: This narrative review provides an evidence-based overview of the comparison between mini-dental implants (MDI) and conventional dental implants for definitive prosthesis retention. In addition, recommendations are made on whether the use of reduced diameter dental implants is more appropriate. : A literature review was conducted via electronic search addressing the following topics: (1) osseointegration, (2) peri-implant soft tissue characteristics, (3) biomechanics, (4) implant survival and (5) implant success. : The procedure for dental implant prosthetic rehabilitation should preferentially include conventional dental implants (i.e. [Formula: see text][Formula: see text]mm fixture diameter). Small (3-3.25[Formula: see text]mm) and narrow (3.3-3.5[Formula: see text]mm) dental implants should primarily be used in non-load-bearing regions. MDI ([Formula: see text][Formula: see text]mm) should be considered to retain definitive prosthesis, only for reasons of anatomy or patient-centred preferences and as a last resort. If MDI are to be used, patients should be made aware of the lack of long-term, high-quality evidence as a part of the informed consent process and that most of the prospective data available pertain to MDI retaining complete dentures.
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