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.
Similar content being viewed by others
References
Jung RE, Zembic A, Pjetursson BE et al (2012) Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 23:2–21
Pjetursson BE, Thoma D, Jung R et al (2012) A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 23:22–38
Srinivasan M, Meyer S, Mombelli A, Müller F (2017) Dental implants in the elderly population: a systematic review and meta-analysis. Clin Oral Implants Res 28:920–930
Esposito M, Barausse C, Pistilli R et al (2019) Posterior atrophic jaws rehabilitated with prostheses supported by 5×5 mm implants with a nanostructured calcium-incorporated titanium surface or by longer implants in augmented bone. Five-year results from a randomised controlled trial. Int J Oral Implant 12:39–54
Thoma DS, Haas R, Abel KS et al (2018) Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11–15 mm) in combination with sinus floor elevation procedures: 5year data. J Clin Periodontol 45:1465–1474
Felice P, Cannizzaro G, Barausse C et al (2014) Short implants versus longer implants in vertically augmented posterior mandibles: a randomised controlled trial with 5-year after loading follow-up. Eur J Oral Implant 7:359–369
Felice P, Pistilli R, Barausse C et al (2019) Posterior atrophic jaws rehabilitated with prostheses supported by 6-mm-long 4-mm-wide implants or by longer implants in augmented bone. Five-year post-loading results from a within-person randomised controlled trial. Int J Oral Implant 12:57–72
Rossi F, Botticelli D, Cesaretti G et al (2016) Use of short implants (6 mm) in a single-tooth replacement: a 5-year follow-up prospective randomized controlled multicenter clinical study. Clin Oral Implants Res 27:458–464
Felice P, Checchi L, Barausse C et al (2016) Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: one-year post-loading results from a multicenter randomised controlled trial. Eur J Oral Implant 9:35–45
Guljé F, Abrahamsson I, Chen S et al (2013) Implants of 6 mm vs. 11 mm lengths in the posterior maxilla and mandible: a 1-year multicenter randomized controlled trial. Clin Oral Implants Res 24:1325–1331
Felice P, Pistilli R, Lizio G et al (2009) Inlay versus onlay iliac bone grafting in atrophic posterior mandible: a prospective controlled clinical trial for the comparison of two techniques. Clin Implant Dent Relat Res 11:69–82
Aloy-Prósper A, Peñarrocha-Oltra D, Peñarrocha-Diago MA, Peñarrocha-Diago M (2015) The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: a systematic review. Med Oral Patol Oral Cir Bucal 20:251
Silva L, de Lima VN, Faverani LP et al (2016) Maxillary sinus lift surgery—with or without graft material? A systematic review. Int J Oral Maxillofac Surg 45:1570–1576
Chiapasco M, Romeo E, Casentini P, Rimondini L (2004) Alveolar distraction osteogenesis vs. vertical guided bone regeneration for the correction of vertically deficient edentulous ridges: a 1-3-year prospective study on humans. Clin Oral Implants Res 15:82–95
Roccuzzo A, Marchese S, Worsaae N, Jensen SS (2020) The sandwich osteotomy technique to treat vertical alveolar bone defects prior to implant placement: a systematic review. Clin Oral Investig 24:1073–1089
Benic GI (2000) Hämmerle CHF (2014) Horizontal bone augmentation by means of guided bone regeneration. Periodontol 66:13–40
Abayev B, Juodzbalys G (2015) Inferior alveolar nerve lateralization and transposition for dental implant placement. Part I: a systematic review of surgical techniques. J Oral Maxillofac Res 6:1–13
Garg AK, Morales MJ (1998) Lateralization of the inferior alveolar nerve with simultaneous implant placement: surgical techniques. Pract periodontics aesthetic Dent 10:1197–1204
Del Fabbro M, Wallace S, Testori T (2013) Long-term implant survival in the grafted maxillary sinus: a systematic review. Int J Periodontics Restorative Dent 33:773–783
Esposito M, Cannizzaro G, Soardi E et al (2011) A 3-year post-loading report of a randomised controlled trial on the rehabilitation of posterior atrophic mandibles: short implants or longer implants in vertically augmented bone? Eur J Oral Implantol 4(4):301–311
Esposito M, Felice P, Worthington H V (2014) Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev 13(5):1–38
Mezzomo LA, Miller R, Triches D et al (2014) Meta-analysis of single crowns supported by short (<10 mm) implants in the posterior region. J Clin Periodontol 41:191–213
Romeo E, Bivio A, Mosca D et al (2010) The use of short dental implants in clinical practice: literature review. Minerva Stomatol 59:23–31
Morand M, Irinakis T (2007) The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants. J Oral Implantol 33:257–266
Renouard F, Nisand D (2006) Impact of implant length and diameter on survival rates. Clin Oral Implants Res 17:35–51
Papaspyridakos P, De Souza A, Vazouras K et al (2018) Survival rates of short dental implants (≤6 mm) compared with implants longer than 6 mm in posterior jaw areas: a meta-analysis. Clin Oral Implants Res 29:8–20
Whittemore R, Chao A, Jang M et al (2014) Methods for knowledge synthesis: an overview. Hear Lung J Acute Crit Care 43:453–461
Tricco AC, Zarin W, Ghassemi M et al (2018) Same family, different species: methodological conduct and quality varies according to purpose for five types of knowledge synthesis. J Clin Epidemiol 96:133–142
Iezzi G, Perrotti V, Felice P et al (2020) 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 22:552–566
Ravidà A, Wang I-C, Sammartino G et al (2019) Prosthetic rehabilitation of the posterior atrophic maxilla, short (≤6 mm) or long (≥10 mm) dental implants? A systematic review, meta-analysis, and trial sequential analysis. Implant Dent 28:590–602
Esposito M, Buti J, Barausse C et al (2019) Short implants versus longer implants in vertically augmented atrophic mandibles: a systematic review of randomised controlled trials with a 5-year post-loading follow-up. Int J oral Implantol 12:267–280
Starch-Jensen T, Nielsen HB (2018) Prosthetic rehabilitation of the partially edentulous atrophic posterior mandible with short implants (≤ 8 mm) Compared with the sandwich osteotomy and delayed placement of standard length implants (> 8 mm): a systematic review. J of oral Maxillofac Res 9:1–17
Chen S, Ou Q, Wang Y, Lin X (2019) Short implants (5–8 mm) versus long implants (≥10 mm) with augmentation in atrophic posterior jaws: a meta-analysis of randomized controlled trials. J Oral Rehabil 46(12):1192–1203
Yan Q, Wu X, Su M, Hua F (2019) Short implants (≤ 6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis. BMJ Open 9(10):1–17
Nielsen HB, Schou S, Isidor F et al (2018) Short implants (8 mm) compared to standard length implants (>8 mm) in conjunction with maxillary sinus floor augmentation: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 48(2):239–249
Nisand D, Picard N, Rocchietta I (2015) Short implants compared to implants in vertically augmented bone: a systematic review. Clin Oral Implants Res 26(11):170–179
Shamseer L, Moher D, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 349:7647
Booth A, Clarke M, Ghersi D et al (2011) An international registry of systematic-review protocols. Lancet 377:108–109
Bougioukas KI, Liakos A, Tsapas A et al (2018) Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol 93:9–24
Higgins J, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. In: Cochrane Collab. www.handbook.cochrane.org. Accessed 18 July 2021
Shea BJ, Reeves BC, Wells G et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. Br Med J 21:358
Aromataris E, Munn Z (2020) JBI manual for evidence synthesis. Joanna Briggs Institute. https://synthesismanual.jbi.global Accessed 19 June 2021
Kui L, Fang YY, Deng Y et al (2020) Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J 133(9):1025
Terheyden H, Meijer GJ, Raghoebar GM (2021) Vertical bone augmentation and regular implants versus short implants in the vertically deficient posterior mandible: a systematic review and meta-analysis of randomized studies. Int J Oral Maxillofac Surg 1–10. https://doi.org/10.1016/j.ijom.2021.01.005
Carosi P, Lorenzi C, Lio F, et al (2021) Short implants (≤6 mm) as an alternative treatment option to maxillary sinus lift. Int J Oral Maxillofac Surg 1–9. https://doi.org/10.1016/j.ijom.2021.02.014
Carosi P, Lorenzi C, Laureti M et al (2021) Short dental implants (≤ 6 mm) to rehabilitate severe mandibular atrophy: a systematic review. Int J Oral Maxillofac Implants 36:30–37
Bitinas D, Bardijevskytė G (2021) Short implants without bone augmentation vs. long implants with bone augmentation: systematic review and meta-analysis. Aust Dent J 1–11
Lozano-Carrascal N, Anglada-Bosqued A, Salomó-Coll O et al (2020) 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 y Cir Bucal 25(2):168–179
Elangovan S, Mawardi HH, Karimbux NY (2012) Quality assessment of systematic reviews on short dental implants. J Periodontol 84(6):758–767
Koletsi D, Valla K, Fleming PS et al (2016) Assessment of publication bias required improvement in oral health systematic reviews. J Clin Epidemiol 76:118–124
Moher D (2013) The problem of duplicate systematic reviews. BMJ 347:5040
Galindo-Moreno P, Fernández-Jiménez A, Avila-Ortiz G et al (2014) Marginal bone loss around implants placed in maxillary native bone or grafted sinuses: a retrospective cohort study. Clin Oral Implants Res 25:378–384
Linkevicius T, Puisys A, Steigmann M et al (2015) Influence of vertical soft tissue thickness on crestal bone changes around implants with platform switching: a comparative clinical study. Clin Implant Dent Relat Res 17:1228–1236
Linkevicius T, Puisys A, Linkevicius R et al (2020) The influence of submerged healing abutment or subcrestal implant placement on soft tissue thickness and crestal bone stability. A 2-year randomized clinical trial. Clin Implant Dent Relat Res 22:497–506
Vetromilla BM, Brondani LP, Pereira-Cenci T, Bergoli CD (2019) Influence of different implant-abutment connection designs on the mechanical and biological behavior of single-tooth implants in the maxillary esthetic zone: a systematic review. J Prosthet Dent 121:398–403
Tabrizi R, Arabion H, Aliabadi E, Hasanzadeh F (2016) Does increasing the number of short implants reduce marginal bone loss in the posterior mandible? A prospective study. Br J Oral Maxillofac Surg 54:731–735
Jung RE, Al-Nawas B, Araujo M et al (2018) Group 1 ITI Consensus Report: the influence of implant length and design and medications on clinical and patient-reported outcomes. Clin Oral Implants Res 29:69–77
Felice P, Barausse C, Pistilli R et al (2018) Short implants versus longer implants in vertically augmented posterior mandibles: result at 8 years after loading from a randomised controlled trial. Eur J Oral Implant 11:385–395
Felice P, Barausse C, Pistilli V et al (2018) Posterior atrophic jaws rehabilitated with prostheses supported by 6 mm long× 4 mm wide implants or by longer implants in augmented bone. 3-year post-loading results from a randomised controlled trial. Eur J Oral Implant 11:175–187
Schwarz F, Derks J, Monje A, Wang HL (2018) Peri-implantitis. J Clin Periodontol 45:246–266
Lombardo G, Marincola M, Cicconetti A et al (2019) Successful management of peri-implantitis around short and ultrashort single-crown implants: a case series with a 3-year follow-up. Int J Dent 2019:1–9. https://doi.org/10.1155/2019/5302752
Papaspyridakos P, Chen CJ, Singh M et al (2012) Success criteria in implant dentistry: a systematic review. J Dent Res 91:242–248
Schulz KF, Altman DGMD (2010) CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med 11(1):1–8
Funding
Patrícia Pauletto and Edwin Ruales-Carrera are supported with scholarship by Coordination for the Improvement of Higher Education Personnel, Brazil.
Author information
Authors and Affiliations
Contributions
MSc. Patrícia Pauletto worked on study conceptualization, design, data collection, and data analysis; drafted the initial manuscript; and approved the final manuscript as submitted.
MSc. Edwin Ruales worked on study conceptualization, design, data collection, and data analysis; drafted the initial manuscript; and approved the final manuscript as submitted.
Dr. Luis André Mezzomo worked on study conceptualization and data analysis, and approved the final manuscript as submitted.
Dr. Cristine Miron Stefani worked on study conceptualization, design, data collection, and data analysis, and approved the final manuscript as submitted.
Dr. Mario Taba Junior worked on study conceptualization and data analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.
Dr. Reginaldo Gonçalves worked on study conceptualization and data analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.
Dr. Carlos Flores-Mir worked on study conceptualization and data analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.
Dr. Graziela De Luca Canto worked on study conceptualization and data analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.
Corresponding author
Ethics declarations
Ethics approval
Ethics approval was not required for this overview.
Informed consent
The formal consent is not required for this type of study.
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Pauletto, P., Ruales-Carrera, E., Mezzomo, L.A. et al. Clinical performance of short versus standard dental implants in vertically augmented bone: an overview of systematic reviews. Clin Oral Invest 25, 6045–6068 (2021). https://doi.org/10.1007/s00784-021-04095-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00784-021-04095-0