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Implantology Prosthodontics Supporting Your Practice

Are short implants in patients with atrophic alveolar ridges successful?

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This summary is based on the article published in the Journal of Dental Research: Tooth Loss in Aggressive Periodontitis: A Systematic Review (2013)

Context 

Short implants (SHIs) have been proposed as an alternative choice for the prosthetic treatment of atrophic alveolar ridges, which may provide surgical advantages including reducing morbidity, treatment time, and costs. However, longer implants have always been considered more reliable due to both an improved crown-to-implant ratio and a greater surface area available for osseointegration, which dissipates the imposed occlusal forces.

The poor bone density of the atrophic jawbone, the posterior location in the mouth, and the augmented crown height of the restorations represent important risk factors in the use of SHIs that might jeopardize their survival.

Purpose of the Review

The review intends to gather and evaluate data from published articles to assess if the provision of short implants in patients with
atrophic alveolar ridges may satisfy the desired outcomes of a successful implant therapy, as described by the Academy of Osseointegration Guidelines (2010)

Key Findings

  • In conclusion, short implant-supported prostheses appear to be a valid option in the treatment of the atrophic jaw.
  • Although SHIs have been historically considered less reliable than standard implants, in this review, recent publications specifically designed to study SHIs have reported successful results and a low incidence of biological and biomechanical complications.
  • It was recognized that the “the implant maximized surface area as the main contributing factor to the high success rate”. (1) 
  • With regard to the prosthetic aspect, although the success of many different kinds of prostheses has been demonstrated in the reviewed works, the authors have recommended precautions, i.e., joining SHIs with standard implants (2), eliminating lateral contacts on mandibular excursions, avoiding cantilevers, augmenting implant numbers, and splinting multiple implants (3).
  • Even though the surgical technique, the implant location, and the type of edentulism did not seem to affect short-implant survival, a notable finding is that most of the failures occurred before prosthesis placement.

References

  1. Griffin TJ, Cheung WS (2004). The use of short, wide implants in posterior areas with reduced bone height: a retrospective investigation. J Prosthet Dent 92:139-144.
  2. ten Bruggenkate CM, Asikainen P, Foitzik C, Krekeler G, Sutter F (1998). Short (6-mm) nonsubmerged dental implants: results of a multicenter
  3. clinical trial of 1 to 7 years. Int J Oral Maxillofac Implants 13:791-798.
  4. Misch CE, Steignga J, Barboza E, Misch-Dietsh F, Cianciola LJ, Kazor C (2006). Short dental implants in posterior partial edentulism: a multicenter retrospective 6-year case series study. J Periodontol 77:1340-1347.

 

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