Short implants versus longer implants with maxillary sinus lift. A systematic review and meta-analysis

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.

Short vs. Standard Length Cone Morse Connection Implants: An In Vitro Pilot Study in Low Density Polyurethane Foam

“…The atrophy of the posterior regions of the jaws with reduced bone quality and quantity could limit the use of standard length implants (≥10 mm), without doing an invasive sinus grafting procedure. Recently, it has been reported in a few systematic reviews with meta-analysis that, in these cases, short implants could be a suitable alternative [2][3][4][5][6][7][8]12,13]. These reviews have reported, for short implants, survival rates similar to those of standard length implants and the capability to osseointegrate and to bear a functional load [8].…”

“…In fact, the choice of a short implant is clinically indicated as an alternative to more invasive regenerative procedures in cases of bone atrophy of the posterior ridge's regions [3].…”

“…Short implants (SI), defined in recent years as implants of less than 10 mm in length [1], seem to have some advantages in certain clinical situations, such as atrophy of the alveolar processes, poor bone quality, and pneumatization of the maxillary sinus [2]. SI are less invasive, simpler to use in the hands of the average clinician, and their surgery is shorter, with a lower morbidity, lower costs and lesser biological complications [1,[3][4][5][6][7]. More recently, Ultrashort or Extra-short (<6 mm) implants have been proposed [8][9][10][11].…”

“…Alternatives to the use of SI are sinus augmentation procedures, the use of zygomatic implants, guided bone regeneration procedures, onlay grafts, inlay grafts, distraction osteogenesis, and lateralization of the inferior alveolar nerve [4,12]. Several recent systematic reviews, some of them with a metanalysis of the data, have shown: no differences in the in the survival rate between SI and standard length implants (ST); no differences in marginal bone loss (MBL); lower biological complications in SI; good primary stability in SI; higher mechanical complications in SI [3,4,9,10,[13][14][15][16].…”

Tomographic Examination of Changes in Mucoperiost of the Maxillary Sinus After Sinus Lifting

“…В даному дослідженні також було проаналізовано всі випадки перфорації мукоперіосту. Дане ускладнення добре описано в літературі і за даними авторів становить від 11.2−20% (Cruz RS et al, 2018;Silva L.D. et al, 2016), а за нашими даними − 12%.…”