Long‐term clinical outcomes of short implant (6mm) in relation to Implant Disease Risk Assessment (IDRA)

Abstract

Aim:To evaluate the long-term survival of short implants and to investigate the association of the Implant Disease Risk Assessment (IDRA) with the occurrence of biological complications. Material and Methods:This study was designed as a cohort study with a median follow-up of 10.0 years. Patients who had received 6-mm implants were reviewed and assigned into low-, moderate-, and high-risk groups (Group L, M, and H) based on the IDRA tool. The implant survival, biological complications, soft tissue condition, hardware complications, and marginal bone loss (MBL) were evaluated. Kaplan-Meier curves and Cox regression were performed for survival analysis.Results: A hundred and ten patients were included. The overall cumulative survival rate was 90.9% (L:100.0%, M: 93.3%, and H: 80.6%). A higher risk profile was significantly associated with a decreased implant survival (hazard ratio: 4.11, 95% CI: 1.17-14.36, p < .05). Higher risk profile (hazard ratio: 2.63, 95% CI: 1.32-5.25, p < .05) was a potential risk factor for biological complications. At follow-up, significant differences in bleeding index, modified plaque index, and peri-implant probing depth were found among groups (p < .01). No significant difference was found in MBL. Conclusion:Acceptable long-term clinical outcomes could be achieved after 10 years for short implants. Despite a statistically nonsignificant difference in MBL, patients with a high-risk profile of IDRA seem to be at greater risk of implant loss and biological complications.

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

“…Even more, before assessing prognosis, several clinical factors should be considered such as, for instance, the individual susceptibility underlying the host response to the biofilm, the higher prevalence of biological complications, splinted or non-splinted implants, and data concerning oral hygiene. All these features are gathered in the Implant Disease Risk Assessment (IDRA) [52], where are referred the Fig. 4 Funnel plot graph illustrating the publication bias and the systematic heterogeneity of the included studies.…”

“…Even more, before assessing prognosis, several clinical factors should be considered such as, for instance, the individual susceptibility underlying the host response to the biofilm, the higher prevalence of biological complications, splinted or non-splinted implants, and data concerning oral hygiene. All these features are gathered in the Implant Disease Risk Assessment (IDRA) [ 52 ], where are referred the history of periodontitis, the percentage of tooth and implant sites with BOP, the number of tooth and implant sites with PD ≥ 5 mm, factors of radiographic bone loss in relation to age, the periodontitis susceptibility, the compliance of patients with supportive periodontal therapy, distance from the restorative margin to the bone crest, and factors related to the implant-supported prosthesis. Additionally, the shortcoming of determining the overall patient’s risk, not only the 2 mm bone loss, based only on the targeted 6-mm implant should be realized.…”

Treatment alternatives for the rehabilitation of the posterior edentulous maxilla

“…[91][92][93][94] Cost-effectiveness, lower invasiveness and morbidity, and patient preferences (e.g., shorter treatment time) are additional factors that should be taken into consideration when making clinical decisions on the use of short dental implants. Clinical guidelines for case selection, treatment planning, surgical placement, prosthetic rehabilitation, risk assessment, and maintenance of short dental implants are essentially the same as those recommended for conventional implants, 95 with additional careful consideration of specific prosthetic aspects, such as crown-to-implant ratio and use of cantilever extensions, due to biomechanical concerns, particularly in sites with significant vertical bone atrophy and large interocclusal space. 96…”