Short dental implants

Journal of Dental Sciences and Education DOI: 10.51271/JDSE-0016 Short dental implants Review @Meltem Karsiyaka Hendek, ®Kubilay Baris, ®Ebru Olgun Department of Periodontology, Faculty of Dentistry Kirikkale University, Kirikkale, Turkey Cite this article: Hendek MK, Baris K, Olgun E. Short dental implants J Dent Sci Educ. 2023;1(3):95-97. Corresponding Author: Meltem Karstyaka Hendek, mltmkrsyk@yahoo.com Received: 22/09/2023 ° Accepted: 29/09/2023 ° Published: 30/09/2023 ABSTRACT Short dental implants have been successfully used to support single and multiple fixed reconstructions in atrophic jaws, despite an increased crown-to-implant ratio. The use of short dental implants allows the treatment of patients for whom complex surgical techniques cannot be performed for medical, anatomical, or financial reasons. Furthermore, the use of short dental implants in clinical practice reduces morbidity, cost, and treatment time and reduces the need for complex surgery. The aim of this review is to evaluate the survival rates of short and extra-short dental implants and to discuss the impact of an increased crown-to-implant ratio on biologic and technical complications. Keywords: Dental implants, implant-supported dental prosthesis, survival rate INTRODUCTION In dental implant treatment, excessively resorbed alveolar bone causes a serious problem during both the surgical and prosthetic phases.'? Over the years, many surgical techniques have been developed to increase bone volume and enable implant placement. These techniques are essential for positioning long dental implants, achieving balanced load distribution, and improving the crown/ implant ratio. Techniques such as maxillary sinus elevation, guided bone regeneration, distraction osteogenesis, and inferior alveolar nerve lateralization have been developed to place long dental implants in excessively resorbed alveolar bone. However, these complex surgical techniques are associated with complications such as intraoperative bleeding, perforation of the Schneiderian membrane or nerve damage, temporarily or permanently altered postoperative mandibular sensation, exposure of the graft or membranes, infections, and increased bone loss around the implant. In addition to these complications, increased treatment time and cost, and the fact that advanced surgical techniques are not suitable for some patients for medical or anatomical reasons, alternative treatments are needed. In this context, the use of short dental implants should be considered as an alternative to complex surgeries. Short dental implants allow cheaper and faster treatment with a reduced morbidity rate as well as ease of application.* However, survival rates and indications are still controversial. Unfavorable crown/ implant ratio, inadequate primary implant stability, and bone-implant contact have been described as reasons for the failure of short dental implants. The aim of this review is to evaluate the survival rates of short and extra-short dental implants and to discuss the impact of an increased crownto-implant ratio on biologic and technical complications. DISCUSSION The length threshold defining a short dental implant is still a matter of debate in the scientific literature.* Some researchers consider this value to be <10 mm, while others define extrashort dental implants as <8 mm or even <6 mm.°” Taschieri et al. (2018) compared the clinical and radiographic outcomes of 27 patients with short dental implants (6.5-8.5 mm) placed without any additional bone augmentation procedure in the posterior maxilla and 25 patients with standard implants (2 10 mm) placed in combination with lateral maxillary sinus floor elevation. After a 72-month follow-up period, no significant differences were observed between the groups in terms of implant failure or changes in marginal bone level. In particular, the short dental implant group was reported to have less postoperative pain, inflammation, and other adverse postoperative effects, as well as faster healing compared to the other group. Ina retrospective study evaluating the performance of short dental implants (<8 mm) based on different factors, including crown/implant ratio and prosthetic design (e.g., splinted vs. nonsplinted restorations), a total of 180 short dental implants placed in 130 patients were evaluated after 3-7 (mean=4.2) years of follow-up. It was reported that four implants in four different patients failed due to severe peri-implantitis, resulting in an overall cumulative survival rate of 97.8% at the implant level. Furthermore, the mean marginal bone loss was 0.90+0.78 mm. Most sites (70%) were shown to have a crown/implant ratio= (mean=1.16+0.36). Correlation analyses revealed that sites with a crown/implant ratio <1 exhibited greater marginal bone loss (1.14+0.75 mm) compared to sites with ratios of 1-1.99 and =2 (0.81+0.77 mm and 0.45+0.47 mm, respectively). It was also observed that peri-implant bone loss and complication rates were not