the "MIMI" minimally invasive insertion protocol, we offer an Implantology continuing education course in the Future Dental Academy in Flonheim, Germany, as well as the CITC-Curriculum of the VIP-ZM, an intensive Implantology continuing education course. This practically oriented Curriculum includes 2 theory blocks and at least 5 implantations that you can perform on your patient under supervision of an experienced implantologist in your dental office.

For further information, click on these links:
(here links to VIP-Curriculum http://www.curriculum.vip-zm.de/ and to Academy https://future-dental-academy.com/en/courses/)

6. I am afraid to perforate the bone because I don’t see it directly! Is MIMI®-Flapless a "blind" procedure?

No, it is not a “blind” procedure because we palpate and check the bone cavity in all dimensions (“BCC”: Bone Cavity Check) with a thin and flexible periodontal probe after each step – and like during an endodontic treatment you feel the bone “with your fingers”: when you extract a tooth during an endodontic treatment, you don’t really see the tooth roots either, but you feel them “digitally” (with your fingers).

It is important to say that you drill in spongy bone at a rotation speed of only about 70 min-1 (instead of 400 to 1,500 min-1 with cylindrical drills, usually done with the conventional method)! So again, like with an endodontic treatment, very slowly! We understand the conical triangular drills, the condensers, and the implant itself as “osteotomes” that allow bone to be condensed gently and controlled. In addition, the conical triangular drills are, used with low speed, always “navigated” within the spongy bone, with the help of the buccal and lingual cortical bone.

Bei MIMI®-Flapless arbeitet man niemals blind Bei MIMI®-Flapless wird in der Spongiosa der Knochen nur mit ca. 70 U/Min aufbereitet Bei MIMI®-Flapless verliert man niemals das Gefühl für den Knochen

7. When performing a delayed implantation, isn’t there a danger of epithelial cells being transported into the bone cavity because of the transgingival drilling and implantation, causing connective tissue healing around the implant?

Also this thesis, out of the stone age of Implantology, has not proven to be true. If epithelial cells are not nourished, they will not live long. In fact, osteosynthesis and bone remodeling are not adversely affected. In addition, conical triangular drills have the positive feature to limit the penetration of elements into the bone cavity.

A connective tissue encapsulation around the implants is rather caused by lateral micro- and macro-movements of the implants, during the weeks 2–8 after implantation, which can lead to an implant loss.

MIMI®-Flapless: Eine Osteosynthese oder ein Knochenumbau werden nicht negativ beeinflusst MIMI®-Flapless: konische Dreikant-Bohrer haben die positive Eigenschaft, faktisch nichts in die Knochen-Kavität hineinbringen zu können

8. Which equipment is necessary, in the dental office, to start with MIMI®-Flapless implantation and Champions® implants?

Actually you only need a green handpiece, controllable and connected to your treatment unit, leaving enough passage. An OPG might also be useful, but to help you out, a dentist colleague of yours or an orthodontist near to you might also be able to perform an OPG for your planning. In your dental office you do not need a surgical device, water cooling, a Piezo tool, or a cone beam.

9. How long and by how many dentist colleagues has MIMI®-Flapless been used?

MIMI®-FLAPLESS HAS BEEN USED IN GERMANY FOR ABOUT 25 YEARS!

Since 1994, I have been specialized in Implant Dentistry and prosthodontic work. Until now, I have inserted more than 22,000 implants using MIMI®-Flapless. From 2001 to 2006, I developed the Champions® implant system, inspired by different dental implants systems I knew. Meanwhile, Champions® implants have been successfully placed in more than 4,000 clinics/dental offices in about 40 countries.

“NICHTS IST BESTÄNDIGER ALS DER WANDEL!” (NOTHING IS MORE CONSTANT THAN CHANGE)

Where some people stop, others continue! I am sure that the MIMI®-Flapless procedure will become the “gold standard” in Implantology! For the well-being of our patients.

10. Do the statutory and private health insurances and allowances cover a MIMI®-Flapless treatment? How does the dentist account for the treatment costs?

In fact, the MIMI®-Flapless treatment is less costly than the conventional treatment, for the patient and the dentist. It is the result that counts!

You can charge insurance for the costs of the MIMI®-Flapless implantation in the same way as for the costs of a conventional implantation with flap. You can also charge the surgery costs for bone spreading and an indirect sinus lift (valid for Germany – other countries may vary).

Note: rarely, some private health insurances confuse the MIMI® method with the “Mini” implants (with a small diameter). However, this has already been explained to them.

Since MIMI®-Flapless with Champions® is cost-efficient, more patients can now afford an implant treatment, and almost twice as many cases are treated per year.