Standard-length Implants Research Articles

Long-Term Comparative Outcomes of Short Implants Versus Maxillary Sinus Elevation in Posterior Maxilla Rehabilitation

Background: Vertical atrophy of the maxilla has traditionally been treated with sinus lift procedures and implant placement, performed in one or two surgical stages. Subsequently, the transcrestal sinus lift technique was introduced, offering distinct advantages in terms of indications and reduced morbidity. Most recently, short implants have emerged as a valid alternative to these procedures, even in cases of severe horizontal resorption, allowing for direct placement in many cases. This study was designed to assess the clinical outcomes of short implant placement in alveolar ridges with severe bone atrophy, compared with conventional-length implants placed in areas undergoing conventional sinus elevation. Methods: A retrospective split-mouth study was conducted to compare conventional sinus elevation with standard-length implants versus short implants for addressing vertical bone atrophy in the posterior maxilla. The primary variable was the variation in the marginal bone level. The secondary variables were implant survival and complications. The evaluation of the statistical significance of the difference in categorical variables was accomplished by Chi-squared test or Fisher’s exact test. The comparison between the study groups in continuous variables was performed using Wilcoxon test. The statistical significance was set at p-value < 0.05. Results: The study sample consisted of 24 patients and a total of 73 dental implants. The lateral sinus elevation group (LSEG) included 39 implants, while the short implants group (SIG) included 32 implants. All prostheses were screw-retained. Changes in marginal bone levels indicated a marginal bone loss of less than 0.5 mm in both groups, with no statistically significant difference. In the LSEG, two cases of mucositis were identified, attributed to improper use of an interdental brush. Additionally, two cases of prosthetic screw fracture were reported in the LSEG as technical complications. Conclusions: Long-term outcome data have provided evidence that the use of short implants is comparable to a state-of-the-art procedure (sinus grafting and placement of implants) regarding implant survival, marginal bone remodeling, and complication rates.

Utilization of Ultrashort Bicon Implants in Clinical Situations: A Retrospective Case Series.

When vertical bone loss results in insufficient crestal height to place standard-length implants without the use of osseous grafting, this poses clinical issues to implant usage. Based on an analysis of the literature and clinical experience, it has been found that it is possible to optimally use the available bone volume of the maxillary and mandibular ridges for implant placement without extensive osseous grafting to increase vertical height. This case report will examine several uses of ultrashort implants utilizing the Bicon system in common clinical situations in the maxillary and mandibular arches without the need for osseous reconstruction to improve the available vertical height of the crest to permit implant placement.

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).

Outcomes of treatment with short dental implants compared with standard-length implants: a retrospective clinical study

BackgroundThe size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants.MethodsPatients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed.ResultsThirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally).ConclusionsIn this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.

A finite element study on the risk of bone loss around posterior short implants in an atrophic mandible.

This study aimed to evaluate the risk of bone loss around single short molar crown-supporting implants in an atrophic mandible. Implants of different lengths (L = 4 or 6 mm) and diameters (Ø = 4.1 or 4.8 mm) were placed in the molar area of an atrophic mandible. Additional control mandible models were simulated for 4.1 mm diameter implants (L = 4, 6, 8, and 10 mm). A vertical masticatory load of 200 N was applied to three or six occlusal contact areas (3ca or 6ca) of the prosthetic crown. The bone strain energy density (SED) of 109.6 µJ/mm3 was assumed to be the pathological threshold for cortical bone. The peri-implant bone resorption risk index (PIBRri) was calculated by dividing the maximum SED of the crestal cortical bone by the SED pathological threshold. Increasing the implant length from 4 to 6 mm, implant diameter from 4.1 to 4.8 mm, and number of contact areas from 3 to 6 reduced the SED and PIBRri values by approximately 20%, 35%, and 40%, respectively, when comparing pairs of models that isolated a specific variable. All models with 6ca had a low bone resorption risk (PIBRri<0.8), while the Ø4.1 short implant with 3ca had a medium (0.8≤PIBRri≤1.0) or high (PIBRri>1.0) resorption risk. Increasing the diameter or occlusal contact area of a 4 mm short implant in an atrophic mandible resulted in reduced bone resorption risks, similar to or lower than those observed in a regular mandible with standard-length implants.

Influence of Occlusal Stress on Implant Abutment Junction and Implant Bone Interface: A Finite Element Analysis Study.

The aim of the present study was to assess the occlusal stress on the implant-abutment junction and implant-bone interface of a long-span implant-supported prosthesis made of two different prosthetic materials. A computerized tomography of the mandible was used to get the finite element model of the bone. The comparative groups were made as follows: S1 and S2 - 3.7 × 11 mm (44 region) and 4.5 × 11 mm (47 region), S1A and S2A - screw-retained porcelain-fused-to-metal prosthesis, S1B and S2B - cement-retained porcelain-fused-to-metal prosthesis, S1C and S2C - screw-retained zirconia prosthesis, and S1D - cement-retained zirconia prosthesis. Maximum stress generated on the implant-abutment interface of all the prostheses under vertical and oblique load was assessed. For all the comparative groups, maximum level of stress was generated at the cervical level of the implant-bone interface in comparison to the apical and middle-third level under both vertical and oblique load. No statistically significant difference between zirconia and porcelain-fused-to-metal prosthesis was seen at the implant-abutment interface and the cervical third of the implant-bone interface. A significant difference was found between all screw-retained and cement-retained groups. The present study concluded that the short implants in combination with standard-length implants using either porcelain-fused-to-metal or zirconia as prosthetic material in the form of long-span implant-supported prosthesis can be a viable treatment option in the posterior mandible. The accuracy of the diagnosis, examination, and knowledge of the site where the implant must be inserted, and the choice of superstructure is important for the stability and lifespan of the implant prosthesis.

Short vs standard implants associated with sinus floor elevation: a randomized controlled trial

Objective: the present equivalence two-arm parallel randomized controlled trial aimed to compare survival and marginal bone loss (MBL) of short implants (≤6 mm) and standard implants (≥8.5 mm) associated with sinus floor elevation (SFE). Methods: adult patients with partial edentulism with occlusal stability in the sinus area and intermediate bone height were selected in this double-blind trial (patient and outcome assessment). Patients were randomly allocated into two groups: standard length implants with SFE (control) or short implants (test). Clinical and radiographic assessments were made at the time of implant placement, 6 months, and annually thereafter up to 2 years after loading. The inter-examiner agreement was analyzed using intraclass correlation coefficient (ICC). One-way ANOVA, Kaplan-Meier, and Log-rank tests were used to compare implant survival (primary outcome) and MBL (secondary outcome) (P&lt;0.05). Results: eight short implants and six standard implants were placed (mean age of patients was 47 ±12.5 years). The implant survival rates were 87.5% for short (one 5 mm implant failed at 7 months) and 100% for standard implants with no statistically significant difference between groups (P=0.4). The mean MBL after 1 year was 0.30 ±0.62 mm for short and 0.21 ±0.36 mm for standard implants (P=0.123). The inter-examiner agreement was set in 0.831. Conclusion: survival of short implants and standard implants associated with SFE was similar after two years of clinical service. Trial registration: Registered on 27-03-2018 at ClinicalTrials.gov (NCT03479333). Funding: This study was partially funded by Capes Finance Code 001 and #88881.187933/2018-01. TPC is partially funded by National Council for Scientific and Technological Development (CNPq - Brazil). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.Keywords: bone resorption; dental implants; sinus floor augmentation; survival.

Biomechanical analysis of different fixed dental restorations on short implants: a finite element study.

Although the use of short implants is becoming more common for patients with atrophic alveolar ridges, their use is still quite limited. This is due to the lack of data of long-term survival compared to standard-length implants. The aim of this study was to determine the load in the bone and implant system with different superstructures. Three kinds of prosthetic restorations were created on short implants based on CT-Data. Two short implants with different macro-geometries were used. The implants were inserted in idealised posterior lower mandibular segments and afterwards restored with a crown, a double splinted crown, and a bridge. The analysis was performed under load of 300 N either divided between a mesial and distal point or as a point load on the pontic/mesial crown. The different design of the implant systems had a noticeable influence on the stress in the cortical bone, in the implant system, and the displacement of the superstructure as well. Compared with implants of standard length, higher stresses were observed, which can lead early failure of the implant during the healing period or a late cervical bone resorption. Precise indications are essential for short implants to avoid the failure of short implants.

Clinical Evaluation of Short (6 mm) and Longer Implants Placed Side by Side in Posterior Partially Edentulous Area: A 3-Year Observational Study.

Short implants have been proposed as an alternative solution for the rehabilitation of atrophic posterior region. To compare the clinical outcomes between 6 mm short implants and conventional implants placed under similar conditions of bone quality and occlusal loading. Nine patients received atone 6 mm implant and one standard-length (8 mm length or longer) implants in a total of 10 partially edentulous areas. Implants were left submerged for 3-6 months healing period and the screw-retained splinted prostheses were delivered. When the provisional or final restoration was placed, and at each year after loading, standardized intraoral radiograph was taken for themarginal bone level (MBL) changes around the implants. Subsequently, the patients were recalled for the clinical examination evaluating the implant survival, sulcus bleeding index, suppuration, and the incidence of prosthetic complications at every 6 months after the definitive crown delivery. The observation period was continued to 3 years (mean follow-up was 3.4 ± 0.3 years) after functional loading. Nine patients (10 short implants and 10 standard length implants) were selected in this study. Cumulative survival rates of the short implants and standard-length implants were 100% in both groups, and no biological and prosthetic complication were found in 3 years observation period. Cortical bone thickness of implant insertion sites was 1.39 ± 0.45 mm at short implants and 1.38 ± 0.69 mm at standard-length implants, and trabecular bone computed tomography values of implant insertion sites was 424.1 ± 290.1 at short implants and 410.9 ± 267.9 at standard-length implants. The MBL changes were -0.30 ± 0.71 mm at short implants and -0.19 ± 0.78 mm at standard-length implants at 3 years follow-up visit. No significant difference was found in the average of MBL changes between implant length. Within the limits of this study, it can be concluded that 6 mm short implants in a posterior edentulous region showed excellent results compared with conventional implants.

Effectiveness of Extra-Short (< 6 mm) Implants Compared to Standard-Length Implants Associated with Bone Graft: Systematic Review.

Purpose: To evaluate the effectiveness of extra-short implants compared to standard-length implants in graft regions at different longitudinal follow-up times. Materials and Methods: A systematic review was performed, following PRISMA criteria. LILACS, MEDLINE/PubMed, Cochrane Library, and Embase databases, including gray literature and manual searches, were conducted without language or date restrictions. Study selection, risk of bias (Rob 2.0), quality of evidence (GRADE), and data collection were performed by two independent reviewers. Disagreements were resolved by a third reviewer. Data were combined using the random-effects model. Results: A total of 1,383 publications were identified, including 11 publications from 4 randomized clinical trials that evaluated 567 implants (276 extra-short and 291 regular implants with graft) in 186 patients. The meta-analysis showed that losses (risk ratio [RR]: 1.24; 95% CI: 0.53 to 2.89; P = .62; I2: 0%) and prosthetic complications (RR: 0.89; 95% CI: 0.31 to 2.59; P = .83; I2: 0%) were similar in both groups. Biologic complications were significantly higher in regular implants with graft (RR: 0.48; CI: 0.29 to 0.77; P = .003; I2: 18%), which also had lower peri-implant bone stability in the mandible at the 12-month follow-up (mean deviation [MD]: -0.25; CI: -0.36 to 0.15; P < .00001; I2 = 0%). Conclusion: Extra-short implants showed similar effictiveness compared to standard-length implants placed in grafted regions at different longitudinal follow-up times and present reduced biologic complications, shorter treatment times, and greater peri-implant bone crest stability.

Insertion Torque, Removal Torque, and Resonance Frequency Analysis Values of Ultrashort, Short, and Standard Dental Implants: An In Vitro Study on Polyurethane Foam Sheets.

Short implants were introduced to reduce morbidity, treatment duration, and complex bone regeneration interventions in atrophic jaws and to improve patient-reported outcomes. This study aimed to determine the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values of ultrashort (3 mm length), short (7 mm length), and standard implants (10 mm length) inserted in 1-, 2-, 3-, and 4-mm thickness polyurethane sheets with densities of 10, 20, and 30 pounds per cubic foot (PCF). Standard-length implants were the gold standard (control). Overall, short-length implant IT values were higher or similar to the control in most experimental conditions. Those inserted into a 3 mm/30 PCF lamina showed the highest IT values, whereas 5 mm diameter ultrashort-length implants inserted into 2 and 3 mm/20 PCF laminas were higher than other implants. RT values followed the same trend and RFA values were more appreciable in short- and standard-length implants in all the scenarios. However, ultrashort-length implants reached a primary stability comparable to that of standard implants in lower thicknesses. In conclusion, although further studies are needed to corroborate this in vitro model with preclinical and clinical studies, our data shed light on short- and ultrashort-length implants geometries to a potential application in critical atrophy of the posterior jaws.

Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis

BackgroundShort implants are proposed as a less invasive alternative with fewer complications than standard implants in combination with sinus lift. The aim of this systematic review and meta-analysis was to state the efficacy of placing short implants (≤ 6 mm) compared to standard-length implants (≥ 8 mm) performing sinus lift techniques in patients with edentulous posterior atrophic jaws. Efficacy will be evaluated through analyzing implant survival (IS) and maintenance of peri-implant bone (MBL).MethodsScreening process was done using the National Library of Medicine (MEDLINE by PubMed), EMBASE, the Cochrane Oral Health, and Web of Science (WOS). The articles included were randomized controlled trials. Risk of bias was evaluated according to The Cochrane Collaboration’s tool. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). A random-effects model was applied. Secondary outcomes such as surgical time, patient satisfaction, mucositis and peri-implantitis, pain, and swelling were analyzed.ResultsFourteen studies (597 patients and 901 implants) were evaluated. IS was 1.02 risk ratio, ranging from 1.00 to 1.05 (CI 95%) (p = 0.09), suggesting that IS was similar when both techniques were used. MBL was higher in patients with standard-length implants plus sinus lift elevation (p = 0.03). MBL was 0.11 (0.01–0.20) mm (p = 0.03) and 0.23 (0.07–0.39) mm (p = 0.005) before and after 1 year of follow-up, respectively, indicating that the marginal bone loss is greater for standard-length implants.DiscussionWithin the limitations of the present study, as relatively small sample size, short dental implants can be used as an alternative to standard-length implants plus sinus elevation in cases of atrophic posterior maxilla. Higher MBL was observed in the groups where standard-length implants were used, but implant survival was similar in both groups. Moreover, with short implants, it was observed a reduced postoperative discomfort, minimal invasiveness, shorter treatment time, and reduced costs.Clinical Clinical relevanceThe low MBL promoted by short implants does contribute to a paradigm shift from sinus grafting with long implants to short implants. Further high-quality long-term studies are required to confirm these findings.

A Comparison of Operative Time and Intraoperative Blood Volume Loss Between Stemless and Short-stem Anatomic Total Shoulder Arthroplasty: A Single Institution's Experience.

Introduction:There has been increasing interest in the use of stemless humeral implants for total shoulder arthroplasty when compared with both short-stem (SS) and standard-length implants. Although evidence for decreased surgical time and blood loss exists for stemless versus standard-length stems, far less literature exists comparing these clinical parameters for stemless versus SS implants.Methods:A retrospective review of consecutive anatomic total shoulder arthroplasty (aTSA) cases conducted by a single, fellowship-trained shoulder surgeon was undertaken from January 2016 through January 2022 with the exception of March 2020 through January 2021 secondary to the COVID-19 pandemic. Demographic patient and surgical data, including age, sex, body mass index, American Society of Anesthesiologists score, age-adjusted Charlson Comorbidity Index, prior ipsilateral shoulder arthroscopy, surgical time, use of a Hemovac drain and/or tranexamic acid, hospital length of stay (LOS), and both postoperative day #1 (POD 1) and discharge visual analog scores. The use of a stemless or SS implant was recorded. Intraoperative total blood volume loss (TBVL) was calculated, in addition to the need for either intraoperative or postoperative transfusions. Nonparametric analysis of covariance was used to examine effects of stemless versus SS aTSA on surgical time and intraoperative TBVL adjusted for demographic, clinical, and surgical variables.Results:There were 47 SS and 83 stemless anatomic implants included, of which 74 patients (57%) overall were women. The median surgical time for the stemless cohort was 111 minutes (IQR 96-130) versus 137 minutes (IQR 113-169) for the SS cohort (P < 0.00001). The median intraoperative TBVL for the stemless cohort was 298.3 mL (IQR 212.6-402.8) versus 359.7 mL (IQR 253.9-415.0) for the SS cohort (P = 0.05). After multivariable regression analysis, use of stemless humeral implants was independently associated with both decreased surgical time and intraoperative blood loss (P < 0.001 and P = 0.005, respectively). There was a shorter median hospital LOS in the stemless group (2 days [IQR 1-2] versus 2 days [IQR 2-3], P = 0.03). The visual analog score pain score at discharge was lower among the stemless cohort (0 [IQR 0-3] versus 4 [IQR 2-6], P < 0.00001). Increased surgical time was associated with intraoperative TBVL (r = 0.340, P < 0.0001).Discussion:Stemless aTSA is associated with a markedly decreased surgical time and intraoperative TBVL when compared with a SS aTSA. Furthermore, the use of a stemless implant results in a shorter hospital LOS and lower discharge pain scores.

Short versus Standard Length Implants with Sinus Floor Elevation for the Atrophic Posterior Maxilla.

Objectivesthe aim of this clinical study was to compare clinical and radiological outcomes of short dental implants inserted in pristine bone to standard length implants inserted in combination with sinus floor elevation.Materials and methodsFor this clinical study, the clinical and radiological outcome of 126 short dental implants (84 patients), inserted in pristine bone were compared with 312 standard length implants (156 patients), placed in combination with maxillary sinus floor elevation procedures.ResultsThe short implant group (test group [TG]; mean follow-up (± standard deviation (SD) 56.6 ± 42.9 months) and the augmented group (control group [CG]; mean follow-up 41.6 ± 37.6 months) showed cumulative survival rates of 91.8% and 92.4%. Cumulative 5-year implant survival rates were 91.8% for the TG and 90.7% for the CG (p=0.421). Mean marginal bone loss was significantly higher in the CG than in the TG, with a mean MBL of 0.70 ± 0.72 mm in the TG and 0.96 ± 0.91 mm in the CG (p<0.001). A comparable and promising oral health-related quality of life (OHRQoL) was observed in the control and test groups.ConclusionsAfter over 3 years, short implants placed in the resorbed posterior maxilla obtained similar results to standard implants combined with maxillary sinus floor augmentation procedures.

A Clinical Paradigm and Pertinent Literature Review for Placing Short Implants

Placing an implant to replace missing teeth can be challenging because of lack of vertical and/or horizontal bone ridge, maxillary sinus pneumatization and inferior alveolar nerve position. Additional surgical procedures may be necessary, with varying predictability, where vertical augmentation being the least predictable. An alternative option is to place short implants and exclude the additional surgical grafting procedures. By reviewing studies, this paper explores the predictability of the short implants for use in the methods. Bicon SHORT® implants are available in 5 and 6 mm lengths and seem to be able to overcome such limits but more long-term studies are still needed to determine long-term prognosis and success of short implants in terms of them being comparable or equal to longer or standard length implants.

Professional and patient-reported outcomes of two surgical approaches for implant-supported single-crown restoration: 1-year results of a randomized controlled clinical trial.

To test whether there is a difference in professional and patient-reported outcome measures (PROM) after single-crown restoration supported by short implants (SI) (6mm) compared with standard length implants (SLI) (13mm) in conjunction with maxillary sinus floor augmentation (MSFA) after 1year of functional implant loading. Forty patients were randomly allocated to SI or SLI/MSFA. PROM included Oral Health Impact Profile (OHIP-14) questionnaire and subjective assessment of the peri-implant soft tissue (A), implant crown (B), implant function (C) and overall implant treatment outcome (D) using visual analogue scale (VAS). Professional assessment included pink aesthetic score (PES) and white aesthetic score (WES). No significant differences in professional or PROM between the two treatment modalities were revealed at any time point (p>.05). OHIP-14 score decreased at baseline and 1year after functional implant loading compared with preoperative measurements indicating improved quality of life with both treatment modalities. The 1-year mean VAS score was 9.4 (A), 9.3 (B), 9.6 (C) and 9.3 (D) for SI compared with 9.3 (A), 9.6 (B), 9.7 (C) and 9.2 (D) for SLI. The 1-year mean PES/WES scores were 11.3 and 8.1 for SI compared with 11.2 and 8.1 for SLI/MSFA. Prosthetic rehabilitation of the posterior part of the maxilla with SI or SLI/MSFA revealed no significant differences in professional and PROM after 1year of implant loading.

Clinical performance of short versus standard dental implants in vertically augmented bone: an overview of systematic reviews.

To answer the question: What do we know so far about the clinical performance of short implants (≤ 7mm) when compared to standard length implants in vertically augmented bone, as well as which is the overall confidence of the systematic reviews (SRs) about this topic? An overview of SRs was conducted. The searches were performed in six electronic databases and grey literature. SRs about short (≤ 7mm) versus standard dental implants performance in vertically augmented bone were included. The assessed outcomes were marginal bone loss (MBL), implant survival (IS), prosthetic (PC) and biological complications (BC), costs, surgical time, and patient satisfaction. AMSTAR 2 was used to evaluate the overall confidence of included SRs. Thirteen SRs were included. Nine of twelve SRs reported a lower MBL for the short implant group. All the included SRs showed no difference in the IS between groups. A higher rate of BC was reported for standard-length implants in four out of five SRs. No differences regarding PC were reported in four of five SRs. Information related to patient preference, cost, and surgery time were underreported. The confidence evaluation of the SRs was stratified as low for five SRs and critically low for eight SRs. In an overall low-to-very low confidence levels, short implants appear to perform better in the mid-term (up to 5years) than standard dental implants associated with vertical bone augmentation regarding MBL and BC, but they have a similar performance regarding IS rates and PC. There is an imperative need to improve the methodological quality of SRs, and efforts should focus on conducting RCTs to broaden the knowledge on this topic. Short implants could represent a viable, simpler, and less invasive treatment when available bone height is limited.

Single-crown restorations supported by short implants (6 mm) compared with standard-length implants (13 mm) in conjunction with maxillary sinus floor augmentation: a randomized, controlled clinical trial

BackgroundThe purpose of the present study was to test the H0-hypothesis of no difference in the clinical and radiographical treatment outcome of single-crown restorations supported by short implants compared with standard length implants in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Forty patients with partial edentulism in the posterior part of the maxilla were randomly allocated to treatment involving single-crown restorations supported by short implants or standard length implants in conjunction with MSFA. Clinical and radiographical evaluation were used to assess survival of suprastructures and implants, peri-implant marginal bone loss (PIMBL), biological, and mechanical complications.ResultsBoth treatment modalities were characterized by 100% survival of suprastructures and implants after 1 year. Mean PIMBL was 0.60 mm with short implants compared with 0.51 mm with standard length implants after 1 year of functional loading. There were no statistically significant differences in survival of suprastructure and implants, PIMBL, and mechanical complications between the two treatment modalities. However, a higher incidence of biological complications was associated with standard length implants in conjunction with MSFA.ConclusionWithin the limitations of the present study, it can be concluded that single-crown restorations supported by short implants seems to be comparable with standard length implants in conjunction with MSFA. However, long-term studies are needed before final conclusions can be provided about the two treatment modalities.Trial registrationClinicaltrials.Gov ID: NCT04518020. Date of registration: August 14, 2020, retrospectively registered.

Short Dental Implants (≤8.5 mm) versus Standard Dental Implants (≥10 mm): A One-Year Post-Loading Prospective Observational Study

Background: Recent data have shown that short dental implants can be the preferred treatment in most of cases of posterior atrophic alveolar ridges, offering higher survival and lower complication rates than long implants. The survival rates, stability, and marginal bone level changes were compared between short implants (7 and 8.5 mm) and standard-length implants (≥10 mm). Methods: Prospective observational study in which adult patients requiring ≥1 osseointegrated implants to replace missing teeth were recruited consecutively. A clinical examination was performed on the day the definitive prosthesis was placed and after 6 and 12 months. Implant stability quotient (ISQ), marginal bone level (MBL) changes, and the correlation between these parameters and the characteristics of the implants were evaluated. Results: A total of 99 implants were inserted (47 short, 52 standard) in 74 patients. The 12-month survival rate was 100%. ISQ values showed a similar pattern for both types of implants. No correlation was found between ISQ changes after one year and MBL values, nor between the latter and the characteristics of the implants. Conclusions: With clinical treatment criteria, shorter implants (7 and 8.5 mm in length) can be just as useful as standard-length implants in atrophic alveolar ridges, demonstrating similar rates of survival, stability, and crestal bone loss.

Short implants without bone augmentation vs. long implants with bone augmentation: systematic review and meta-analysis.

Anatomical limits such as the location of the lower alveolar nerve, the maxillary sinus in atrophied jaws might extend implant surgery treatment. The purpose of this systematic literature review is to review the literature and determine whether short implants can be an effective alternative to standard-length implants after bone augmentation. A systematic search was performed on PRISMA wizard. Searched for clinical trials 2010-2020 in the Medline database. The keywords chosen are "short versus long implants, augmented bone, clinical trial", and their various variations. Meta-analyses of the studies of implant loss after 1, 3 and 5years showed a statistically insignificant difference between groups. The number of complications after 1year was statistically significantly higher in the control group. Meta-analyses with follow-up periods of 3 and 5years showed a statistically insignificant difference; Meta-analyses of studies of marginal bone loss after 1, 3 and 5years showed a statistically insignificant difference between the groups. Short dental implants may be a suitable alternative to standard length dental implants after bone augmentation. The risk of their complications is possibly lower because of the lack of need for bone augmentation.