Short dental implants
What is the current thinking on short dental implant?
Short dental implants will continue to grow in popularity as they offer a lot of advantages. Where and when we can use them effectively will continue to be an issue that we research.
Short dental implant research
Short dental implants are a suitable alternative. Tong IJOMI 2017 Systemic reviews show dental implants equal to or less than 6.5mm or 6mm 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. However, Li JPros 2022 finds 8.5mm and less do the same whether splint or not. 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 implant vs longer implant and graft?
A study shows bone loss is higher in the longer implants in augmented bone than in the 5mm implants. Felice JOI 2019 Building off a previous study, 5mm to 6.6mm implants do just as well 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.
Sabatini JOMI 2021 finds the 4mm Straumann does as well as conventional in terms of stability.
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
Short implants or sinus lift?
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. Short implants have better or comparable results for every metric when doing a sinus lift. Vetromilla meta-analysis JPD 2021.
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