Mini Implants

I recently received a question on mini implants and let me take this opportunity to highlight one of the many differences between mini and standard implants.
The patient had mini implants placed in his front lower jaw recently. A bridge was constructed and the patient felt uncomfortable because the bridge seemed to be pushing against his tongue. What could be the cause for this problem?
I have not seen the patient, but I would guess that the implants were placed quite far back on the ridge of his lower jaw due to the lack of bone. Of course, with standard implants, the dentist would need to do the same. However, most standard implants come in 2 pieces - the implant/fixture and the abutment while mini implants always come in one piece. The abutment is part of the fixture.

When a standard implant is not placed in ideal position - for instance it’s placed close to the tongue, an angled or slanted abutment can be connected to correct the inclination. With most mini implant systems, this is not possible as the abutment is always in line with the fixture.
Patients who opt for mini implants in situations where ideal implant placement is difficult or impossible are putting themselves at risk of an uncomfortable, non-functioning or unaesthetic restoration.
Having said that, I do use some “mini implants” myself. However, these implants are not that mini. The smallest I would use is a 2.5mm diameter implant. Normally, I would go for the 3.1mm which is hardly a mini implant. The advantage of the system I’m using is that the abutment can be bent into position if the fixture is not in an ideal alignment.

This simulates the use of an angled or slanted abutment to correct any alignment issues. Do bear in mind that all mini implants and standard implants that come in one fixture/abutment unit cannot have their alignment corrected after placement.