Inlay results in less bone resorption and more predictable outcomes, but requires an experienced surgeon. In contrast, onlay results in greater bone resorption and requires a bone block graft oversized in height, but involves a shorter learning curve. Once implant placement has been carried out, the outcomes are similar for both procedures.

When residual bone height over the mandibular canal is between 7 and 8 mm, 7 mm short implants might be a preferable choice than vertical augmentation, reducing the chair time, expenses and morbidity. These 1-year preliminary results need to be confirmed by follow-up of at least 5 years.

Randomised controlled trial PURPOSE. To evaluate whether short (5 to 8.5 mm) dental implants could be a suitable alternative to longer (at least 11.5 mm long) implants for supporting dental prostheses placed in atrophic fully edentulous maxillae augmented with autogenous bone. MATERIALS AND METHODS.Twenty-eight patients with fully edentulous atrophic maxillae having 5 to 9 mm of residual crestal bone height at least 5 mm thick, as measured on CT scans, were randomised into two groups, either to receive four to eight short (5 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mm-long implants (13 patients). Both bone blocks and windows at lifted maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants, which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar-retained overdentures were delivered. Provisional prostheses were replaced after 4 months by definitive screw-retained metal-resin cross-arch restorations. Outcome measures were: augmentation, prosthesis or implant failures, any complications, peri-implant marginal bone level changes, and patient satisfaction. Patients were followed-up until 5 years after loading. RESULTS.All patients could be rehabilitated with implant-supported prostheses, but four patients dropped-out from the augmentation group and three from the short implant group. One bilateral sinus lift procedure failed due to infection, though short implants could be placed. Four implants failed in four patients from the augmentation group versus three short implants in three patients (Fisher's exact test P = 0.6500; difference in proportions = -0.17; 95% CI -0.51 to 0.21). No prosthesis failed. Significantly more complications occurred in augmented patients: 12 complications occurred in nine augmented patients versus one complication in the short implant group (Fisher's exact test P = 0.0003; difference in proportions = -0.82; 95% CI -0.97 to -0.41). Periapical radiographs of only four patients were readable, so no bone level could be measured at 5 years after loading. With the exception of three patients from the augmentation group, who were only partially satisfied with function, all remaining patients were fully satisfied with the treatment (P = 0.0957); all would have the treatment again.CONCLUSIONS. This study showed that in patients with fully edentulous atrophic maxillae, short implants can be a preferable alternative to longer implants placed in bone augmented with autogenous bone, the treatment being less invasive, cheaper, faster and associated with fewer complications. CONFLICT OF INTEREST STATEMENT.MegaGen partially supported this trial and donated the implants and prosthetic components used in the present investigation. However, data property belonged to the authors and MegaGen by no means interfered with the conduct of the trial or the publication of its results.

Background: The aim of the present in vitro study was to reproduce and evaluate the response of bone and bacteria to traditional and innovative implant surfaces with difference wettability.Materials & methods: Two hundred fifty-two samples made of grade 4 titanium with different coating (machined, MAC; double etched, Ti-treated; Zirconium Nitride, Ti-ZrN) were used for this in vitro study. Disks were divided in test (bio-activated using Plasma of Argon) and control group (untreated).To assess the surface morphology of the specimens, representative images were acquired recurring to a SEM. To characterize the biological response in vitro, the widely diffused pre-osteoblastic murine cell line MC3T3-E1 was used. To quantify the amount of protein adsorbed, the titanium disks were incubated in presence of Fetal Bovine Serum (FBS) in Phosphate Buffered Saline (PBS) at 2% concentration. The sterilized titanium disks were then colonized by bacterial species from a single sputum sample obtained from a healthy volunteer. For every analysis, 24 disks were used (12 for each group).Results: Compared to control groups, plasma treatment significantly increase the protein adsorption level on all different titanium surfaces (5.88±0.21 vs 7.85±0.21, 7.13±0.14 vs 9.74±0.65, 4.41±0.62 vs 6.13±0.52 respectively for MAC, Ti-treated and Ti-ZrN). Similar behavior was descripted for cell adhesion (27.67±2.03 vs 58.00±20.13, 116.67±12.02 vs 159.33±8.09, 52.00±4.73 vs 78.33±4.67 respectively for MAC, TR and Ti-ZrN).Plasma treatment significantly augmented the number of CFU only in MAC and ZrN samples.Conclusions: With the limitations of the present in vitro study, the following conclusions could be drawn: a) rough implant surfaces present a higher adhesion and proliferation of preosteoblastic cells and bacterial biofilm; b) rough implant surfaces benefited the most by the Plasma of Argon treatment

The deantigenated equine bone was biocompatible and resorbed only minimally. This material seems to offer excellent potential for being incorporated in a procedure that increases the width of edentulous alveolar crests.

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