Abstract
This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: -0.05; 95%CI: -0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.
Highlights
Dental implants are considered an option for oral rehabilitation, in the posterior maxillary region.[1]
Studies meeting at least one of the following criteria were excluded: a. animal studies; b. in vitro studies; c. case series or case reports; d. retrospective studies; e. patients or data repeated in other articles included; f. computer simulations; g. studies that presented only short implants without a comparison group; h. studies that considered short implants longer than 8.5 mm; and i. studies with short implants associated with maxillary sinus augmentation technique
Search The following question was elaborated for the PICO process: Do short posterior maxillary implants exhibit the same clinical predictability as long implants placed after maxillary sinus augmentation? The population (P) was patients rehabilitated with dental implants in the posterior maxilla; the intervention (I) was short implant (≤ 8.5 mm) placement; the comparison (C) was long implant (> 8.5 mm) placement after maxillary sinus augmentation; and the outcomes (O) were the survival rate of implants, amount of marginal bone loss, and biological and prosthetic complication rates
Summary
Dental implants are considered an option for oral rehabilitation, in the posterior maxillary region.[1] it is not possible to place dental implants with an adequate length in some clinical situations, primarily due to the lack of sufficient bone.[2] One option to overcome this limitation is using short implants.[3] Another option is augmentation of the bone height through techniques such as maxillary sinus augmentation with or without bone grafting, which enables long implant placement.[4]
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