Very small diameter (1.8–3.3 mm) dental implants may be successfully used to support fixed partial dentures in edentulous sites of compromised bone width or length. Very small implants can be successfully used in highly selected sites where there is adequate bone density and bone volume for immediate implant stability. Adequate or augmentable attached gingiva may be a requirement. A small diameter implant presents less of an obstacle for angiogenesis and there is less percutaneous exposure and bone displacement as compared with standard sized implants. In posterior sites, rounded and narrow prosthetic teeth present small occlusal tables to minimize axial and off-axial directed forces. Multiple splinted implants may be necessary to minimize metal fatigue from cyclic loading. Anterior restorations supported by mini implants may need occlusal relief to minimize the effects of cyclic loading.