Prosthetic Rehabilitation of the Partially Edentulous Atrophic Posterior Mandible with Short Implants (≤ 8 mm) Compared with the Sandwich Osteotomy and Delayed Placement of Standard Length Implants (> 8 mm): a Systematic Review

Abstract

ObjectivesTest the hypothesis of no difference in prosthetic rehabilitation of the partially edentulous atrophic posterior mandible with short implants (≤ 8 mm) compared with the sandwich osteotomy and delayed placement of standard lengths implants (> 8 mm).Material and MethodsA MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search was conducted by including studies published in English. No year of publication restriction was applied.ResultsSix randomized controlled trials characterized by low or moderate risk of bias fulfilled the inclusion criteria. There were no statistically significant differences (P > 0.05) in the survival rate of suprastructures and implants between the two treatment modalities after one year. Sandwich osteotomy and delayed implant placement demonstrated statistically significant higher long-term peri-implant marginal bone loss as well as biological and technical complications compared with short implants (P < 0.0001). Moreover, patients significantly favoured prosthetic rehabilitation with short implants (P < 0.0001).ConclusionsShort implants and the sandwich osteotomy with delayed placement of standard length implants appear to result in predictable outcomes in terms of high survival rate of suprastructures and implants after prosthetic rehabilitation of the partially edentulous atrophic posterior mandible. However, further long-term randomized controlled trials assessing donor site morbidity, an economic perspective, professional and patient-related outcome measures with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of short implants for prosthetic rehabilitation of the partially edentulous atrophic posterior mandible compared with the sandwich osteotomy and delayed placement of standard length implants.

Are <7‐mm long implants in native bone as effective as longer implants in augmented bone for the rehabilitation of posterior atrophic jaws? A systematic review and meta‐analysis

“…This up‐to‐date review found that implants shorter than 7 mm can be as effective as standard‐length implants in augmented sites for the rehabilitation of partially edentulous and posterior atrophic jaws. As compared to previous reviews that investigated the performance of SH implants, 3,4,6,7,12,17,23,24,26,27,93‐97 the present one counted on a wider database and a longer follow‐up, and only focused on RCTs comparing SH implants inserted in edentulous atrophic jaws and ST implants in reconstructed atrophic jaws, of comparable residual bone dimension. In fact, several studies were excluded because the residual bone dimension differed between test and control group (eg, SH implants in atrophic jaws vs ST implants in non‐atrophic edentulous jaws), or ST implants were inserted without augmentation procedures, or SH implants were inserted with concomitant augmentation procedures.…”

Virtual Bone Augmentation in Atrophic Mandible to Assess Optimal Implant-Prosthetic Rehabilitation—A Finite Element Study

“…Further, as there are still insufficient data that could determine the optimal treatment, whether it would be rehabilitation using short implants or bone augmentation that would allow the use of longer implants, clinicians often face problematic situations [3]. However, some studies suggest that short implants may be more advantageous than longer implants placement following bone augmentation because of the reduced number of complications [7,8,11,12]. In comparison with sandwich osteotomy and delayed implant placement, prosthetic rehabilitation of the partially edentulous atrophic mandible with short implants has been shown to have a comparable survival rate [11].…”

“…However, some studies suggest that short implants may be more advantageous than longer implants placement following bone augmentation because of the reduced number of complications [7,8,11,12]. In comparison with sandwich osteotomy and delayed implant placement, prosthetic rehabilitation of the partially edentulous atrophic mandible with short implants has been shown to have a comparable survival rate [11]. Moreover, short implants placed in an atrophic ridge and long implants placed after alveolar bone augmentation have been reported to present similar short-term peri-implant alveolar bone loss, regardless of the arch [7].…”

Long‐term survival analysis of standard‐length and short implants with multifunctional abutments

“…It also provides a wide range of retentive possibilities, even for non‐parallel implants . With a low vertical profile of 2.1 mm and diameter of 4.4 mm, the OT Equator abutment (Rhein83) fits into patients mouths with vertical space limitations; it can also be placed over standard‐length (≥8 mm) and short (<8 mm) implants . In addition, this component can be applied to temporary and definitive prostheses, by using the same anchoring system.…”

“…10,11 With a low vertical profile of 2.1 mm and diameter of 4.4 mm, the OT Equator abutment (Rhein83) fits into patients mouths with vertical space limitations; it can also be placed over standard-length (≥8 mm) and short (<8 mm) implants. 10,12 In addition, this component can be applied to temporary and definitive prostheses, by using the same anchoring system. Despite the advantages, this new abutment system is not indicated for single crowns since it does not present anti-rotational components.…”