Short Implants Research Articles

Clinical Evaluation of Stability of Short Deep Threaded Dental Implant During Early Healing Period: A Prospective Controlled Clinical Trial

Objectives: To assess the initial stability of short, deep-threaded dental implants placed in the posterior mandible and to determine the influence of deep-thread design on implant stability during early healing. Methods: Twenty short, deep-threaded implants were placed in the posterior mandibular region of ten patients. Insertion torque value (ITV) was recorded at implant placement. Implant stability quotient (ISQ) was measured immediately post-surgery and at weeks 2, 3, 4, and 5. Results: No significant difference in ITV was observed between short and standard implants. ISQ values did not significantly differ between implant types across the evaluation period (F = 1.17, p = 0.3). Conclusion; Short, deep-threaded implants demonstrate comparable primary stability to standard implants in the posterior mandible. These findings support their use as a viable treatment option for patients with advanced alveolar ridge resorption

Nonlinear Finite Element Analysis of Bone–Implant Contact in Three Short Dental Implant Models with Varying Osseointegration Percentages

Objectives: Dental implants have become a cornerstone of restorative dentistry, providing a long-lasting method for tooth replacement. The degree of osseointegration has a significant effect on biomechanical stability at the bone–implant contact (BIC), determining the continued efficacy of these implants. However, the exact consequences of changing osseointegration levels on different implant designs, especially in bones with variable densities, are not well known. Methods: This study used 3D finite element analysis (FEA) to look at the biomechanical performance of three short dental implants: BioMet 3iT3, Straumann® Standard Plus Short-Regular Neck (SPS-RN), and Straumann® Standard Plus Short-Wide Neck (SPS-WN). This paper tested the implants at four stages of osseointegration: 25%, 50%, 75%, and 100% in both high-density (bone type III) and low-density (bone type IV) cancellous bone. It also created and examined realistic CAD models under static occlusal loading conditions to assess stress distribution and major strains at the bone–implant contact. Results: The study discovered that as osseointegration increases, von Mises stress and principal strains go down significantly for all implant types. The SPS-WN implant had the lowest strain values, especially for bone with low density. These reductions demonstrate increased mechanical stability as the bone–implant interface becomes more capable of dispersing mechanical stresses, minimizing the potential for localized deformation and bone resorption. Conclusions: The results highlight the importance of achieving optimum osseointegration to reduce mechanical stress and increase the lifespan of dental implants. The SPS-WN type implant performed better in biomechanical tests than the others, especially when bone conditions were not ideal. This makes it a great choice for clinical applications that need long-term implant success.

Dimensions of Posterior Implant Restorations Related to Intra-Coronal Cantilever and Occlusal Forces: An In Vitro Study.

The aim of the present study was to investigate the relation of the implant position to the implant crown and analyze the location and magnitude of bite force. The dimensions of 49 posterior implant-supported restorations were recorded in terms of: 1. implant diameter, 2. crown length, 3. crown width, 4. crown height, 5. occlusal surface of the restoration. The crown/implant height was measured and the distance between the implant center and the restoration center revealed the size of intra-coronal cantilevers. The occlusal force analysis determined the point and magnitude of loading. Correlation coefficient r was used for the statistical process and statistical control was carried out with the aid of t-test with minimum level of significance p < 0.05. - The mean crown-to-implant ratio was 0.9 and in short implants (< 10mm) the ratio was 1.28. - Intra-coronal cantilever extensions ranged from 2.1 mm to 6.35 mm depending on crown size. - Occlusal loading was identified in cantilever areas of the crown. - Implant center deviates from crown center in 71%-82% of the cases depending on site location. - Implants with non-ideal position may support a functionally occluding crown. Intra-coronal cantilevers are a critical factor to avoid clinical complications and should be taken under consideration both in the planning and fabrication phase of implant restorations.

Short implant versus conventional implant in the posterior atrophic maxilla: A systematic review and meta-analysis

Objective: A comparative study undertaken to measure the the marginal bone loss (MBL), implant survival rate, and prosthetic and biological complications among short implants (8 mm or shorter) and conventional implants (longer than 8 mm) in the posterior atrophic maxilla. Materials and Methods: A search in three databases PubMed (Medline), Scopus, and Cochrane was conducted. The present systematic review was registered with identification number CRD42020212805 at the International Prospective Register of Systematic Reviews. Data extraction included the publication year, patients’ number and number of implants, implant length and width, MBL, implant survival rate, and biological and mechanical complications. The Cochrane Risk of Bias 1.0 tool was used to assess the risk of bias. A meta-analysis was performed to evaluate the outcome variables. Comparisons for dichotomous variables, such as prosthetic and biological complications and implant survival rate, were done by applying the Mantel–Haenszel method. In contrast, a comparison was made by applying the inverse variance method for continuous variables like MBL. Results: Initially, 618 reports were recognized from electronic database searches. Five randomized controlled trials (RCTs) were included in the meta-analyses regarding the MBL, implant survival rate, and prosthetic complications, while three were included for biological complications. In 5 years of follow-up, no evidence of difference could be found between conventional and short implants for survival rate (risk ratio [RR]: 3.54; 95% confidence interval [CI]: 0.99–12.67; P = 0.05; I 2 = 0%). We do not find any evidence of difference for MBL between short implants and conventional implants (mean difference: −0.29; 95% CI: −0.49 to −0.08; P = 0.02; I 2 = 65%). Furthermore, no evidence of a difference exists between short and conventional implants for prosthetic complications (RR: 1.56; 95% CI: 0.68–3.55; P = 0.29; I 2 = 0%). The biological complications were seen less with short implants (RR: 0.47; 95% CI: 0.24–0.93; P = 0.03; I 2 = 0%). Conclusion: The results suggest no significant difference among conventional and short implants regarding survival rate in the posterior atrophic maxilla. The results of this systematic review and meta-analysis suggest that, for a 5-year period of follow-up, short implants are related to rarer biological complications and comparable MBL compared to conventional implants. Despite these promising findings, long-term studies with consistent study designs and clinical protocols are required to appraise the performance and durability of short implants.

Characteristics and impacts of dental implant displacement into the maxillary sinus

Background/purposeDental implants displaced into the maxillary sinus are considered to require surgical removal as the treatment of choice. However, displaced implants have been reported to affect the maxillary sinus in different ways. This study aimed to evaluate characteristics and impacts of dental implant displacement into the maxillary sinus. Materials and methodsFourteen sinuses with displaced implants into the maxillary sinus were included. Demographic data and radiographic images were analyzed, with a focus on the impact of various factors such as demographic data, timing of displacement, duration of retention, and residual bone height on maxillary sinus opacification and sinus wall thickness. ResultsImplants were displaced during or in the early stage after implant placement in 9 cases and after functional loading in 5 cases. Radiographic evaluations showed higher sinus opacification score (P = 0.019) and increased wall thickness (P = 0.198) in cases with displacement after functional loading, although the difference in wall thickness was not statistically significant. When the duration of implant retention in the sinus was longer, higher sinus opacification and sinus wall thickness were observed, although the differences were not statistically significant. Univariate regression analysis demonstrated that the timing of displacement significantly influenced maxillary sinus opacification (P = 0.013) and sinus wall thickness (P = 0.013). For all cases, evidence of site preparation and the use of short implants were not observed. ConclusionThis study suggests that adequate pre-implant site preparation and timely intervention are essential to prevent and manage implant displacement into the maxillary sinus.

Evaluation of the Peri-Implant Tissues of Patients with Severe Bone Atrophy Treated with a New Short and Extra-Short Implant System-A Pilot Study.

This study aimed to assess clinical and radiographic outcomes, including implant survival, marginal bone loss, and patient satisfaction, in individuals with severe bone atrophy treated using a newly developed system of short and extra-short implants. A total of 44 implants (37 short and 7 extra-short) were placed with immediate loading in 11 patients. The patients were followed up at between 6 and 24 months. Bone changes, keratinized mucosa, bleeding on probing, probing depth, crown-to-implant ratio, and patient satisfaction were evaluated. An implant survival and success rate of 100% was observed. The peri-implant bone condition showed no significant associations between marginal bone loss (MBL) and gingival recession. In extra-short implants, the crown-to-implant ratio did not affect MBL in the evaluated times. However, short implants showed a statistically significant inverse correlation between mesial measurement and crown-to-implant ratio (p = 0.006) and between distal measurement and crown-to-implant ratio (p = 0.004) over six months. Plaque was present in the mesiobuccal regions in 38.64% of the implants, with extra-short implants having the highest relative frequency (71.4%). Bleeding was observed in 18.9% of the short implants in the mesiolingual region and 14.3% of the extra-short implants. There was a statistically significant association between bleeding on probing in the mesiobuccal region and the type of implant (p = 0.026). The analysis of probing depth showed no difference between the types of implants. Within the limits of this study, short and extra-short implants presented similar clinical and radiographic behavior of soft and hard tissues in the evaluated times.

Immediate versus conventional loading in short and ultra-short implants: a protocol design.

After tooth extraction, inevitable resorption of the postextraction socket occurs. Placing an immediate implant does not fully preserve the bone integrity of the socket. Preservation techniques cannot avoid alveolar resorption. In residual atrophies, bone augmentation techniques are necessary for subsequent rehabilitation with implants. The aim of this study was to propose a protocol of immediate loading in short implants as an alternative to bone augmentation techniques, comparing the immediate versus conventional loading, evaluating peri-implant bone loss, the biological and prosthetic complications, the survival of the implant and prosthesis and the patient satisfaction after one year. This study consists of a randomized controlled clinical trial. For implant planning, periapical intraoral radiographs and Cone Beam Computed Tomography will be used. All patients will receive Straumann Group® (Basel, Switzerland) titanium-zirconia implants with a 4.1mm or 4.8mm diameter and a 4 mm or 6 mm length. The expected results show similar or even minor bone loss, biological and prosthetic complications, identical or even better survival of the short implants with immediate loading, and greater satisfaction. Short implants demonstrate similar survival to conventional length implants, with comparable or even minor biological and prosthetic complications and bone loss. Immediate loading gives satisfactory results similar to conventional loading, with similar biological and prosthetic complications, and generally depends on poor hygiene levels. Bone loss is even less, and the satisfaction increases.

Evaluating the Feasibility of Short Dental Implants as Alternatives to Long Dental Implants in Mandibular Bone: A Finite Element Study.

This study uses finite element analysis to investigate the potential application of shorter dental implants as a substitute for longer implants in the lower jaw (mandible). FEA allows the evaluation of the stress patterns around the implant-bone interface, a critical factor for successful osseointegration. Ten models were generated, encompassing five long (L1-L5) and five short implant models (S1-S5) with variations in diameter and length. Hypermesh software was utilized to meticulously prepare the FEA models, ensuring accurate mesh generation. The FEA simulations were conducted under four distinct loading scenarios (100 N occlusal load, 40 N lateral load, 100 N oblique at 30°, and 100 N oblique at 45°) to realistically mimic the forces exerted during biting, using an ABAQUS CAE solver. The results revealed that the von Mises stress generated within the short implant models was demonstrably lower compared to their long implants. Additionally, a significant drop in stress was observed with increasing the diameter of the short implants, to a certain diameter range. These findings suggest the potential for successful substitution of long implant model L4 with short implant model S4 due to the demonstrably lower stress values achieved. Furthermore, the data indicates the possibility of utilizing short implant models S3 and S5 as alternatives to long implant models L3 and L5, respectively. These observations hold significant promise for evaluating the feasibility of replacing long implants with shorter variants, potentially leading to a reduction in implant-related failures.

On the Concerning Early Failure of a Short Stem Press-Fit Humeral Component

IntroductionAnatomic total shoulder arthroplasty (TSA) is a common surgical intervention for various shoulder pathologies, predominantly glenohumeral osteoarthritis. While generally considered safe and effective, complications remain a challenge. Short stem implants, aim to preserve bone stock and reduce complications. However, concerns about a specific short stem implant (Univers Apex; Arthrex, Naples, FL, USA) have surfaced due to high reported rates relatively early aseptic loosening. MethodsThis retrospective study analyzed 116 consecutive TSA patients with Univers Apex implants from 2004 to 2022. 15 revision cases were assessed for radiographic loosening, and explanted implants were examined for damage using a 0-3 scale. Histopathological analysis evaluated cellular responses to wear debris. ResultsOf the patients, 13% (15/116) required revision at 23.2 months on average. A distinct radiographic loosening pattern was identified, with humeral component subsidence and thinning of the proximal humeral cortex. Histopathology revealed a robust inflammatory response to wear debris, with a potential association between macrophage infiltration, hinge damage, and polyethylene wear. ConclusionThis study reveals a notable rate of early aseptic humeral loosening with the Univers Apex short stem implant, emphasizing concerns raised in previous reports and providing a potential explanation for the high rate of early failure. Surgeons should exercise caution and closely monitor patients with this implant design.

Influence of Crown Height and Width on Marginal Bone Loss and Long-Term Stability of Dental Implants: A Systematic Review.

Still, a major focus of research in implantology is how crown height and width affect marginal bone loss (MBL) and the long-term durability of dental implants. Maximizing the success of implants and lowering problems depends on an awareness of these elements. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, this systematic review searched pertinent studies across several databases using keywords unique to databases. Studies on MBL and long-term implant stability evaluated in the review included those on crown height and width, horizontal and vertical cantilevers, and prosthesis dimensions. In the chosen studies, we found that both implant success and crestal bone loss were greatly influenced by crown height and width. Particularly in the posterior sections, horizontal cantilevers were connected to both increasing MBL and mechanical problems. Vertical cantilevers also affected MBL; however, their impacts were more obvious in circumstances with greater crown heights. Greater prosthesis widths, especially in the mandibular molar area, were linked to higher MBL. Bone density and insertion torque (IT) were the main determinants of MBL, more than the primary implant stability quotient. Early MBL was influenced by abutment height, mucosal thickness, and implant insertion depth; bone levels stabilized six months later. Short implants allow single crowns to be supported, but in some cases, a higher failure rate was seen. The success and stability of dental implants were found to be mostly dependent on crown height, width, and cantilever design. MBL and long-term stability are greatly influenced by horizontal and vertical cantilevers, which calls for careful design and planning. With specific care for bone density, IT, and early MBL stabilization, both short and standard implants can produce equivalent results. These results highlight the need for customized treatment plans to maximize implant success and lifetime.

Clinical outcomes of short dental implants supporting prostheses in the posterior region.

Aim In clinically challenging scenarios with limited bone height and anatomical restrictions, the use of short implants have been proposed as a potential treatment strategy. The purpose of this retrospective study was to evaluate the clinical outcomes of short implants supporting prostheses in the posterior premolar region of the maxilla and mandible.Materials and methods A total of 30 patients requiring short 6 mm length implant placement in the posterior premolar region were included. Following a period of osseointegration, the implants were restored with either single crowns, fixed bridges or implant-supported removable overdentures. Implant and prosthetic survival with technical complications were recorded.Results In total, 45 implants were placed, with four failures reported before loading in two patients, resulting in a patient implant survival rate of 93.3% over the two-year follow-up. There was no statistically significant difference found between implant failure and arch placement. Prosthetic survival was 100% and minor technical complications recorded were low.Conclusion This study showed that short 6 mm implants could provide a viable treatment option, with high survival rates comparable with alternative bone augmentation procedures. Further research with longer observation periods would be required to validate these current findings.

Fracture strength of poly ether ether ketone abutment over short implant after fatigue

Abstract Background Poly ether ether ketone (PEEK) crowns and abutments can be used to fabricate esthetic and stable implant supported single tooth abutment and short implants can be used to avoid problems and contraindication of standard implants. The aim of this work was to evaluate fracture strength of PEEK abutment over short implant after fatigue. Methods This experimental laboratory study was carried out on 40 implants. Implants were categorized into two equal groups: group I: short implants which subdivided into two equal groups (group IA: PEEK abutments and group IB: Titanium abutments), and group II: standard implants which subdivided into two equal groups (group IIA: PEEK abutments and group IIB: Titanium abutments). Zirconia crowns were fabricated and cemented to abutments with resin cement and artificially aged through dynamic loading by chewing simulator to stimulate 3 months clinically. Results All test specimens survived the artificial aging process using simulated oral conditions. Group (GIIA) show the highest fracture resistance with the mean value (1526.81 ± 2.91) followed by group (GIA) (1265.32 ± 1.06) then group (GIIB) (1095.44 ± 0.84) and finally group (GIB) (1086.99 ± 1.52), there was highly significance difference between short and standard implants. The effect of abutment material there was also highly significant difference between PEEK and titanium Abutments, group (GIIA) under electron microscope showed unfavorable fracture while all other groups showed favorable fracture only. Conclusions The highest fracture strength was found in zirconia crowns cemented to PEEK abutment over standard implant, The lowest fracture strength was found in zirconia crowns cemented to titanium abutment over short implant and Standard implants have favorable stress distribution than short implants under loading.

Outcome Difference between Short and Longer Dental Implants Placed Simultaneously with Alveolar Bone Augmentation: a Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aim to provide detailed insights into the clinical performance of short and longer dental implants placed simultaneously with bone augmentation. The search for literature was performed across MEDLINE (PubMed), ScienceDirect and the Cochrane Library databases, adhering to specific selection criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only articles published in English between 2014 and 2024 were considered for data collection. Primary outcomes were survival rate (SR), marginal bone loss (MBL) and complications. Clinical outcomes were as follows: bleeding on probing (BOP), periodontal pocket depth (PPD), and implant stability quotient (ISQ). Quality and risk of bias assessment were evaluated by the Critical Appraisal Checklist tool for randomized controlled trials developed by the Joanna Briggs Institute. A total of 14678 articles were screened, with 9 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 495 patients with 984 implants (491 short and 493 longer implants) showing a SR of 93.91% for the short implants and 91.83% for the longer implants. Meta-analysis revealed statistically significant difference between short implants and longer implants simultaneously placed with alveolar bone augmentation in relation to MBL (-0.513 mm, 95% CI = -0.93 to -0.096; P = 0.02), and in PPD (-0.247, 95% CI = -0.515 to 0.022; P = 0.07). When comparing the results of treatment with short and longer dental implants combined with alveolar bone augmentation, short implants showed better clinical results regarding the parameters of survival rate, marginal bone loss and complications.

The Effect of Osteotomy Preparation Technique and Implant Diameter on Primary Stability and Bone-implant Interface of Short Implants (6 mm).

To evaluate the effect of osteotomy preparation technique and implant diameter on primary stability and bone-implant interface of short implants (6mm), when placed in bone with high degree of cancellous content. 90 short (S) implants (6 mm) divided in nine groups based on width (Narrow 4.2 mm, Regular 4.8 mm, Wide 5.4 mm) (N,R,W) and osteotomy preparation (Standard, Osteotome, Osseodensification) (ST, OT, OD) and placed in porcine tibia plateau bone samples: Group SN-ST; Group SN-OT; Group SN-OD; Group SRST; Group SR-OT; Group SR-OD; Group SW-ST; Group SW-OT and Group SW-OD. Insertion torque and Implant Stability Quotient (ISQ) were measured. Four implants from each group SNST, SN-OT, SN-OD were evaluated histomorphometrically. Insertion torque was significantly higher for implants of Group SW-OD compared to Group SW-ST (50.00 ±14.14 Ncm vs 28.00 ±10.85 Ncm, p&#61; 0.005) and Group SW-OT compared to Group SW-ST (46.87 ±17.10 Ncm vs 28.00 ±10.85 Ncm, p&#61;0.026). Insertion torque was significantly higher for implants of Group SW-OD compared to Group SN-OD (50.00 ±14.14 Ncm vs 31.5 ±15.82 Ncm, p&#61;0.04). No significant differences were observed for the percentage of bone, marrow space and connective tissue in contact to the implant surface between studied groups. Osteotomy preparation technique at sites with high degree of cancellous content can influence the implant insertion torque for short and wide implants (5.4x6mm). Implant width can influence the insertion torque of short implants placed with the osseodensification technique.

Survival Rates of Short Dental Implants (≤6 mm) Used as an Alternative to Longer (>6 mm) Implants for the Rehabilitation of Posterior Partial Edentulism: A Systematic Review of RCTs.

Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants (>6 mm) in atrophic alveolar ridges in terms of implant survival rates, peri-implant marginal bone loss (MBL), prevalence of peri-implantitis and technical complications. A thorough electronic search was performed until September 2023. RCTs with follow-up of at least 1-year post-loading comparing short implants with rough surfaces to longer implants in the posterior jaws of systemically and periodontally healthy, partially edentulous adults were considered. Studies with incomplete information on the number of patients, follow-up or definition of "short implants" were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used for Risk of bias assessment. Fixed-effects meta-analysis of the selected studies was applied to compare the outcome variables. Random-effect meta-analysis was performed, on the basis of within-study comparisons. In total, 16 articles were selected for meta-analysis and incorporated 408 short implants and 475 longer implants inserted in 317 and 388 patients, respectively. The survival rates of longer implants in pristine or augmented bone were significantly increased compared to short implants (95%CI: 2-5%, p < 0.001). Standard-length implants displayed increased, although non-statistically significant MBL (95%CI: -0.17-0.04, p > 0.05), and prevalence of peri-implantitis (95%CI: 0-5%, p > 0.05). No statistically significant differences were observed between short and long implants in terms of technical complications (implant-level 95%CI: -4-6%, p > 0.05). Short implants represent a promising alternative treatment option for the rehabilitation of posterior jaws to avoid additional bone augmentation procedures. Nonetheless, they should be selected cautiously due to a potentially limited survival rate compared to longer implants. A major limitation of this study is the variability in the included studies regarding sample size, patient profile, type of bone, loading protocol, definition of peri-implantitis, among others. This study received no external funding. The study protocol was registered in PROSPERO (CRD42023485514).

PRIMARY AND POST-OSSEOINTEGRATION STABILITY OF SHORT (ULTRA-SHORT) IMPLANTS ON EDENTULOUS ATROPHIED DISTAL SEGMENTS OF THE MANDIBLE - AN INDICATOR OF IMMEDIATE OR DELAYED LOAD

Introduction. The issue of determining the possibility of immediate or long-term load on the selected type of implants, which will ensure the predictable result of their long-term functionality, remains an ongoing discussion. The results of the resonance frequency analysis, which perfectly characterize the stability of short and ultrashort implants at all stages of their osseointegration and post-osseointegration periods, can serve as such an indicator basis. Aim. To analyze the primary and post-osseointegration stability of short (ultra-short) implants placed by the methods at the level of the cortical bone layer and subcortically in case of bone atrophy caused by acquired final dentition defects. Materials and methods. The primary and post-osseointegration stability of thirty-nine dental short (h = 6.5 mm X b = 4.0 mm – 20 pieces) and ultra-short (h = 5.5 mm X b = 4.0 mm – 19 pieces) implants placed on the edentulous distal segments of the human mandible was studied. According to the clinical assessment that met the aim and objectives of this study, all patients were divided into four study groups: the first group consisted of patients with a preserved dentition who did not require dental implantation; the second group – 25-45 years old, the third group – 46-60 years old, and the fourth group – ≥ 61 years old. Using the resonance frequency analysis (RFA) method by Penguin Instruments, the results were interpreted in declarative units of measurement – the implant stability quotient (ISQ). Results. The installed short (ultrashort) implants, according to the methodology by the level of the cortical layer of bone tissue, are characterized by their high primary stability by anti-rotational force: in the second group of the study (25-45 years old) with a mean number (M) of 87.0 and an error of the mean (± m) of ± 2.3 ISQ; in the third group (46-60 years old) – 76.4 ± 3.0 ISQ; in the fourth group (persons ≥ 61 years old) – 69.8 ± 4.8 ISQ. Low values of primary stability were obtained in implants installed by the subcortical implantation technique in the second age group of the study and amounted to 59.6 ± 2.7 ISQ with a slight increase to 66.0 ± 4.1 ISQ in the third group and 71.7 ± 4.2 ISQ in the fourth group of the study, which do not guarantee the prognosis of functional redistribution of the supra occlusion immediate load on the biological basis, with further preservation of the course of normal physiological processes in the bone tissue around the implanted implants. Conclusions. Rehabilitation of patients with bone atrophy caused by the loss of the masticatory group of teeth is possible using short (h = 6.5-6.0 mm) and ultra-short (h = 5.5 mm) implants, with clinical justification for the choice of methods of immediate or post-osseointegration load, with a detailed resonance frequency analysis as a priority and reliable method – an effective indicator of their stability, at all stages of clinical rehabilitation of patients.

Assessing the Impact of Dental Implant Length on Early Failure Rates: A Retrospective Analysis.

The selection criteria of implant is very critical. Implant length determines the mechanics of osseointegration. To investigate the influence of dental implant length on early failure rates, osseointegration success, peri-implant bone loss, and patient-reported outcomes. A retrospective analysis was conducted involving 124 participants who underwent dental implant placement. Implant lengths were categorized as short (n = 54), standard (n = 35), or long (n = 35) based on standard industry classifications. Baseline characteristics, implant lengths, and early failure rates within the first six months post-implantation were extracted from clinical records. Preliminary analysis revealed variations in early failure rates among different implant length categories. Short implants demonstrated a distinct pattern of complications compared to standard and long implants. Early failure rates were 8% for short implants, 4% for standard implants, and 2% for long implants (P = 0.04). Osseointegration success rates were 90%, 95%, and 98% for short, standard, and long implants, respectively. Peri-implant bone loss was 1.5 mm, 1.0 mm, and 0.8 mm for short, standard, and long implants, respectively (P = 0.02). Patient-reported outcomes indicated higher satisfaction levels in the long implant group (P = 0.03). The study highlights the importance of considering implant length in clinical decision-making and suggests potential associations with osseointegration success, peri-implant bone loss, and patient satisfaction.

A Finite Element Analysis to Study the Stress Distribution on Distal Implants in All-on-Six Treatment Concepts as Affected Tilted and Short Implant.

The number of implants and their respective configurations for implant-supported treatment modalities have been studied for 4 implant-supported prostheses; however, it is not yet clear whether the use of tilting or short implants in rehabilitation would result in substantially improved bone/implant/prosthesis biomechanics in all-on-six concepts. This study compared the biomechanical behavior of tilted long implants and axially short implants to support fixed prostheses in an atrophic maxilla with all-on-six treatment concepts. Three different implant configurations were planned, and six models were obtained with posterior maxilla D3 and D4 bone densities in this study. Implants proper for the all-on-four concept were placed in all models. In models 1 and 2, the short implant was placed; in models 3 and 4, 30°, the mesial-angled implant was placed; and in models 5 and 6, 45°, the mesial-angled implant was placed to the molar region. In the models created, 200 N vertical and 150 N oblique (45° angled buccopalatal direction) forces were implemented to the bilateral tooth regions 4-5-6 on the rigid titanium-supported fixed hybrid prosthesis made on these models. When the stress values in the models were investigated, the oblique forces had higher stress values than the vertical forces did. When the stresses created by oblique forces were assessed, the highest values were observed in the models created with short implants, and the lowest stress values were observed in the models made with 30° angle to mesial. When bone densities were assessed, more stress values were noted in models with D4 bone density. It has been shown that mesial tilted long implants placed in the posterior molar region, in addition to all four implant treatment concepts, create less stress against undesirable oblique forces compared with short implants.

Effectiveness of zygomatic-implant fixed rehabilitation for the atrophic edentulous maxilla: protocol for a systematic review and network meta-analysis

BackgroundAtrophic edentulous maxilla is a debilitating condition caused by the progressive and irreversible bone resorption following loss of teeth, that results in bone of inadequate volume and density. This makes conventional implant therapy extremely challenging without complex reconstructive procedures. Several techniques such as sinus augmentation, short implants, and tilted implants have been used for the rehabilitation of the atrophic maxilla. In recent years, zygomatic implants have emerged as a graftless rehabilitation technique. However, few studies compare zygomatic-implant fixed rehabilitation with other fixed rehabilitation techniques. The existing body of evidence on zygomatic implants is largely based on clinical and disease-oriented outcomes.MethodsA network meta-analysis (NMA) will be conducted in order to compare the effectiveness of zygomatic-implant fixed rehabilitation with the other rehabilitation techniques. Experimental and observational studies comparing different implant-assisted fixed rehabilitation in adults with atrophic maxilla will be included. The primary and secondary outcomes will be patient’s satisfaction and quality of life respectively. Additional outcomes include the implant’s survival/success, and biological and prosthetic complications. An electronic search will be performed through various databases for articles in English and French, without time limits. Risk of bias will be assessed using the Revised Cochrane Risk-of-Bias tool for randomized controlled trials, and ROBINS-I for non-randomized and observational studies. Two independent reviewers will screen the titles and abstracts and extract data. Any discrepancy between reviewers will be discussed and resolved through consensus or with the help of a third reviewer.Pairwise meta-analyses will be performed using a random effects model. I2, τ2, transitivity, subgroup/meta-regression analyses will assess and explain heterogeneity and distribution of effect modifiers. A network plot will be created to connect the different interventions directly and indirectly. Interventions will be ranked using the surface under cumulative ranking curve. Confidence in the results of the NMA will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).DiscussionThis study will be the first to assess the effectiveness of zygomatic-implant fixed rehabilitation for the atrophic maxilla using NMA. The evidence obtained will aid clinical decision-making and will advance the knowledge of the rehabilitation techniques for the atrophic maxilla.Systematic review registrationPROSPERO CRD42023353303.

Mechanical and modal analysis of different implant strategies for loss of three teeth with bone atrophy in the maxillary posterior region

Purpose: This study aimed to evaluate the stress distribution and secondary stability involved in five implant strategies, including implant-supported prostheses (ISP) and tooth-implant-supported prostheses (TISP), used for bone atrophy in the maxillary posterior region with teeth loss using finite element analysis, and to explore the more desirable implant methods. Methods: Five implant strategies were made to analyze and compare: M1, implant-supported prosthesis consisting of a short implant with a regular implant; M2, implant-supported prosthesis consisting of a tilted implant with a regular implant; M3, cantilever structure; M4, tooth-implant-supported prosthesis consisting of a short implant with a regular implant; M5, tooth-implant-supported prosthesis consisting of a regular implant, and M6, with only the natural teeth as a control group. Dynamic loading of the above models was performed in finite element analysis software to assess the stress distribution of the bone tissue and implants using the von Mise criterion. Finally, the secondary stability of different models was evaluated by modal analysis. Results: The maximum stress distribution in the cortical bone in M1(60 MPa) was smaller than that in M2(97 MPa) and M3(101 MPa), The first principal strain minimum was obtained in M2 (2271 μ ε ). M4 (33 MPa, 10085 Hz) with the best mechanical properties and highest resonance frequency. But increased the loading on the natural teeth. Conclusions: Short implants and tilted implants are both preferred implant strategies, if cantilever construction is necessary, a tooth-implant-supported prosthesis consisting of a short implant and a regular implant is recommended.