Objectives The aim of this study was to conduct a systematic review to compare the survival rates between short implants (length < 10 mm) versus standard-length implants (≥ 10 mm) inserted in grafted bone. As secondary outcomes, marginal bone loss and survival rates of the implant supported prostheses were also analysed. Materials and methods Randomised controlled trials (RCT) that compared both techniques were searched on three electronic databases till June 2016, a manual search was performed on the bibliography of the collected articles, and the authors were contacted for additional references. The estimates of the interventions were expressed in relative risk (RR), mean implant survival rates and mean differences in marginal bone. Results Eight RCTs were included in this study. From a total of 458 short implants, 15 failed (mean survival rates = 96.7%), While from 488 regular implants, 13 failed (mean survival rates = 97.3%). The technique did not significantly affect: the implant failure rate (P > 0.05), with RR of 1.34 (95% CI 0.67-2.87), the mean differences of marginal bone loss (P = 0.18; MD − 0.04 mm [− 0.10; 0.02] 95% CI), at loading or prosthesis failures rates (RR:0.98; 95% CI 0.40-2.41). The mean differences of marginal bone at 1 year follow-up (post loading) presented significant marginal changes in the short implant group (P = 0.002; MD − 0.10 mm [− 0.16; − 0.03] 95% CI) although a significant high heterogeneity was found between groups. Conclusions This systematic review suggests no difference between both techniques in the treatment of atrophic arches. However, more long-term RCTs are needed to evaluate the predictability at the long run. Clinical relevance The use of short implants might be considered an alternative treatment, since it usually requires fewer surgical phases and tends to be a more affordable option.

The aim of this study was to conduct a systematic review to compare the clinical outcomes of two different resorbable collagen membranes in terms of regenerated bone volume, postoperative complications and membrane degradation during bone regeneration procedures. Randomized controlled trials (RCT) or controlled trials (CT) that compared both techniques were reviewed on four electronic databases up to December 2015, a manual search was performed on the bibliography of the collected articles and the authors were contacted for additional references if undetected on the electronic and manual search. Membrane exposure was evaluated as a dichotomous outcome and the statistical unit was the membrane. The results were presented as relative risk (RR) with a 95% confidence interval. Eight RCTs and one CT were included in this study. The majority of the studies depicted a bone augmentation area, which ranged from 46.15% to 94.6% for the non-cross-link membranes and from 44% to 92.6% for the cross-link membranes at the 4-6 month re-entry surgery. From a total of 289 patients, a forest plot concerning the membrane exposure was constructed using the obtained RR of the included studies. The overall RR was 1.43 (95% CI: 0.85-2.39) with no statistically significant differences between the two groups, although with a marginal tendency towards higher exposure in the cross-link membrane group. This systematic review suggests the different membranes present themselves as appropriate for bone regeneration procedures, although cross-link membranes present higher rates of postoperative complications. However, more RCT with higher sample sizes are needed to evaluate the different membranes. The suggested lack of clinical differences between the compared membranes suggest that further cost-benefit ratio, tissue integration and postoperative complication oriented studies should be performed so that clinicians can take a patient-centred, evidencebased decision. K E Y W O R D Sbone grafting, membranes, regeneration, systematic review/meta-analysis

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Oral bisphosphonates are commonly used to improve bone density in patients who suffer from a variety of pathologies. However, they have also been known to cause bisphosphonate-related osteonecrosis of the jaws (BRONJ). The aim of this clinical case presentation is to (1) determine whether the currently recommended length of time that oral bisphosphonates should be discontinued, before performing dental implant surgery, is sufficient to prevent BRONJ and (2) to describe an alternative treatment for BRONJ. A 65-year-old female patient developed BRONJ after receiving mandibular dental implants 5 months after discontinuing alendronic acid (Fosamax). The BRONJ was treated by surgical osteotomy and plasma rich in growth factors (PRGF), and the patient was followed up with biweekly examinations, which included 0.2% chlorhexidine mouthwashes and removal of any remaining necrotic bone. The dental implants were loaded 41 weeks after surgery and followed up with periapical radiographs and implant stability quotient measurements at 3, 6, 12, and 24 months postloading. Although the Association of Oral and Maxillofacial Surgeons protocols for suspension of presurgical oral bisphosphonates were followed, this patient still developed BRONJ after implant surgery. While a multitude of treatments have been described in the literature, there is not enough scientific evidence to support any one treatment. Based on this clinical case, it can be concluded that the potential adverse effects of oral bisphosphonates on the jaws could be greater than expected and that treatment with PRGF produces promising results, although more long-term studies are necessary to confirm these findings.

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