Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis.

Vittorio Moraschini,Carlos Fernando De Almeida Barros Mourão,Daniel Costa Ferreira De Almeida,Kayvon Javid,Ingrid Chaves Cavalcante Kischinhevsky,Pietro Montemezzi,Jamil Awad Shibli,Monica Diuana Calasans-Maia,José Mauro Granjeiro

doi:10.3390/healthcare9030315

Abstract

This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration’s tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.

Highlights

Osseointegration has proved to be predictable in implant dentistry, but some clinical challenges demand treatment alternatives with predictability and low morbidity [1,2,3,4]
Focused Question What are the clinical outcomes of extra-short 4 mm dental implants?
This study evaluated the null hypothesis that there were no differences in clinical outcomes between extra-short 4 mm dental implants and longer implants (>8 mm)

Summary

Introduction

Osseointegration has proved to be predictable in implant dentistry, but some clinical challenges demand treatment alternatives with predictability and low morbidity [1,2,3,4]. The literature reports that bone regeneration with autogenous onlay grafts, guided bone regeneration, and bone distraction are viable options to treat bone resorption [7,8,9,10,11] Such techniques have associated disadvantages such as morbidity, the need for multiple procedures, a high cost, patient acceptance, and a significant incidence of postoperative complications [12,13,14,15,16,17]. A recent systematic review (SR) evaluated the effectiveness of extra-short implants (5 and 6 mm in length) They concluded that this alternative is feasible in ridges exhibiting atrophy, demonstrating a satisfactory survival rate, as well as a low rate of prosthetic and biologic complications across to a five-year follow-up [23]

Methods

Results

Discussion

Conclusion