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Ravidà A, Serroni M, Borgnakke WS, Romandini M, Wang ICI, Arena C, Annunziata M, Cecoro G, Saleh MHA. Short (≤6 mm) compared with ≥10-mm dental implants in different clinical scenarios: A systematic review of randomized clinical trials with meta-analysis, trial sequential analysis and quality of evidence grading. J Clin Periodontol 2024; 51:936-965. [PMID: 38764386 DOI: 10.1111/jcpe.13981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 02/15/2024] [Accepted: 03/16/2024] [Indexed: 05/21/2024]
Abstract
AIM To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short (≤6 mm) perform as well as long (≥10 mm) implants regarding implant survival, marginal bone loss, and biologic and prosthetic complications in different clinical scenarios. MATERIALS AND METHODS Cochrane Collaboration's risk of bias tool and the GRADE approach were applied. Results were synthesized using random-effects meta-analyses assessed by trial sequential analyses. RESULTS Forty reports on 19 RCTs comprising 2214 (1097 short; 1117 long) implants were included. Moderate/high certainty/quality evidence demonstrated similar 5-year survival rates for ≤6-mm and ≥10-mm implants in non-augmented bone and full-mouth rehabilitation in either jaw, and for 6-mm implants in the maxilla instead of sinus lift. Nevertheless, the evidence for 5-year survival rates remains inconclusive or insufficient for the remaining combinations of implant lengths and clinical scenarios. They include 4-mm and 5-mm implants as alternatives to sinus lift as well as placing all implant lengths ≤6 mm instead of vertical ridge augmentation with long implants. Marginal bone level and short- and long-term biologic or prosthetic complications were similar. CONCLUSIONS Based on moderate/high certainty/quality evidence from 5-year RCTs, implants ≤6 mm may be viable alternatives to ≥10-mm implants in either jaw in native bone and full-arch rehabilitation, and 6-mm implants may be used as an alternative to sinus lift. TRIAL REGISTRATION PROSPERO ID: CRD42021254365.
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Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Matteo Serroni
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Innovative Technologies in Medicine and Dentistry, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Wenche S Borgnakke
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - I-Ching Izzie Wang
- Department of Periodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa, USA
| | - Claudia Arena
- Department of Mental and Physical Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - Gennaro Cecoro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Emfietzoglou R, Dereka X. Survival Rates of Short Dental Implants (≤6 mm) Used as an Alternative to Longer (>6 mm) Implants for the Rehabilitation of Posterior Partial Edentulism: A Systematic Review of RCTs. Dent J (Basel) 2024; 12:185. [PMID: 38920886 PMCID: PMC11202938 DOI: 10.3390/dj12060185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants (>6 mm) in atrophic alveolar ridges in terms of implant survival rates, peri-implant marginal bone loss (MBL), prevalence of peri-implantitis and technical complications. A thorough electronic search was performed until September 2023. RCTs with follow-up of at least 1-year post-loading comparing short implants with rough surfaces to longer implants in the posterior jaws of systemically and periodontally healthy, partially edentulous adults were considered. Studies with incomplete information on the number of patients, follow-up or definition of "short implants" were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used for Risk of bias assessment. Fixed-effects meta-analysis of the selected studies was applied to compare the outcome variables. Random-effect meta-analysis was performed, on the basis of within-study comparisons. In total, 16 articles were selected for meta-analysis and incorporated 408 short implants and 475 longer implants inserted in 317 and 388 patients, respectively. The survival rates of longer implants in pristine or augmented bone were significantly increased compared to short implants (95%CI: 2-5%, p < 0.001). Standard-length implants displayed increased, although non-statistically significant MBL (95%CI: -0.17-0.04, p > 0.05), and prevalence of peri-implantitis (95%CI: 0-5%, p > 0.05). No statistically significant differences were observed between short and long implants in terms of technical complications (implant-level 95%CI: -4-6%, p > 0.05). Short implants represent a promising alternative treatment option for the rehabilitation of posterior jaws to avoid additional bone augmentation procedures. Nonetheless, they should be selected cautiously due to a potentially limited survival rate compared to longer implants. A major limitation of this study is the variability in the included studies regarding sample size, patient profile, type of bone, loading protocol, definition of peri-implantitis, among others. This study received no external funding. The study protocol was registered in PROSPERO (CRD42023485514).
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Thoma DS, Haas R, Sporniak-Tutak K, Garcia A, Taylor TD, Tutak M, Pohl V, Hämmerle CHF. Randomized controlled multi-centre study comparing shorter dental implants (6 mm) to longer dental implants (11-15 mm) in combination with sinus floor elevation procedures: 10-year data. J Clin Periodontol 2024; 51:499-509. [PMID: 38296249 DOI: 10.1111/jcpe.13954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/27/2023] [Accepted: 01/12/2024] [Indexed: 03/16/2024]
Abstract
AIM To compare implant survival and complication rates between shorter and standard-length implants with sinus augmentation and restored with single crowns, at 10 years of loading. MATERIALS AND METHODS One-hundred and one patients (137 implants) with a ridge height of 5-7 mm in the posterior maxilla were randomly assigned to two treatment modalities: shorter implants (6 mm) (group short [GS]) or standard-length implants (11-15 mm) with sinus grafting (group graft [GG]). Following the insertion of final restorations, patients were regularly recalled for up to 10 years. Assessed outcomes encompassed implant survival, marginal bone levels (MBLs), biological and technical parameters and patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile). Non-parametric statistical analysis was used to analyse the data. RESULTS For the 5- to 10-year follow-up period, 77 patients with 105 implants (GS: 36 patients/48 implants; GG: 41/57) were available for re-examination (drop-out rate 21%). Implant survival rates at the patient level were 96.0% (GS; 2 failures) and 100% (GG) (inter-group p = .24). Median MBLs amounted to 0.00 mm (min 0.00; max 3.25; GS) and 0.00 mm (min 0.00; max 4.55; GG) (inter-group p = .73). Technical complications predominantly occurred within the first 5 years (inter-group p > .05). Peri-implantitis rates were 4.2% (GS) and 13.3% (GG) (intergroup p = .37). Median OHIP-49 scores were 7.00 (0.00; 39.00; GS) and 9.00 (0.00; 196; GG) (inter-group p = .61) at 10 years. CONCLUSIONS Based on similar 10-year implant survival rates, reduced patient morbidity and lower costs, the use of shorter dental implants might well serve as an alternative treatment concept to longer implants placed in conjunction with sinus grafting for patients with a limited ridge height in the posterior maxilla. Study register: https://clinicaltrials.gov/ct2/show/NCT01030523.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Robert Haas
- Akademie für Orale Implantologie, Private Practice, Vienna, Austria
| | | | - Abel Garcia
- University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Marcin Tutak
- Aesthetic Dent, Private Practice, Szczecin, Poland
| | - Veronika Pohl
- Akademie für Orale Implantologie, Private Practice, Vienna, Austria
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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Nickenig HJ, Terheyden H, Reich RH, Kreppel M, Linz C, Lentzen MP. Oral health-related quality of life (OHRQoL) and implant therapy: A prospective multicenter study of preoperative, intermediate, and posttreatment assessment. J Craniomaxillofac Surg 2024; 52:59-64. [PMID: 37891090 DOI: 10.1016/j.jcms.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 10/29/2023] Open
Abstract
The purpose of this multicenter continuation study was to use high patient numbers in order to generate reliable statements regarding the association between different implant indications and OHRQoL. Patients with various types of indication for dental implants, ranging from single tooth loss to edentulous jaws, were included. Quality of life relating to dental implants was assessed through the oral health impact profile (OHIP-G-21), which has a summary score from 0 to 20 in healthy patients. In total, 16 253 patients from 29 centers (European Centers for Dental Implantology (ECDI)) were involved in the study between 2009 and 2021.8251 patients (50.7%) completed the questionnaire after implant insertion, and 4996 patients (30.7%) after prosthodontic treatment. The average age was 54 years (range 18-88 years). Posterior single-tooth gap (28.5%) and free-end gap (27.8%) were the most frequent indications. The preoperative OHIP-G-21 score for all patients was 32.81 (SD 11.92), while the score during the healing period was 30.00 (SD 10.72), and after completion of treatment 27.24 (SD 9.26) (p < 0.001). The most significant improvements in OHIP-G-21 scores were in the indication of edentulous jaw (phase 1, 41.81 (SD 15.53); phase 2, 35.39 (SD 14.22); phase 3, 29.60 (SD 10.12) (p < 0.001). The study revealed significant improvements in the most frequently reported problems (chewing, serious concerns, appearance) (p < 0.001). Insertion of dental implants and prosthodontic rehabilitation led to an improved OHRQoL for patients with all indications for dental implants. Special attention should be paid to patients with edentulous jaw, since in comparison with other indications it had the greatest impact on improving OHRQoL. The psychological dissatisfaction scale of the OHIP-G-21 represented the most important factors for patients, and these scores were substantially influenced by implant therapy. Thus, treating physicians should increase their focus on these factors, in order to avoid dissatisfaction and increase the likelihood of complete implant therapy success.
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Affiliation(s)
- Hans-Joachim Nickenig
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Hendrik Terheyden
- Department for Oral and Maxillofacial Surgery, Red Cross Hospital Kassel, Germany
| | - Rudolf H Reich
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Bonn and Faculty of Medicine, University of Bonn, Germany
| | - Matthias Kreppel
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Christian Linz
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany
| | - Max-Philipp Lentzen
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital Cologne and Faculty of Medicine, University of Cologne, Germany.
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Li A, Mu Z, Zeng B, Shen T, Hu R, Wang H, Deng H. Evaluation of two treatment concepts of four implants supporting fixed prosthesis in an atrophic maxilla: finite element analysis. BMC Oral Health 2023; 23:983. [PMID: 38066579 PMCID: PMC10709970 DOI: 10.1186/s12903-023-03706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Currently, oblique placement of long implants or the use of short implants to circumvent the maxillary sinus area and provide support for fixed prostheses are viable alternatives. The purpose of this study was to compare these two treatment concepts and ascertain which one exhibits superior biomechanical characteristics. METHODS Two different treatment concept models were constructed. The first one, LT4I, consisting of two mesial vertical implants positioned in lateral incisor regions and two distal tilted implants (45°) situated in second premolar regions of the maxilla. The second model, VS4I, includes two mesial vertical implants in lateral incisor regions and two vertically positioned short implants in second premolar regions. Numerical simulations were conducted under three loading types: firstly, oblique forces upon the molars; secondly, vertical forces upon the molars; thirdly, oblique forces upon the incisors. The maximum principal stress (σmax) and minimum principal stress (σmin) of the bone, as well as von Mises stress of the implants, were calcuated. RESULTS Under oblique loading on the molar, higher stress values in the bone were observed in LT4I group. Under vertical loading on molar, higher stress values in the bone were also observed in LT4I group. Furthermore, little difference was found between the two groups under oblique loading on the incisor. CONCLUSION Both treatment concepts can be applicable for edentulous individuals with moderate atrophic maxilla. Compared to tilted implants, short implants can transmit less occlusal force to the supporting tissues.
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Affiliation(s)
- Anlin Li
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China
| | - Zhixiang Mu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China
| | - BaiRui Zeng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China
| | - Tianxi Shen
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China
| | - Rongdang Hu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China
| | - Huining Wang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China.
| | - Hui Deng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, PR China.
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Kermanshah H, Keshtkar A, Hassani A, Bitaraf T. Comparing short implants to standard dental implants: a systematic review and meta-analysis of randomized controlled trials with extended follow-up. Evid Based Dent 2023; 24:192-193. [PMID: 37568011 DOI: 10.1038/s41432-023-00924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE To compare the difference of marginal level changes (MBL), implant failure (IF), biological and prosthetic complications (BC and PC), and prosthetic failure (PF) of short implants (SH) and standard implants (ST). MATERIALS AND METHODS Electronic searches (PubMed, Web of Science, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and manual searches were performed to identify all randomized controlled trials (RCTs) evaluating SH to ST. Applying Stata, a meta-analysis was conducted on the weighted mean difference (WMD) and standardized mean difference (SMD) of MBL and the risk difference (RD) of the secondary outcome. RESULTS Twenty-four articles were involved in the present study. There were statistically significant differences in MBLs, preferring short implants in the maxilla (WMD: -0.147 (CI: -0.224, -0.070), I2: 76.6%; SMD: -0.757 (CI: -1.226, -0.289), I2: 89.2%) and in the mandible (WMD: -0.377 (CI: -0.656, -0.098), I2: 85.8%; SMD: -0.811 (CI: -1.418, -0.204), I2: 78.8%). There were no significant differences in IF (RD: 0.011 (-0.002, 0.023), I2: 0.0%), PF (RD:0.003 (-0.007, 0.014), I2: 0.0%), and PC (RD:0.001 (-0.008, 0.010), I2: 0.0%). There were significantly higher biological complications (RD: -0.071 (-0.106, -0.036), I2: 0.82.9%) for ST compared to SH in both jaws up to a 10-year follow-up. CONCLUSION SH and ST had comparable overall outcomes, but short implants had less marginal bone loss and lower biological complications. However, more research is needed to confirm these findings.
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Affiliation(s)
- Hamid Kermanshah
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hassani
- Department of Oral and Maxillofacial Surgery, Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Tahereh Bitaraf
- Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, 19585/175, Tehran, Iran.
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Dental and Craniomaxillofacial Implant Surgery. J Oral Maxillofac Surg 2023; 81:E75-E94. [PMID: 37833030 DOI: 10.1016/j.joms.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Shimogishi M, Kawakami S, Tachikawa N. Clinical Evaluation of Short (6 mm) and Longer Implants Placed Side by Side in Posterior Partially Edentulous Area: A 3-Year Observational Study. Int J Dent 2023; 2023:9086628. [PMID: 37456792 PMCID: PMC10348857 DOI: 10.1155/2023/9086628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/04/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Background Short implants have been proposed as an alternative solution for the rehabilitation of atrophic posterior region. Purpose To compare the clinical outcomes between 6 mm short implants and conventional implants placed under similar conditions of bone quality and occlusal loading. Materials and Methods Nine patients received atone 6 mm implant and one standard-length (8 mm length or longer) implants in a total of 10 partially edentulous areas. Implants were left submerged for 3-6 months healing period and the screw-retained splinted prostheses were delivered. When the provisional or final restoration was placed, and at each year after loading, standardized intraoral radiograph was taken for themarginal bone level (MBL) changes around the implants. Subsequently, the patients were recalled for the clinical examination evaluating the implant survival, sulcus bleeding index, suppuration, and the incidence of prosthetic complications at every 6 months after the definitive crown delivery. The observation period was continued to 3 years (mean follow-up was 3.4 ± 0.3 years) after functional loading. Results Nine patients (10 short implants and 10 standard length implants) were selected in this study. Cumulative survival rates of the short implants and standard-length implants were 100% in both groups, and no biological and prosthetic complication were found in 3 years observation period. Cortical bone thickness of implant insertion sites was 1.39 ± 0.45 mm at short implants and 1.38 ± 0.69 mm at standard-length implants, and trabecular bone computed tomography values of implant insertion sites was 424.1 ± 290.1 at short implants and 410.9 ± 267.9 at standard-length implants. The MBL changes were -0.30 ± 0.71 mm at short implants and -0.19 ± 0.78 mm at standard-length implants at 3 years follow-up visit. No significant difference was found in the average of MBL changes between implant length. Conclusions Within the limits of this study, it can be concluded that 6 mm short implants in a posterior edentulous region showed excellent results compared with conventional implants.
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Affiliation(s)
- Masahiro Shimogishi
- Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sawako Kawakami
- Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tachikawa
- Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Carls PF, Bernasconi M, Carinci F, Lawrence M, Lambrecht JT. The use of autologous bone for augmentation procedures leads to low prevalence of peri-implantitis-a retrospective study over a 20-year period. J Craniomaxillofac Surg 2023; 51:130-138. [PMID: 36774308 DOI: 10.1016/j.jcms.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/11/2022] [Accepted: 12/27/2022] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to compare the prevalence of peri-implantitis in implants inserted into pristine bone (control) to implants where autologous bone was used for grafting procedures (study). All patients who underwent implant surgery during a 20 years interval by one maxillofacial implant surgeon and received a prosthodontic rehabilitation afterwards were eligible for inclusion in the study. Periimplant bone resorption and periimplant disease were assessed. Of 421 patients 384 (91.2%) patients responded to a recall after having been treated over a 20-year period by one maxillofacial surgeon and several dentists. A total of 110 patients had 239 implants in pristine bone, and 274 patients had 607 implants placed in combination with autologous bone grafting procedures. Mean time in function was 74 months (range 15-236 months). In all, 342 implants (34.8%) were in function for longer than 7 years. A total of 64 implant sites (7.6%) in 39 patients (10.2%) showed signs of peri-implant mucositis. In addition, 17 implants (2.0%) in 14 patients (3.6%) revealed signs of peri-implantitis, of which five implants were in the control group (2.09%) whereas 12 implants were in the study group (1.98%), with no statistically significant difference (p = 0.8405). More than half of the patients with peri-implantitis had a history of periodontitis. Three implants were lost due to peri-implantitis and four implants failed for other reasons, resulting in an overall success rate of 99.2% in 846 implants. CONCLUSIONS: Within the limitations of the study it seems that the use of autologous bone still is a relevant option when performing augmentation procedures because of the low prevalence of peri-implantitis.
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Affiliation(s)
- Peter F Carls
- Oxford University Hospitals & Oral & Maxillofacial Surgery Practice, Oxford, United Kingdom.
| | - Marco Bernasconi
- Zurich University Dental School & Private Dental Practice, Zurich, Switzerland
| | - Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Italy
| | - Mark Lawrence
- Private Dental Practice, Wallingford, Oxfordshire, United Kingdom
| | - J Thomas Lambrecht
- Department of Oral Surgery, Oral Radiology and Oral Medicine, University Center for Dental Medicine Basel, University of Basel, Switzerland
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Short Implants versus Standard Implants and Sinus Floor Elevation in Atrophic Posterior Maxilla: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with ≥5 Years' Follow-Up. J Pers Med 2023; 13:jpm13020169. [PMID: 36836403 PMCID: PMC9960634 DOI: 10.3390/jpm13020169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background and objectives: The aim of this systematic review with meta-analysis was to assess the performance of short implants in comparison with standard implants and sinus floor elevation in atrophic posterior maxilla. Materials and methods: The protocol of the study was registered in the PROSPERO database (CRD42022375320). An electronic search on three databases (PubMed, Scopus, Web of Science) was performed to find randomized clinical trials (RCTs) with ≥5 years' follow-up, published until December 2022. Risk of bias (ROB) was calculated using Cochrane ROB. A meta-analysis was performed for primary (implant survival rate, ISR) and secondary outcomes (marginal bone loss, MBL; biological and prosthetic complications). Results: Of 1619 articles, 5 RCTs met the inclusion criteria. The ISR showed a risk ratio (RR) of 0.97 [0.94, 1.00] (CI 95%), p = 0.07. The MBL indicated a WMD of -0.29 [-0.49, -0.09] (CI 95%), p = 0.005. Biological complications showed a RR of 0.46 [0.23, 0.91] (CI 95%), p = 0.03. Prosthetic complications showed a RR of 1.51 [0.64, 3.55] (CI 95%), p = 0.34. Conclusions: The available evidence suggests that short implants might be used as an alternative to standard implants and sinus floor elevation. After 5 years, in terms of ISR, standard implants and sinus floor elevation showed a higher survival rate comparted to short implants, although statistical significance was not achieved. Future RCTs with long-term follow-up are needed to draw a clear conclusion on the advantages of one method over another.
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Grunau O, Terheyden H. Lateral augmentation of the sinus floor followed by regular implants versus short implants in the vertically deficient posterior maxilla: a systematic review and timewise meta-analysis of randomized studies. Int J Oral Maxillofac Surg 2022:S0901-5027(22)00466-0. [DOI: 10.1016/j.ijom.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
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Response to comments on: Short versus standard implants for single-crown restorations in the posterior region: A systematic review and meta-analysis. J Prosthet Dent 2022; 128:541-544. [PMID: 36137813 DOI: 10.1016/j.prosdent.2022.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 11/24/2022]
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Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6681-6698. [PMID: 36070150 DOI: 10.1007/s00784-022-04628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Short implants are proposed as a less invasive alternative with fewer complications than standard implants in combination with sinus lift. The aim of this systematic review and meta-analysis was to state the efficacy of placing short implants (≤ 6 mm) compared to standard-length implants (≥ 8 mm) performing sinus lift techniques in patients with edentulous posterior atrophic jaws. Efficacy will be evaluated through analyzing implant survival (IS) and maintenance of peri-implant bone (MBL). METHODS Screening process was done using the National Library of Medicine (MEDLINE by PubMed), EMBASE, the Cochrane Oral Health, and Web of Science (WOS). The articles included were randomized controlled trials. Risk of bias was evaluated according to The Cochrane Collaboration's tool. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). A random-effects model was applied. Secondary outcomes such as surgical time, patient satisfaction, mucositis and peri-implantitis, pain, and swelling were analyzed. RESULTS Fourteen studies (597 patients and 901 implants) were evaluated. IS was 1.02 risk ratio, ranging from 1.00 to 1.05 (CI 95%) (p = 0.09), suggesting that IS was similar when both techniques were used. MBL was higher in patients with standard-length implants plus sinus lift elevation (p = 0.03). MBL was 0.11 (0.01-0.20) mm (p = 0.03) and 0.23 (0.07-0.39) mm (p = 0.005) before and after 1 year of follow-up, respectively, indicating that the marginal bone loss is greater for standard-length implants. DISCUSSION Within the limitations of the present study, as relatively small sample size, short dental implants can be used as an alternative to standard-length implants plus sinus elevation in cases of atrophic posterior maxilla. Higher MBL was observed in the groups where standard-length implants were used, but implant survival was similar in both groups. Moreover, with short implants, it was observed a reduced postoperative discomfort, minimal invasiveness, shorter treatment time, and reduced costs. CLINICAL CLINICAL RELEVANCE The low MBL promoted by short implants does contribute to a paradigm shift from sinus grafting with long implants to short implants. Further high-quality long-term studies are required to confirm these findings.
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Medikeri RS, Pereira MA, Waingade M, Navale S. Survival of surface-modified short versus long implants in complete or partially edentulous patients with a follow-up of 1 year or more: a systematic review and meta-analysis. J Periodontal Implant Sci 2022; 52:261-281. [PMID: 36047581 PMCID: PMC9436640 DOI: 10.5051/jpis.2007340367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 09/24/2021] [Accepted: 11/16/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Short implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants. METHODS Electronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL. RESULTS The failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1-10 years). A significant difference was observed in mean MBL (mean difference=-0.43, 95% CI, -0.63, -0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants. CONCLUSIONS Short surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42020160185.
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Affiliation(s)
| | | | - Manjushri Waingade
- Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, India
| | - Shwetambari Navale
- Department of Periodontology, Sinhgad Dental College and Hospital, Pune, India
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Short Implants versus Longer Implants with Sinus Floor Elevation: A Systemic Review and Meta-Analysis of Randomized Controlled Trials with a Post-Loading Follow-Up Duration of 5 Years. MATERIALS 2022; 15:ma15134722. [PMID: 35806845 PMCID: PMC9267683 DOI: 10.3390/ma15134722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/08/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
This study compared the outcome of fixed prostheses supported by short implants (<8 mm) and longer implants (≥8 mm) with an elevated sinus floor after 5 years of follow-up. The literature searches were performed electronically and manually in PubMed, EMBASE, and Web of Science databases to identify relevant articles published from 1 January 2013 to 31 January 2020. We selected eligible studies using inclusion criteria and assessed their quality. From 1688 identified studies, five randomized controlled trials were included. Between the short implant group and the control group, the implant failure-related pooled risk ratio (RR) was 3.64 (p = 0.07). The RR for technical complications was 2.61 (p = 0.0002), favoring longer implants. Marginal peri-implant bone loss after 1 and 5 years of function showed statistically significant less bone loss at short implants (1 year: mean difference = 0.21 mm; p < 0.00001; 5 years: mean difference = 0.26 mm; p = 0.02). The implant failure and the biological failure of both groups were similar after 5 years of follow-up. Short implants could be an alternative to long implants with an elevated sinus floor for atrophic maxillae in aging populations. Studies with larger trials and longer periods of follow-up (10 years) remain essential.
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Sui H, Tang Z, Zhang X, Wei D, Meng H, Han J. A prospective, multicentre study of 6-mm short implants in posterior alveolar bone supporting splinted crowns: A 5-year follow-up study. J Clin Periodontol 2022; 49:537-546. [PMID: 35246872 DOI: 10.1111/jcpe.13610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/30/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the clinical and radiographic outcomes of 6-mm short implants, placed in the posterior jaws and supporting splinted crowns, at 5 years after early loading. MATERIALS AND METHODS Forty-five patients with 95 implants (diameter: 4 mm; length: 6 mm) were enrolled at three centres. Two to three implants were placed in either the maxillary or the mandibular posterior region in each patient and restored with screw-retained splinted crowns at 6 weeks later. Clinical and radiographic outcomes were evaluated at implant placement, at loading, and at 6, 12, 24, 36, and 60 months after loading. Biological and mechanical complications were recorded. Marginal changes in bone level in relation to clinical parameters were evaluated using a generalized linear mixed model. RESULTS During the 5 years of follow-up, the mean change in the marginal bone level (MBL) was 0.04 ± 0.14 mm. Four implants in four patients were lost before loading, one implant in one patient was lost at the 5-year follow-up, and two patients were lost to follow-up. The survival and success rates were 88.4% (38/43) at the patient level. The incidence rates of peri-implant mucositis and peri-implantitis were 29.4% and 7.0%, respectively. The rate of technical complications was 14.0%. CONCLUSIONS Over a 5-year period, 6-mm short implants supporting early loaded splinted crowns in maxillary or mandibular posterior regions showed stable MBLs and acceptable technical and biological complication rates.
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Affiliation(s)
- Huiping Sui
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Zhihui Tang
- Department of Oral and Maxillofacial Surgery, The Second Clinic of Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiao Zhang
- Department of Oral and Maxillofacial Surgery, The First Dental Center, Peking University School of Stomatology, Beijing, China
| | - Diyuan Wei
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
| | - Jie Han
- Department of Periodontology, Peking University School of Stomatology, Beijing, China
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Mo JJ, Lai YR, Qian SJ, Shi JY, Lai HC, Tang GY. Long-term clinical outcomes of short implant (6mm) in relation to Implant Disease Risk Assessment (IDRA). Clin Oral Implants Res 2022; 33:713-722. [PMID: 35509121 DOI: 10.1111/clr.13935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the long-term survivals 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<0.05). Higher risk profile (hazard ratio: 2.63, 95% CI: 1.32-5.25, p<0.05) 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<0.01). 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.
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Affiliation(s)
- Jia-Ji Mo
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Yi-Rao Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.,Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shu-Jiao Qian
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Jun-Yu Shi
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Hong-Chang Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Guo-Yao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Otolaryngology-Head and Neck Surgery, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Comments regarding: Xu X, Hu B, Xu Y, Liu Q, Ding H, Xu L. Short versus standard implants for single-crown restorations in the posterior region: A systematic review and meta-analysis. J Prosthet Dent 2020;124:530-8. J Prosthet Dent 2022; 128:541. [DOI: 10.1016/j.prosdent.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/20/2022]
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de Oliveira Fernandes GV, Costa BMGN, Trindade HF, Castilho RM, Fernandes JCH. Comparative analysis between extra‐short implants (≤ 6mm) and 6mm‐longer implants: A
Meta‐Analysis
of Randomized Controlled Trial. Aust Dent J 2022; 67:194-211. [DOI: 10.1111/adj.12900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Rogerio M. Castilho
- University of Michigan Periodontics and Oral Medicine Department Ann Arbor Michigan U.S.A
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Nielsen HB, Schou S, Bruun NH, Starch-Jensen T. Professional and patient-reported outcomes of two surgical approaches for implant-supported single-crown restoration: 1-year results of a randomized controlled clinical trial. Clin Oral Implants Res 2021; 33:197-208. [PMID: 34866250 DOI: 10.1111/clr.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test whether there is a difference in professional and patient-reported outcome measures (PROM) after single-crown restoration supported by short implants (SI) (6 mm) compared with standard length implants (SLI) (13 mm) in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. MATERIAL AND METHODS Forty patients were randomly allocated to SI or SLI/MSFA. PROM included Oral Health Impact Profile (OHIP-14) questionnaire and subjective assessment of the peri-implant soft tissue (A), implant crown (B), implant function (C) and overall implant treatment outcome (D) using visual analogue scale (VAS). Professional assessment included pink aesthetic score (PES) and white aesthetic score (WES). RESULTS No significant differences in professional or PROM between the two treatment modalities were revealed at any time point (p > .05). OHIP-14 score decreased at baseline and 1 year after functional implant loading compared with preoperative measurements indicating improved quality of life with both treatment modalities. The 1-year mean VAS score was 9.4 (A), 9.3 (B), 9.6 (C) and 9.3 (D) for SI compared with 9.3 (A), 9.6 (B), 9.7 (C) and 9.2 (D) for SLI. The 1-year mean PES/WES scores were 11.3 and 8.1 for SI compared with 11.2 and 8.1 for SLI/MSFA. CONCLUSIONS Prosthetic rehabilitation of the posterior part of the maxilla with SI or SLI/MSFA revealed no significant differences in professional and PROM after 1 year of implant loading.
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Affiliation(s)
| | - Søren Schou
- Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Bruun
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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Posterior jaws rehabilitation with < 7mm-short implants. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e45-e56. [PMID: 34563727 DOI: 10.1016/j.jormas.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/23/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The results with shorter and shorter implants have been revolutionizing the implantology scenario and are worthy of being well-analyzed and understood. This review aims to add further knowledge about the last 10-years observation period on < 7mm-short implants in the posterior atrophic jaws, better defining the indication of their use. METHODS From a Medline database research, systematic reviews, controlled and no- controlled trials (CT, n-CT) with ≥ 3years-follow-ups on <7 mm / ≥ 5mm-short implants (group A), and clinical studies with ≥ 1year-follow-up on 4mm-short implants (group B) were considered. The outcomes, in terms of implant survival rate (SR), marginal bone loss (MBL), and complications were analyzed according to the duration of follow-ups, implant site (maxilla and mandible), type of prosthesis (single crown or splinted units), vertically impaired or normal sites. RESULTS Thirty-four trials (28 for group A and six for group B) were selected. Group A: a mean follow up of 5,8 (3-10) years came out; pre-and post-loading SR range was 94.4- 100% and 89.6-100%, respectively; the range of MBL was 0.12-1.49; 50% of CT found less statistically significant surgical complications in comparison with standard implants (ST) in reconstructed sites, while major prosthetic problems were recorded with short -implants (SH) in 37.5% of CT; in no atrophied sites, a mean SR range of 86.7-100 % vs. 88-100 % and a total bone loss of 2 vs.1.6 for SH vs.ST emerged. Group B: the overall mean follow-up period was 2,3 years, and the pre-and post- SR ranges were 93-100 % and 87.5-100 %, respectively. The MBL range was 0.02- 0.63 mm. All RCT reported significantly fewer surgical complications with SH than with ST in reconstructed mandibles within one year. No prosthetic complications were reported for up to 5 years using no pontics or cantilevers fixed bridges. CONCLUSIONS Similar or even better results for SH than ST in terms of post-loading SR and MBL came out for < 7mm/ ≥ 5mm-short implants in atrophic bone regardless of the prosthetic solutions, with less surgical complications but a few more prosthetic problems; the good results up to 5 years for 4mm-short implants in mandibles are associated with splinted and no-risk prosthetic solutions.
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Pellegrino G, Lizio G, Rossi F, Tuci L, Ferraioli L, Stefanelli LV, Di Carlo S, De Angelis F. A 4 mm-Long Implant Rehabilitation in the Posterior Maxilla with Dynamic Navigation Technology: A Case Report after a Three-Years Post-Loading Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189808. [PMID: 34574728 PMCID: PMC8466597 DOI: 10.3390/ijerph18189808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022]
Abstract
The use of short (<8 mm long) and ultra-short (<6 mm long) implants allows the prosthetic rehabilitation of the posterior ridges of the jaws avoiding reconstructive procedures. Nevertheless, this approach requires vast experience to ensure the primary stability of the fixture in a correct position. Computer-aided implantology (CAI) achieves better results than the free-hand one in terms of placement accuracy, reducing the surgical risks and the operative timings. Dynamic navigation (DN) allows the surgeon to track the position and movements of the drill in real-time on the CT imaging data set. It is more versatile than the computed static system, enabling the operator to change the guidance coordinates according to the intra-operative feedbacks. A mono-edentulous upper right first molar site was rehabilitated with a four mm-long implant to avoid reconstructive techniques, drastically rejected by the patients. The case was managed within a DN protocol considering the minimal available bone and the prosthetic demands. The phases of this procedure were strictly documented up to a 3-year follow-up. No intra-operative problems occurred, and adequate primary stability of the implant was obtained. The prosthetic loading was carried out within only six weeks without any complications. No variation of the baseline clinical scenario as evidenced clinically and radiographically at the end of follow-up. No similar cases are reported in the literature.
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Affiliation(s)
- Gerardo Pellegrino
- Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy; (G.P.); (F.R.); (L.T.); (L.F.)
| | - Giuseppe Lizio
- Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy; (G.P.); (F.R.); (L.T.); (L.F.)
- Correspondence:
| | - Fabio Rossi
- Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy; (G.P.); (F.R.); (L.T.); (L.F.)
| | - Lorenzo Tuci
- Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy; (G.P.); (F.R.); (L.T.); (L.F.)
| | - Lorenzo Ferraioli
- Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy; (G.P.); (F.R.); (L.T.); (L.F.)
| | - Luigi Vito Stefanelli
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (L.V.S.); (S.D.C.); (F.D.A.)
| | - Stefano Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (L.V.S.); (S.D.C.); (F.D.A.)
| | - Francesca De Angelis
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (L.V.S.); (S.D.C.); (F.D.A.)
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Thoma DS, Wolleb K, Schellenberg R, Strauss FJ, Hämmerle CHF, Jung RE. Two short implants versus one short implant with a cantilever: 5-Year results of a randomized clinical trial. J Clin Periodontol 2021; 48:1480-1490. [PMID: 34448219 PMCID: PMC9292666 DOI: 10.1111/jcpe.13541] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/02/2021] [Indexed: 02/05/2023]
Abstract
Aim To test whether or not the use of a short implant with a cantilever results in similar clinical and radiographic outcomes compared to two adjacent short implants with single tooth reconstructions. Materials and methods Thirty‐six patients with two adjacent missing teeth in the posterior region were randomly assigned to receive either a single 6‐mm implant with a cantilever (ONE‐C) or two 6‐mm implants (TWO). Fixed reconstructions were inserted 3–6 months after implant placement and patients were re‐examined up to 5 years (FU‐5). Results A total of 26 patients were available for re‐examination at FU‐5. The survival rate amounted to 84.2% in ONE‐C and to 80.4% in TWO (inter‐group: p = .894). Technical complication rates amounted to 64.2% (ONE‐C) and to 54.4% (TWO) (inter‐group: p = 1.000). From baseline to FU‐5, the median changes of the marginal bone levels were 0.13 mm in ONE‐C and 0.05 mm in TWO (inter‐group: p = .775). Probing depth, bleeding on probing, and plaque control record values showed no significant differences between the two treatment modalities (p > .05). Conclusions Short implants with a cantilever render similar clinical and radiographic outcomes compared to two adjacent short implants at 5 years, however, they tend to fail at earlier time points suggesting an overload of the implants. Considering the modest survival rates, the clinical indication of either treatment option needs to be carefully evaluated. ClinicalTrials.gov (NCT01649531).
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Roman Schellenberg
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Clinical performance of short versus standard dental implants in vertically augmented bone: an overview of systematic reviews. Clin Oral Investig 2021; 25:6045-6068. [PMID: 34398327 DOI: 10.1007/s00784-021-04095-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To answer the question: What do we know so far about the clinical performance of short implants (≤ 7 mm) when compared to standard length implants in vertically augmented bone, as well as which is the overall confidence of the systematic reviews (SRs) about this topic? MATERIALS AND METHODS An overview of SRs was conducted. The searches were performed in six electronic databases and grey literature. SRs about short (≤ 7 mm) versus standard dental implants performance in vertically augmented bone were included. The assessed outcomes were marginal bone loss (MBL), implant survival (IS), prosthetic (PC) and biological complications (BC), costs, surgical time, and patient satisfaction. AMSTAR 2 was used to evaluate the overall confidence of included SRs. RESULTS Thirteen SRs were included. Nine of twelve SRs reported a lower MBL for the short implant group. All the included SRs showed no difference in the IS between groups. A higher rate of BC was reported for standard-length implants in four out of five SRs. No differences regarding PC were reported in four of five SRs. Information related to patient preference, cost, and surgery time were underreported. The confidence evaluation of the SRs was stratified as low for five SRs and critically low for eight SRs. CONCLUSIONS In an overall low-to-very low confidence levels, short implants appear to perform better in the mid-term (up to 5 years) than standard dental implants associated with vertical bone augmentation regarding MBL and BC, but they have a similar performance regarding IS rates and PC. There is an imperative need to improve the methodological quality of SRs, and efforts should focus on conducting RCTs to broaden the knowledge on this topic. CLINICAL RELEVANCE Short implants could represent a viable, simpler, and less invasive treatment when available bone height is limited.
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Nielsen HB, Schou S, Bruun NH, Starch-Jensen T. Single-crown restorations supported by short implants (6 mm) compared with standard-length implants (13 mm) in conjunction with maxillary sinus floor augmentation: a randomized, controlled clinical trial. Int J Implant Dent 2021; 7:66. [PMID: 34268630 PMCID: PMC8282885 DOI: 10.1186/s40729-021-00348-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of the present study was to test the H0-hypothesis of no difference in the clinical and radiographical treatment outcome of single-crown restorations supported by short implants compared with standard length implants in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Forty patients with partial edentulism in the posterior part of the maxilla were randomly allocated to treatment involving single-crown restorations supported by short implants or standard length implants in conjunction with MSFA. Clinical and radiographical evaluation were used to assess survival of suprastructures and implants, peri-implant marginal bone loss (PIMBL), biological, and mechanical complications. Results Both treatment modalities were characterized by 100% survival of suprastructures and implants after 1 year. Mean PIMBL was 0.60 mm with short implants compared with 0.51 mm with standard length implants after 1 year of functional loading. There were no statistically significant differences in survival of suprastructure and implants, PIMBL, and mechanical complications between the two treatment modalities. However, a higher incidence of biological complications was associated with standard length implants in conjunction with MSFA. Conclusion Within the limitations of the present study, it can be concluded that single-crown restorations supported by short implants seems to be comparable with standard length implants in conjunction with MSFA. However, long-term studies are needed before final conclusions can be provided about the two treatment modalities. Trial registration Clinicaltrials.Gov ID: NCT04518020. Date of registration: August 14, 2020, retrospectively registered.
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Affiliation(s)
- Helle Baungaard Nielsen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
| | - Søren Schou
- Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Bruun
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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Bergamo ETP, Zahoui A, Barrera RB, Huwais S, Coelho PG, Karateew ED, Bonfante EA. Osseodensification effect on implants primary and secondary stability: Multicenter controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:317-328. [PMID: 34047046 PMCID: PMC8362055 DOI: 10.1111/cid.13007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/16/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022]
Abstract
Background Osseodensification (OD) has shown to improve implant stability; however, the influences of implant design, dimensions, and surgical site characteristics are unknown. Purpose To compare the insertion torque (IT) and temporal implant stability quotients (ISQ) of implants placed via OD or subtractive drilling (SD). Materials and Methods This multicenter controlled clinical trial enrolled 56 patients, whom were in need of at least 2 implants (n = 150 implants). Patients were treated with narrow, regular, or wide implants and short, regular, or long implants in the anterior or posterior region of the maxilla or in the posterior region of the mandible. Osteotomies were performed following manufacturers recommendation. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery, 3 and 6 weeks. Results Data complied as a function of osteotomy indicated significantly higher IT for OD relative to SD. OD outperformed conventional SD for all pairwise comparisons of arches (maxilla and mandible) and areas operated (anterior and posterior), diameters and lengths of the implants, except for short implants. Overall, ISQ data also demonstrated significantly higher values for OD compared to SD regardless of the healing period. Relative to immediate readings, ISQ values significantly decreased at 3 weeks, returning to immediate levels at 6 weeks; however, ISQ values strictly remained above 68 throughout healing time for OD. Data as a function of arch operated and osteotomy, area operated and osteotomy, implant dimensions and osteotomy, also exhibited higher ISQ values for OD relative to SD on pairwise comparisons, except for short implants. Conclusions OD demonstrated higher IT and temporal ISQ values relative to SD, irrespective of arch and area operated as well as implant design and dimension, with an exception for short implants. Future studies should focus on biomechanical parameters and bone level change evaluation after loading.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Raúl Bravo Barrera
- Implantology Postgraduate Program, San Sebastian University, Santiago, Chile
| | - Salah Huwais
- Department of Periodontology, Postgraduate Program, University of Illinois at Chicago College of Dentistry, Chicago, Illinois, USA
| | - Paulo G Coelho
- Department of Biomimetics and Biomaterials, NYU College of Dentistry, New York City, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, New York City, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York City, New York, USA
| | - Edward Dwayne Karateew
- Department of Periodontology, Postgraduate Program, University of Illinois at Chicago College of Dentistry, Chicago, Illinois, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
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Pardo-Zamora G, Ortiz-Ruíz AJ, Camacho-Alonso F, Martínez-Marco JF, Molina-González JM, Piqué-Clusella N, Vicente-Hernández A. Short Dental Implants (≤8.5 mm) versus Standard Dental Implants (≥10 mm): A One-Year Post-Loading Prospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115683. [PMID: 34073250 PMCID: PMC8199359 DOI: 10.3390/ijerph18115683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
Background: Recent data have shown that short dental implants can be the preferred treatment in most of cases of posterior atrophic alveolar ridges, offering higher survival and lower complication rates than long implants. The survival rates, stability, and marginal bone level changes were compared between short implants (7 and 8.5 mm) and standard-length implants (≥10 mm). Methods: Prospective observational study in which adult patients requiring ≥1 osseointegrated implants to replace missing teeth were recruited consecutively. A clinical examination was performed on the day the definitive prosthesis was placed and after 6 and 12 months. Implant stability quotient (ISQ), marginal bone level (MBL) changes, and the correlation between these parameters and the characteristics of the implants were evaluated. Results: A total of 99 implants were inserted (47 short, 52 standard) in 74 patients. The 12-month survival rate was 100%. ISQ values showed a similar pattern for both types of implants. No correlation was found between ISQ changes after one year and MBL values, nor between the latter and the characteristics of the implants. Conclusions: With clinical treatment criteria, shorter implants (7 and 8.5 mm in length) can be just as useful as standard-length implants in atrophic alveolar ridges, demonstrating similar rates of survival, stability, and crestal bone loss.
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Affiliation(s)
- Guillermo Pardo-Zamora
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.J.O.-R.); (F.C.-A.); (J.F.M.-M.); (J.M.M.-G.); (A.V.-H.)
- Correspondence: ; Tel.: +34-606-064-848
| | - Antonio José Ortiz-Ruíz
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.J.O.-R.); (F.C.-A.); (J.F.M.-M.); (J.M.M.-G.); (A.V.-H.)
| | - Fabio Camacho-Alonso
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.J.O.-R.); (F.C.-A.); (J.F.M.-M.); (J.M.M.-G.); (A.V.-H.)
| | - José Francisco Martínez-Marco
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.J.O.-R.); (F.C.-A.); (J.F.M.-M.); (J.M.M.-G.); (A.V.-H.)
| | - Juan Manuel Molina-González
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.J.O.-R.); (F.C.-A.); (J.F.M.-M.); (J.M.M.-G.); (A.V.-H.)
| | - Núria Piqué-Clusella
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Av Joan XXIII, 27-31, 08028 Barcelona, Spain;
| | - Ascensión Vicente-Hernández
- Department of General Dentistry and Implants, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.J.O.-R.); (F.C.-A.); (J.F.M.-M.); (J.M.M.-G.); (A.V.-H.)
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Clinical Outcome of Dental Implants after Maxillary Sinus Augmentation with and without Bone Grafting: A Retrospective Evaluation. MATERIALS 2021; 14:ma14102479. [PMID: 34064784 PMCID: PMC8151007 DOI: 10.3390/ma14102479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/21/2022]
Abstract
(1) Background: The purpose of the present study was to retrospectively evaluate and compare the outcome of two sinus augmentation grafting protocols using a xenograft or blood clot alone over a 72-month follow-up. (2) Methods: Patients who received simultaneous lateral sinus floor augmentation and implant placement were included. Subjects were divided into two groups according to the grafting material, namely xenograft or blood clot, and into sub-groups based on the residual alveolar bone height (RABH) below the maxillary sinus, namely 4 to 6 mm or >6 mm. Kaplan-Meier survival estimates were calculated for each material group and for each sub-group at 1, 3, and 6 years. (3) Results: In total, 289 implants inserted in 136 patients with a one-stage procedure were considered. A total of 35 failures were registered. Overall survival rates were 94.2% for xenograft and 85.9% for blood clot alone at 1 year, 91.1% and 81.6% at 3 years, and 91.1% and 78.7% at 6 years. (4) Conclusions: In patients with 4-6 mm RABH, graftless interventions exploiting blood clot alone were not as successful as those using xenograft. When the RABH is low, sinus floor augmentation associated with grafting materials should be preferred whenever possible.
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Dubourg S, Huck O, Jung S. Implant-based oral rehabilitation in systemic sclerosis patients: a systematic review. J ORAL IMPLANTOL 2021; 48:251-260. [PMID: 33945625 DOI: 10.1563/aaid-joi-d-20-00384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Systemic sclerosis is a rare multisystem autoimmune disorder that significantly impacts the orofacial region. Several oral features including microstomia and increased tooth loss contribute to the mouth-related disability. Prosthetic rehabilitation is very challenging in these patients. As the spectrum of dental implants indications has been recently extended to patients with various systemic disorders, the aim of this systematic review was to evaluate the outcome of dental implants in patients with systemic sclerosis. A literature search was conducted in Medline/PubMed database to identify eligible case-reports. 10 publications were included in qualitative synthesis. A total of 71 implants have been reported in 10 patients with systemic sclerosis with a mean of 7.1 +/- 3.8 implants per patient. Pre-implant surgeries have been described for 3 patients. Implant survival rates were higher than 98% but the mean follow-up time was only 28.3 +/- 18.6 months. Complications have been observed in 3 patients with 1 implant failure and peri-implant bone resorption in 2 patients. Although implant survival rates were high, an individualized assessment of risk-benefit balance is mandatory before indicating implant-based rehabilitation in patients suffering from systemic sclerosis and a scrupulous maintenance program has to be implemented. Further studies are strongly required to establish clinical guidelines.
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Affiliation(s)
- Sarah Dubourg
- Hôpitaux Universitaires de Strasbourg, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), Pôle de Médecine et de Chirurgie Bucco-Dentaires - Strasbourg, France
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire - Hôpitaux Universitaires de Strasbourg, Service de Parodontologie et Centre de Référence Maladies Rares Orales et Dentaires - INSERM UMR 1260 - Strasbourg, France
| | - Sophie Jung
- Universite de Strasbourg 1: Universite de Strasbourg Faculté de Chirurgie Dentaire 8 rue Sainte Elisabeth FRANCE STRASBOURG Alsace 67000 Université de Strasbourg, Faculté de Chirurgie Dentaire - Hôpitaux Universitaires de Strasbourg, Centre de Référence Maladies Rares Orales et Dentaires - INSERM UMR_S 1109 - Strasbourg, France
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Yu X, Xu R, Zhang Z, Yang Y, Deng F. A meta-analysis indicating extra-short implants (≤ 6 mm) as an alternative to longer implants (≥ 8 mm) with bone augmentation. Sci Rep 2021; 11:8152. [PMID: 33854095 PMCID: PMC8047002 DOI: 10.1038/s41598-021-87507-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 03/30/2021] [Indexed: 12/28/2022] Open
Abstract
Extra-short implants, of which clinical outcomes remain controversial, are becoming a potential option rather than long implants with bone augmentation in atrophic partially or totally edentulous jaws. The aim of this study was to compare the clinical outcomes and complications between extra-short implants (≤ 6 mm) and longer implants (≥ 8 mm), with and without bone augmentation procedures. Electronic (via PubMed, Web of Science, EMBASE, Cochrane Library) and manual searches were performed for articles published prior to November 2020. Only randomized controlled trials (RCTs) comparing extra-short implants and longer implants in the same study reporting survival rate with an observation period at least 1 year were selected. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. A quantitative meta-analysis was performed to compare the survival rate, marginal bone loss (MBL), biological and prosthesis complication rate. Risk of bias was assessed with the Cochrane risk of bias tool 2 and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. 21 RCTs were included, among which two were prior registered and 14 adhered to the CONSORT statement. No significant difference was found in the survival rate between extra-short and longer implant at 1- and 3-years follow-up (RR: 1.002, CI 0.981 to 1.024, P = 0.856 at 1 year; RR: 0.996, CI 0.968 to 1.025, P = 0.772 at 3 years, moderate quality), while longer implants had significantly higher survival rate than extra-short implants (RR: 0.970, CI 0.944 to 0.997, P < 0.05) at 5 years. Interestingly, no significant difference was observed when bone augmentations were performed at 5 years (RR: 0.977, CI 0.945 to 1.010, P = 0.171 for reconstructed bone; RR: 0.955, CI 0.912 to 0.999, P < 0.05 for native bone). Both the MBL (from implant placement) (WMD: - 0.22, CI - 0.277 to - 0.164, P < 0.01, low quality) and biological complications rate (RR: 0.321, CI 0.243 to 0.422, P < 0.01, moderate quality) preferred extra-short implants. However, there was no significant difference in terms of MBL (from prosthesis restoration) (WMD: 0.016, CI - 0.036 to 0.068, P = 0.555, moderate quality) or prosthesis complications rate (RR: 1.308, CI 0.893 to 1.915, P = 0.168, moderate quality). The placement of extra-short implants could be an acceptable alternative to longer implants in atrophic posterior arch. Further high-quality RCTs with a long follow-up period are required to corroborate the present outcomes.Registration number The review protocol was registered with PROSPERO (CRD42020155342).
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Affiliation(s)
- Xiaoran Yu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Ruogu Xu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Zhengchuan Zhang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Yang Yang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Feilong Deng
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China. .,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China.
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31
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Two-Year Follow-Up of 4-mm-Long Implants Used as Distal Support of Full-Arch FDPs Compared to 10-mm Implants Installed after Sinus Floor Elevation. A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073846. [PMID: 33917587 PMCID: PMC8038839 DOI: 10.3390/ijerph18073846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND In edentulous patients, bone resorption cannot allow the installation of standard implants and it is demanded to use short implants in the residual alveolar bone or longer implants in grafted bone. AIM To compare the survival and bone level changes of standard plus short 4-mm implants used as distal support of a maxillary full-arch fixed dental prostheses (FDPs) with standard (10-mm) implants placed in association with a bilateral sinus floor augmentation procedure. MATERIAL AND METHODS Full-arch FDPs supported by six implants were randomly placed in both groups. In the control group, all implants were 10 mm long and 4.1 mm in diameter. The distal implant in both sides of the maxilla was installed after 4 months from bilaterally sinus floor elevation. In the test group (short group), the distal implant in both sides of the maxilla was 4 mm long and 4.1 mm in diameter. No sinus floor elevations were performed in the test group. Clinical assessments and X-rays were taken at prosthesis delivering and after 6, 12, 18, and 24 months. Patient-reported outcome measures (PROMs) were also evaluated before surgery and after 6, 12, and 24 months. RESULTS The changes over time of the bone level for the short implants were -0.01 ± 0.11 mm, -0.04 ± 0.13 mm, -0.17 ± 0.29 mm, and -0.28 ± 0.37 mm after 6, 12, 18, and 24 months from prosthesis delivering, respectively. For the standard implants, bone changes were -0.21 ± 0.33 mm (p = 0.103), -0.30 ± 0.32 mm (p = 0.023), -0.40 ± 0.37 mm (p = 0.144), and -0.54 ± 0.49 mm (p = 0.128), respectively. A statistically relevant difference was found only at 12 months after loading between the two groups. CONCLUSIONS Similar results on implant survival rate and marginal bone loss were observed for the short and standard implants, placed in association with a bilateral sinus floor augmentation procedure, used as distal support of a maxillary full-arch FDP. A statistically relevant difference was found only at 12 months after loading between the two groups (p = 0.023).
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32
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Strauss FJ, Hämmerle CHF, Thoma DS. Short communication: Cemented implant reconstructions are associated with less marginal bone loss than screw-retained reconstructions at 3 and 5 years of loading. Clin Oral Implants Res 2021; 32:651-656. [PMID: 33686723 DOI: 10.1111/clr.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/28/2021] [Accepted: 03/03/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To analyse whether there is a difference in marginal bone levels (MBL) and the respective changes between cemented and screw-retained reconstructions at 3 and 5 years of loading. METHODS Radiographic data from 14 prospective multicentre clinical trials following implant loading with fixed cemented (CEM) or screw-retained (SCREW) reconstructions with a 3- to 5-year follow-up were retrieved from a database. MBL and MBL changes were assessed at initiation of implant loading (BL), at 3 (FU-3) and 5 years (FU-5) thereafter. The presence of peri-implantitis was also determined. RESULTS Data from 1,672 implants at BL, 1,565 implants at FU-3 and 1,109 implants at FU-5 were available. The mean MBL amounted to 0.57 mm (SD 0.87) at BL, 0.55 mm (SD 0.86) at FU-3 and 0.65 mm (SD 1.18) at FU-5. At FU-3, the mean MBL was 0.44 mm (SD 0.65) in group CEM and 0.63 mm (SD 0.99) in group SCREW showing a significant difference between the groups (intergroup <0.05). At FU-5, the mean MBL was 0.42 mm (SD 0.77) in CEM and 0.80 mm (SD 1.37) in SCREW, again with significant differences between both groups (p < .05). MBL changes between BL and FU-3 amounted to 0.11 mm (SD 1.02) (bone loss) in SCREW and -0.17 mm (SD 1.03) (bone gain) in CEM. Similarly, mean MBL changes from BL to FU-5 amounted to 0.23 mm (SD 1.31) (bone loss) in SCREW and -0.26 mm (SD 1.27) (bone gain) in CEM. The prevalence of peri-implantitis amounted to 6.9% in CEM and 5.6% in group SCREW (intergroup p = .29063) at FU-3. At FU-5, peri-implantitis amounted to 4.6% in CEM and 6.2% in group SCREW (intergroup p = .28242). CONCLUSION Cemented implant reconstructions compared with screw-retained reconstructions revealed higher marginal bone levels and similar rates of peri-implantitis during 5 years. The difference in MBL and the respective changes between the two groups, however, appear to be clinically negligible.
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Affiliation(s)
- Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Shi JY, Lai YR, Qian SJ, Qiao SC, Tonetti MS, Lai HC. Clinical, radiographic and economic evaluation of short-6-mm implants and longer implants combined with osteotome sinus floor elevation in moderately atrophic maxillae: A 3-year randomized clinical trial. J Clin Periodontol 2021; 48:695-704. [PMID: 33570787 DOI: 10.1111/jcpe.13444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/06/2021] [Accepted: 02/08/2021] [Indexed: 12/25/2022]
Abstract
AIM To compare the 3-year clinical, radiographic and economic outcomes of short-6-mm implants and longer implants combined with osteotome sinus floor elevation (OSFE) in the posterior maxilla. MATERIAL AND METHODS This study enrolled 225 patients (225 implants with diameter of 4.1 mm and 4.8 mm) with a posterior maxillary residual bone height (RBH) of 6-8 mm. Patients were randomly divided into three groups: Group 1 (6 mm implants alone), Group 2 (8 mm implants + OSFE) and Group 3 (10 mm implants + OSFE). The following outcomes were recorded at 1 and 3-year examinations: implant survival, probing pocket depth (PPD), bleeding on probing (BOP), modified plaque index (mPI), marginal bone loss (MBL), biological and technical complications, complication-free survival and treatment costs. RESULTS At the 3-year follow-up, 199 patients (Group 1: 67; Group 2: 62; Group 3: 70) were re-examined. Implant survival rates were 91.80%, 97.08% and 100.00% in groups 1, 2 and 3. Implant survival rate in Group 1 was significantly lower than that in Group 3 (p = 0.029). A multivariate Cox model showed that the short-6-mm implants with wide diameter had a protective effect on implant survival (hazard ratio: 0.59, p = 0.001). No significant differences in BOP%, PPD, mPI, MBL and complication-free survival rate were found among the three groups. The average costs of retreatment were 8.31%, 1.96% and 0.56% of the total costs in groups 1, 2 and 3. The cost to avoid a 1% increase in implant loss associated with 6-mm implants over a 3-year period was 369 CNY (56 USD) using a 10-mm implant with OSFE and 484 CNY (74 USD) using an 8-mm implant with OSFE. CONCLUSION In the moderately atrophic posterior maxillae, the three treatments showed acceptable clinical, radiographic and economic outcomes with up to 3-year follow-up. 10-mm implants combined with OSFE showed more favourable implant survival and fewer maintenance costs in comparison with short-6-mm implants, which were less expensive.
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Affiliation(s)
- Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yi-Rao Lai
- Department of Oral and Maxillo-facial Implantology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shu-Jiao Qian
- Department of Oral and Maxillo-facial Implantology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Maurizio S Tonetti
- Department of Oral and Maxillo-facial Implantology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Short (6 mm) and Regular Dental Implants in the Posterior Maxilla-7-Years Follow-up Study. J Clin Med 2021; 10:jcm10050940. [PMID: 33804340 PMCID: PMC7957497 DOI: 10.3390/jcm10050940] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/14/2021] [Accepted: 02/19/2021] [Indexed: 12/15/2022] Open
Abstract
Short 6 mm dental implants are considered as an alternative to the maxillary sinus elevation and bone augmentation procedure where there is a reduced alveolar ridge height. The aim of this study was to compare the implant survival rate between short dental implants (6 mm) and regular length implants (11-13 mm) when placed in combination with bone grafting and loaded with a single non splinted crown, seven years after placing the implant. It was conducted as a controlled clinical study of 30 patients with partial edentulism in the posterior maxilla. The protocol included radiological and clinical evaluation of the C/I ratio (length of the superstructure divided by the length of the implant crestal part), marginal bone level (MBL), ultrasonography measurement of soft tissue surrounding implant (STT), patient-reported outcomes, and biological and technical complications. A total number of 28 implants (93%) remained integrated during follow-up period. MBL of 0.50 and 0.52 mm was observed for short implants and regular implants, respectively. MBL was checked for correlation with STT, and a negative correlation was found between MBL: STT. Our study has demonstrated a significantly lower implant survival rate for short implants compared to regular implants (87% compared to 100%). Despite the loss of several implants, good clinical results were achieved in the remaining implants in both groups. It is, therefore, worth considering short implants as an alternative to regular implants with a sinus lift surgery.
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Carosi P, Lorenzi C, Lio F, Laureti M, Ferrigno N, Arcuri C. Short implants (≤6mm) as an alternative treatment option to maxillary sinus lift. Int J Oral Maxillofac Surg 2021; 50:1502-1510. [PMID: 33637392 DOI: 10.1016/j.ijom.2021.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/15/2020] [Accepted: 02/06/2021] [Indexed: 02/03/2023]
Abstract
The aim of this systematic review was to evaluate survival rate of short dental implants placed in the posterior area of the maxilla. The electronic literature search of studies published between January 1, 2010 and February 29, 2020 was performed using specific word combinations. The outcome was to meta-analyse the implant survival rate (ISR). The search generated 238 potential studies. After screening procedures, only nine randomized controlled trials fulfilled the inclusion criteria and were selected for qualitative and quantitative analysis. ISR of short implants ranged from 91.9% to 100%, while standard-length implants ISR ranged from 82.9% to 100% with a follow-up from 1 to 5 years in function. The risk ratio difference was 1.24 (95% confidence interval: 0.63-2.45, P=0.52) for short dental implants failure when compared with standard dental implants, and was not statistically significant. Based on the evidence of the included studies, short implants (≤6mm) reported high survival rates over short to medium follow-up in posterior maxilla, but the long-term success is as yet not demonstrated.
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Affiliation(s)
- P Carosi
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy.
| | - C Lorenzi
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy
| | - F Lio
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy
| | - M Laureti
- Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - N Ferrigno
- Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - C Arcuri
- Department of Clinical Sciences and Translational Medicine, School of Dentistry, University of Rome 'Tor Vergata', Rome, Italy
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Chaware SH, Thakare V, Chaudhary R, Jankar A, Thakkar S, Borse S. The rehabilitation of posterior atrophic maxilla by using the graftless option of short implant versus conventional long implant with sinus graft: A systematic review and meta-analysis of randomized controlled clinical trial. J Indian Prosthodont Soc 2021; 21:28-44. [PMID: 33835066 PMCID: PMC8061432 DOI: 10.4103/jips.jips_400_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/08/2020] [Accepted: 10/03/2020] [Indexed: 01/23/2023] Open
Abstract
Aim The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla. Setting and Design Systematic review and meta analysis. Materials and Methods Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (<8.5 mm) and long implant (>8.5 mm) with sinus graft were included. (Prospero CRD42020186972). Statistical Analysis Used Random-effect model, fixed-effect model, A funnel plot and the Egger's test. Results Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I2 = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I2 = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I2 = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I2 = 0%). Conclusion There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.
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Affiliation(s)
- Sachin Haribhau Chaware
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Vrushali Thakare
- Department of Public Health Dentistry, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Ritu Chaudhary
- Department of Prosthodontics, Royal College of Surgeons England, Britannia Dental Surgery, Newport, UK
| | - Ajit Jankar
- Department of Prosthodontics, MIDSR Dental College, Latur, Maharashtra, India
| | - Smruti Thakkar
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Sidesh Borse
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
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Short versus standard implants for single-crown restorations in the posterior region: A systematic review and meta-analysis. J Prosthet Dent 2020; 124:530-538. [DOI: 10.1016/j.prosdent.2019.09.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 01/10/2023]
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Guljé FL, Meijer HJA, Abrahamsson I, Barwacz CA, Chen S, Palmer PJ, Zadeh H, Stanford CM. Comparison of 6-mm and 11-mm dental implants in the posterior region supporting fixed dental prostheses: 5-year results of an open multicenter randomized controlled trial. Clin Oral Implants Res 2020; 32:15-22. [PMID: 33025645 PMCID: PMC7821315 DOI: 10.1111/clr.13674] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022]
Abstract
Objective The aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6‐mm or 11‐mm implants, placed in the posterior maxilla and mandible, during a 5‐year follow‐up period. Materials and methods Ninety‐five patients with adequate bone height for 11‐mm implants, were randomly allocated to a 6‐mm group (test group with short implants) or an 11‐mm group (control group with standard‐length implants). Two or three implants of the same length were placed in each patient and after 6 weeks loaded with a splinted provisional restoration. This was followed by definitive splinted restoration 6 months after implant placement. Clinical and radiographic parameters, including the occurrence of complications were recorded. Results A total of 49 patients were enrolled to receive 6‐mm implants (n = 108) and 46 patients to receive 11‐mm implants (n = 101). Three implants (two of 6 mm and one of 11 mm in length) were lost before loading and one 6‐mm implant after 15 months of function, and one 11‐mm implant was lost during the first year of function. The 5‐year survival rates were 96.0% and 98.9% in the 6‐mm and 11‐mm group, respectively. The mean marginal bone level changes 5 years post‐loading were 0.01 ± 0.45 mm (bone gain) in the 6‐mm group and −0.12 ± 0.93 mm (bone loss) in the 11‐mm group (p = .7670). Clinical parameters, including plaque, bleeding on probing and pocket probing depth were not significantly different between the groups, and also technical complications were low. Conclusion The clinical and radiographic outcomes of 6‐mm short and 11‐mm standard‐length implants were not different during a 5‐year evaluation period.
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Affiliation(s)
- Felix L Guljé
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dental Implants, De Mondhoek, Apeldoorn, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ingemar Abrahamsson
- Department of Periodontology, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden
| | - Christopher A Barwacz
- Department of Family Dentistry, University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA, USA
| | - Stephen Chen
- Department of Periodontics, Melbourne, School of Dental Science, University of Melbourne, Melbourne, Vic., Australia
| | - Paul J Palmer
- King's College London Dental Institute at Guy's King's and St Thomas' Hospitals, London, UK
| | - Homayoun Zadeh
- VISTA Institute for Therapeutic Innovations, Woodland Hills, CA, USA
| | - Clark M Stanford
- Department of Restorative Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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Iezzi G, Perrotti V, Felice P, Barausse C, Piattelli A, Del Fabbro M. 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. Clin Implant Dent Relat Res 2020; 22:552-566. [DOI: 10.1111/cid.12946] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/12/2020] [Indexed: 08/30/2023]
Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Pietro Felice
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Carlo Barausse
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
- Biomaterials Engineering Catholic University of San Antonio de Murcia (UCAM) Murcia Spain
- Fondazione Villaserena per la Ricerca Città Sant'Angelo Pescara Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
- Dental Clinic IRCCS Orthopedic Institute Galeazzi Milan Italy
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Rameh S, Menhall A, Younes R. Key factors influencing short implant success. Oral Maxillofac Surg 2020; 24:263-275. [PMID: 32323043 DOI: 10.1007/s10006-020-00841-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
AIM This systematic article reviews the literature on the confounding parameters that affect short implant survival in order to establish specific surgical and prosthetic protocols that create an optimal biomechanical scenario and ensure implant longevity. MATERIALS AND METHODS The available literature was screened for randomized clinical trials and prospective cohort and retrospective studies, published up to February 20, 2020, on the prognosis of short-length implants placed in posterior jaws. Studies evaluating the 5-year clinical performance of short dental implants (5 mm or 6 mm) in fixed rehabilitations of partially edentulous posterior jaws were included. RESULTS Eleven studies were selected after assessment of inclusion and exclusion criteria, of which 8 were RCTs, 2 were prospective studies, and 1 was a retrospective study. After 5 years in function, 22 short (12 in maxilla and 10 in mandible) and 10 standard (2 in maxilla and 8 in mandible) implants were lost, resulting in high survival rates independent of implant length or location. More biological complications were found in standard implants especially those placed in augmented posterior mandibles (135 complications compared to 48 in short mandibular implants). Splinted prostheses were associated with less technical complications (15 out of 53 complications affecting short implants). CONCLUSION The findings of this review showed that, when used correctly, short implants achieve predictable and promising long-term outcomes, provided they are placed following a comprehensive surgical and prosthetic protocol, based on the different biomechanical parameters essential to optimize long-term prognosis. CLINICAL SIGNIFICANCE The use of short implants in clinical practice has considerably increased in a wide variety of cases, given that they offer several advantages for both patient and practitioner. Recent literature shows that, when specific criteria are respected, new generations of short implants present high, long-term survival rates. This review is designed to provide a thorough understanding of the surgical and prosthetic protocols that create an optimal biomechanical scenario for short implants and improve their prognosis.
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Affiliation(s)
- Stephanie Rameh
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Cranio-Facial Research Laboratory, Unit of Oral Biology, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Abdallah Menhall
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
- Cranio-Facial Research Laboratory, Unit of Oral Biology, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
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Xu X, Huang J, Fu X, Kuang Y, Yue H, Song J, Xu L. Short implants versus longer implants in the posterior alveolar region after an observation period of at least five years: A systematic review and meta-analysis. J Dent 2020; 100:103386. [PMID: 32479956 DOI: 10.1016/j.jdent.2020.103386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/30/2020] [Accepted: 05/26/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES This meta-analysis compared clinical outcomes, including survival rate, marginal bone loss (MBL), and technical and biological complications of short implants (<7 mm) and long implants (≥7 mm) placed in the posterior alveolar bone. SOURCES Electronic (via PubMed, EMBASE, Cochrane Library) and manual searches were performed for articles published prior to November 29, 2019. STUDY SELECTION The review protocol was registered with PROSPERO (CRD42019140718). Only randomized controlled trials (RCTs) comparing short implants and standard implants in the same study after an observation period of at least five years were included. DATA Nine RCTs were included in this study. The survival rates of short implants (<7 mm) ranged from 86.7 %-98.5 %, whereas the survival rates of longer implants (≥7 mm) were 95.1%-100% with follow-up ranging from 5 to 10 years. Dichotomous variables were compared using the Mantel-Haenszel (MH) method, and continuous variables were compared using the inverse variance (IV) method. The random effects model and the fixed effects model were used. Meta-analyses showed that short implants had a poorer survival rate than longer implants (P = 0.008). Short implants were associated with lower MBL than longer implants (P < 0.001). The biological complications of short implants were lower (P < 0.001) and the technical complications were higher, than those of long implants (P = 0.006). CONCLUSIONS The results indicate that although the survival rate of short implants in the maxilla may be lower than that of long implants, the survival rate of short implants in the mandible is similar to that of long implants, and short implants can result in a lower rate of biological complications. The conclusions should be interpreted with caution due to the limited numbers of participants and implants. CLINICAL SIGNIFICANCE When selecting the length of implants, surgeons should consider survival rate, the location of implant placement, their own clinical experience, and the incidence of complications.
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Affiliation(s)
- Xinxin Xu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China; College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Jiao Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Xuewei Fu
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yunchun Kuang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Yue
- Department of Stomatology Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China; College of Stomatology, Chongqing Medical University, Chongqing, China.
| | - Ling Xu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China; Stomatological Hospital of Chongqing Medical University, Chongqing, China.
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Lozano-Carrascal N, Anglada-Bosqued A, Salomó-Coll O, Hernández-Alfaro F, Wang HL, Gargallo-Albiol J. Short implants (<8mm) versus longer implants (≥8mm) with lateral sinus floor augmentation in posterior atrophic maxilla: A meta-analysis of RCT`s in humans. Med Oral Patol Oral Cir Bucal 2020; 25:e168-e179. [PMID: 32040465 PMCID: PMC7103450 DOI: 10.4317/medoral.23248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 01/20/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND One of the greatest challenges that dentists face today is to rehabilitate severe atrophied alveolar ridges in partially and completely edentulous patients with implants. Despite the high survival rate of implants placed next to sinus elevation, this technique presents complications that can be avoided by placing short implants, an option that also presents high survival rates. For this reason, the aim of this study is to compare the survival rate, marginal bone loss and complications associated with short implants (<8 mm) versus longer implants (≥8mm) placed with lateral sinus floor elevation in posterior atrophic maxillae. MATERIAL AND METHODS A literature search was conducted by two independent reviewers in the PubMed/Medline (National Library of Medicine, Washington, DC) electronic database for articles published from January 2007 to July 2018. Seven qualified articles were selected for the meta-analysis. RESULTS The test for overall effect did not find statistical significance in the survival rates, overall complications, intra-operative complications, post-operative complications and prosthetic complications. However, the test showed statistically significant differences in biological complications in favor of standard implants, and marginal bone loss between control and test groups in favor of short implants (<8mm) was found. CONCLUSIONS Within the limitations of the present study, prosthetic rehabilitations with short implants (<8mm) in posterior maxilla is a reliable treatment option as an alternative to lateral wall sinus floor augmentation.
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Affiliation(s)
- N Lozano-Carrascal
- Surgery Department. International University of Catalonia Josep trueta s/n, Sant Cugat del Valles, Barcelona, Spain
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
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