Posterior Jaws Rehabilitation with < 7mm-short Implants. A Review

Author(s):  
Giuseppe Lizio ◽  
Gerardo Pellegrino ◽  
Pietro Felice
Keyword(s):  
2020 ◽  
Vol 46 (4) ◽  
pp. 396-406 ◽  
Author(s):  
Giorgio Lombardo ◽  
Annarita Signoriello ◽  
Miguel Simancas-Pallares ◽  
Mauro Marincola ◽  
Pier Francesco Nocini

The purpose of this retrospective study was to determine survival and peri-implant marginal bone loss of short and ultra-short implants placed in the posterior mandible. A total of 98 patients received 201 locking-taper implants between January 2014 and January 2015. Implants were placed with a 2-stage approach and restored with single crowns. Clinical and radiographic examinations were performed at 3-year recall appointments. At that time, the proportion of implant survival by length, and variations of crestal bone levels (mean crestal bone loss and mean apical shift of the “first bone-to-implant contact point” position) were assessed. Significance level was set at 0.05. The total number of implants examined 36 months after loading included: 71 implants, 8.0 mm in length; 82 implants, 6.0 mm in length; and 48 implants, 5.0 mm in length. Five implants failed. The overall proportion of survival was 97.51%, with 98.59% for the 8.0-mm implants, 97.56% for the 6.0-mm implants, and 95.83% for the 5.0-mm implants. No statistically significant differences were found among the groups regarding implant survival (P = .73), mean crestal bone loss (P = .31), or mean apical shift of the “first bone-to-implant contact point” position (P = .36). Single-crown short and ultra-short implants may offer predictable outcomes in the atrophic posterior mandibular regions, though further investigations with longer follow-up evaluations are necessary to validate our results.


Author(s):  
Marcos Augusto Tomazi ◽  
Alexandre da Silveira Gerzson ◽  
Angelo Menuci Neto ◽  
André Luciano Pasinato da Costa

The edentulous atrophic posterior mandible is often a great challenge for implant rehabilitation. Although a number of treatment options have been proposed, including the use of short implants and surgical grafting techniques, in cases of severe bone atrophy, techniques for mobilization of the inferior alveolar nerve (IAN) have been shown to be efficient, with good results. Four female patients underwent IAN lateralization for prosthetic rehabilitation of the posterior mandible from 2013 to 2019, with 1 year to 5 years and 4 months of follow-up. This case series describes a new technique for mobilization of the IAN, named in-block lateralization, to facilitate access to the IAN and to reduce nerve manipulation. The implant is immediately installed (allowing nerve lateralization in unitary spaces) and the original mandibular anatomy is restored with autogenous bone from the original bed during the same surgical procedure. When well indicated and well performed, this new approach provides better and easier visualization of the IAN as well as safer manipulation aiming to achieve good results for implant stability and minimal risk of neurosensory disturbances, allowing rehabilitation even in unitary spaces.


Author(s):  
A.M. Tsitsiashvili ◽  
A.M. Panin ◽  
Ye.N. Nikolayeva ◽  
A.A. Arutyunyan ◽  
M.S. Podporin ◽  
...  

The aim of the study was to evaluate the effectiveness of antibiotic chemotherapy regimens and the dynamics of the nature of microbial associations of the operating area at the surgical stages of treatment of patients using dental implants in conditions of limited bone tissue. The study involved 37 patients (17 m and 20 w, from 32 to 68 years). According to the tactics of the treatment and the type of antibacterial effect, the patients were divided into 3 groups. Per os was prescribed antibiotics as a step therapy: amoxicillin (flemoxin 500 mg 1 tablet 2 per day for 7 days) and amoxicillin / clavulanate (flemoclav 625 mg 1 table 2 per day 7 days), doxycycline (unidox 100 mg 1 table 1 per day 5 days). The 1st group of patients (n1=12; 31.9%) — a multi-stage approach (MA), where the 1st operation is bone grafting (BG) (Flemoxin 500 mg), after 6—9 months, the 2nd dental implantation (DI) (flemoklav 625 mg), after 3—6 months the 3rd — installation of gingival formers (GF) (unidox 100 mg). The 2nd group of patients (n2=14; 36.2%) — a one-stage approach (OA), where the 1st operation is BG with simultaneous DI (flemoxin 500 mg), after 6—9 months — the 2nd — installation of GF (flemoklav 625 mg). 3rd group — narrow/short implants (N/S) without BG were installed (n3=11; 31.9%). The 1st operation — DI (Flemoxin 500 mg), the 2nd — installation of GF (Flemoklav 625 mg). A bacteriological study with the identification of pure cultures of bacteria and determination of sensitivity to antibacterial drugs was performed for all patients before treatment and in dynamics. In MA, there was a suppression of the growth of certain types of bacteria and an increase in the number of species resistant to this antibiotic. In the framework of the OA, when prescribing antibiotics, the results were comparable. With N/S implants, growth inhibition of a number of species present at the beginning of treatment was noted. In multi-stage operations, we consider it reasonable to use beta-lactamase-protected drugs, or drugs of another group that include representatives of parodontopathogenic species and potential carriers of multiple resistance genes in their spectrum of action.


Author(s):  
Fabio Rossi ◽  
Lorenzo Tuci ◽  
Lorenzo Ferraioli ◽  
Emanuele Ricci ◽  
Andreea Suerica ◽  
...  

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).


2021 ◽  
Vol 10 (5) ◽  
pp. 940
Author(s):  
Jakub Hadzik ◽  
Paweł Kubasiewicz-Ross ◽  
Izabela Nawrot-Hadzik ◽  
Tomasz Gedrange ◽  
Artur Pitułaj ◽  
...  

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaoran Yu ◽  
Ruogu Xu ◽  
Zhengchuan Zhang ◽  
Yang Yang ◽  
Feilong Deng

AbstractExtra-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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