Dental Implant Research

Dental Implant Research

Oct 12 

  • 1.5-2mm bone buccal and lingual
  • narrow diameter 3.75mm or less
  • conical connection abutment
  • platform switch .4mm or more
  • provisionalize immediately
  • definitive stock Zr abutment and abutment level impression
  • 1.5mm to tooth 3mm between implants
  • 5mm from crest to contact point for papilla fill
  • subcrestal placement

They are talking about Ankylos implant system or similar

Meta-analysis Amri JPD 2016 1mm between implants may not lead to bone loss – this does contradict the 3mm recommendation but that may be related to getting a papilla and not bone loss

Loading protocol doesn’t impact positive effect laser texturing has  Guarnieri 2014

Cochrane systematic review of dental implants

There is a suggestion that immediate and immediate-delayed implants may be at a higher risk of implant failure and complications than delayed implants, on the other hand the aesthetic outcome might be better when placing implants just after tooth extraction. There is not enough reliable evidence supporting or refuting the need for augmentation procedures at immediate implants placed in fresh extraction sockets or whether any of the augmentation techniques is superior to the others.

Wider and longer implants may be placed at time extraction 1 2

96-100% immediate loaded full-arch fixed prosthesis in mandible 1 2 3

immediate survival rates beat delayed

>10mm beat less than – 8.5mm and less do well systemic review  – 6-7.5mm seem fine too – 8-9mm 10 year results same as longer 

in the 5-8.5mm the longer the longer survival systemic review

at least 7mm Balevi JADA Feb 2013 no additional risk failure in first year after loading non-augmented conventional healing

pristine bone sites beat augmented

>3.5mm beat <3.5mm

immediate placement immediate load with full arch SR prov works 1 2

Study of immediate placement immediate load SR prov.  Immediate load of implants in post extraction sites are very predictable as it appears that primary stability more than arch is the fundamental factor.  Immediate>delayed, augmented=pristine, greater than 10mm matters, width does not, bruxism matters. 1

Cluster implant failure trend

type IV bone better with anodic oxidized implant

3 implant replace three teeth leave unsplinted 1

Bone level vs tissue level – bone loss =

Dental Implant Survival Rate under specific conditions

Meta analysis and systemic review of survival rate of dental implants in irradiated patients is 85% Nobrega JPD 2016


Short dental implant research

Short dental implants are a suitable alternative.  Tong IJOMI 2017 Systemic review showing dental implants equal to or less than 6.5mm in length have similar survival rates. Al-Johany JOMI 2019. Ravida JOMI 2019 states dental implants equal to 6 mm or less have satisfactory survival and complication rates but do better when we splint them. Interesting to note that just one year earlier Papaspyridakos 2018 COIR states implants equal or less than 6mm may present a greater risk of failure. So 6.5mm may be the magical number for now but a lot of this likely has to do with thread design, metallurgy, and surfaces so the number will likely drop more in the future.

Short implants in the 5-7 mm range in the maxilla do as well as longer ones with sinus grafting over a 5 year period. What is nice about the Thoma 2018 JCP and Guljé 2019 JOI articles is that they are following these patients and repeatedly putting out the results. For example, here is a 3 year mark study. Another study shows bone loss is higher in the longer implants in augmented bone than in the 5mm implants. Felice JOI 2019

Building off the previous study, 5mm to 6.6mm implants do just as good as longer implants in augmented bone, meaning better to do the shorter implant than augment then bone since cheaper and faster. Esposito JOI 2019

The 4mm dental implant

These 4mm Straumann implants do well splinted. Gašperšič JPRD 2021

If more than 4mm bone present in the posterior mandible then short implants should be the recommendation based on literature evidence. If less than 4mm then GBR is the recommendation. Felice IJPRD 2021

4mm tissue level implants work well for an all on x prosthesis with longer implants in the anterior. Schimmel JPD 2021

Dental implant and keratinized tissue

Most studies show that there is no difference in survival with or without keratinized tissue. However, most dentists definitely prefer to have some. Bone loss was higher with keratinized tissue in some studies. Todisco JOI 2019

Short implants for sinus lifts

Short implant have better or comparable results for every metric when doing a sinus lift. Vetromilla meta-analysis JPD 2021.

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