Short implants versus bone grafting and standard-length implants placement: a systematic review

Abstract

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.

Comparing short dental implant and standard dental implant in terms of marginal bone level changes: A systematic review and meta‐analysis of randomized controlled trials

“…The current results are comparable with previous systematic reviews comparing short implants to longer implants and showed no significant difference of marginal bone loss . Crown height space, splinting of crowns, occlusal loading, and implant design that can influence the marginal bone loss, were reported by few selected studies; they are considered as limitation of this systematic review .…”

“…The current results are comparable with previous systematic reviews comparing short implants to longer implants and showed no significant difference of marginal bone loss . Crown height space, splinting of crowns, occlusal loading, and implant design that can influence the marginal bone loss, were reported by few selected studies; they are considered as limitation of this systematic review . The uniqueness of the present study was that comprehensive data of short and standard implants were assessed in nine subsets (SH vs ST, SH vs baseline, ST vs baseline, both jaws, maxilla, mandible, up to 1 year, 2‐4 years, 5 years) and tree subgroups (bone type, implant length, and quality of study).…”

“…These results are supported by recent systematic reviews and meta‐analyses that found no significant difference of implant survivals for short implants compared to standard implant …”

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

“…Newly published systematic reviews and meta-analysis have revealed high survival rates of suprastructures and implants after prosthetic rehabilitation with short implants compared with various bone augmentation techniques and placement of standard length implants, which is in accordance with the result of the present systematic review [ 20 , 21 , 41 ]. However, the use of short implants is still considered controversial as a consequence of an unfavourable crown-to-implant ratio, increased risk of biological and technical complications due to potential overload and early implant failure owing to diminished bone-to-implant contact and PIMBL [ 12 , 18 , 42 , 43 ].…”

Principles of biomechanics in oral implantology

“…The disadvantages of bone augmentation (morbidity at the donor site, increased complication risks, increased time and costs, resorption of bone graft etc.) together with the increasing performance of reduced size implants should be kept in mind when developing the treatment plan [23][24][25]. Also, when the ridge is narrow in its coronal part, it is advised to reduce the bone height and insert shorter implants with an increased diameter than longer, narrow implants [26].…”