Survival of surface-modified short versus long implants in complete or partially edentulous patients with a follow-up of 1 year or more: a systematic review and meta-analysis

Raghavendra Shrishail Medikeri,Marisca Austin Pereira,Manjushri Waingade,Shwetambari Navale 대한치주과학회 2022 Journal of Periodontal & Implant Science Vol.52 No.4

Purpose: Short implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants. Methods: Electronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL. Results: The failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1–10 years). A significant difference was observed in mean MBL (mean difference=−0.43, 95% CI, −0.63, −0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants. Conclusions: Short surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42020160185

기능적 부하 후 “Short Implant” 주변의 골 흡수에 대한 방사선학적 연구

박영주(Young-Ju Park),남정훈(Jeong-Hun Nam),노경록(Kyung-Lok Noh),연병무(Byoung-Moo Yeon),유우근(Woo-Geun Yu),이정원(Jeong-Won Lee),안장훈(Jang-Hun Ahn),강태인(Tae-In Gang),박미희(Mi-Hee Park) 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.8

Purpose: The short dental implant is considered as possible solution in the alveolar bone height deficient cases. The aim of this study was to evaluate clinical availability of short implants by measuring the marginal bone loss of short length implants and comparing with that of conventional length implants. Materials and Methods: The groups were composed of patients who had received at least one implant. The samples of this study were selected from patients who with functional loading after prosthetic treatment for 1 year follow up period. The implants with a length of 5.7㎜ and 6㎜ were considered short. (Bicon Dental implants, USA). The experiment group was composed of 4.5×6㎜, 5×6㎜, 6×5.7㎜ implants (total 18 implants were placed in 14 patients, 8 on maxilla, 10 on mandible). The control group was composed of 4.5×8㎜, 5×8㎜, 4.5×11㎜, 5×11㎜. All implants were selected only by implants placed on molar area. We evaluated marginal bone loss in radiographic images at baseline (implant loading) and 3, 6, 12 months after loading. Additionally, crown-to-implant ratio was evaluated, and marginal bone loss according to crown-to-implant ratio after functional loading was analyzed. Results: The short implant group had a mean marginal bone level of -0.52±0.69 ㎜; the 8㎜ group, -0.22±0.82㎜; and the 11㎜ group, -0.10 ± l.09㎜ after 1 year of functional loading. But significant differences were not detected between three groups at every follow-up period. Crown-to-implant ratio in short implant group was 1.55±0.23; 8㎜ group was 1.15±0.18; and 11㎜ group was 0.92±0.15. Additionally, significant differences between three groups were founded. (P<.0001) The greatest marginal bone loss after 1 year follow-up was founded at crown-to-implant ratio 1-1.49 range in short implant. Conclusion: The marginal bone loss of short implants was comparable to that of long implants. So, the short implants can be a clinically acceptable option.

짧은 길이의 거친 표면 임프란트에 대한 후향적 연구

공준하,이백수,김여갑,권용대,윤병욱,최병준,Kong, Jun-Ha,Lee, Baek-Soo,Kim, Yeo-Gab,Kwon, Yong-Dae,Yoon, Byung-Wook,Choi, Byung-Joon 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.1

Background: Reduced bone height is one of the major problems faced in restoring tooth loss with implants. By the use of short implants, it is possible to reduce complicated and invasive treatment such as bone graft, allowing more simple surgery. But short implants are generally considered to have lower success rates than that of standard implants. Purpose: To assess the results of short Straumann implants by a retrospective study of short Straumann implants with TPS(titanium plasma-sprayed) and SLA(sandblasted, large grit, acid etched) surfaces. Materials and methods: 173 implants in 106 patients who received short Straumann implant surgery(${\le}8\;mm$) in the department of oral and maxillofacial surgery, Kyunghee Dental Hospital, from February 1996 to October 2006 were selected and studied. All of the implants were followed up after prosthetic rehabilitation. The average follow-up period was 34 months with 119 months as the longest follow up period. The average follow-up period after prosthetic rehabilitation was 31 months. 64 females(60.4%) and 42 males(39.6%) participated in the research with the age range of 19 to 85(mean age 47). 20 patients(18.9%) were under 40, 85 patients(80.2%) were over 40 and under 70, and only one patient(0.9%) was over 70 years old. Results: 27 implants(15.6%) had TPS surface while 146 implants(84.4%) had SLA surface. 9 implants(5.2%) were 3.3, 108 implans(62.4%) were 4.1mm and 56 implants(32.4%) were 4.8mm in diameter. 167 implants(96.5%) were 8mm and 6 implants(3.5%) were 6mm in length. There were 24 implants(13.9%) on the maxillas and 149 implants(68.8%) on the mandibles. 119 implants(68.8%) were rehabilitated with FPD(fixed partial denture), 47 implants(27.2%) with single crowns and 4 implants(2.3%) with overdentures. Among the fixed partial dentures, 30 of them were splinted with short implants only. After over an year of follow-up period, 139 implants(96.5%) out of 144 implants showed marginal bone loss of less than 1mm. 3 out of 173 implants failed showing 98.27% survival rate. Conclusions: The use of short Straumann implants(${\le}8mm$) can be a simple and reliable treatment method in minimal residual bone height.

Short-term, Multi-center Prospective Clinical Study of Short Implants Measuring Less Than 7mm

Kim, Young-Kyun,Yi, Yang-Jin,Kim, Su-Gwan,Cho, Yong-Seok,Yang, Choon-Mo,Liang, Po-Chin,Chen, Yu-Yal,I, Lee-Long,Sim, Christopher,Tan, Winston,Ser, Go Wee,Yue, Deng,Yi, Man,Ping, Gong Korean Academy of Dental Science 2010 Journal of korean dental science Vol.3 No.1

Objective : This prospective study sought to verify the stability of three types of short implants measuring 7mm or less. Materials and methods : Implants measuring 7mm or less were placed in patients at multicenter dental clinics in Korea, China, Taiwan, and Singapore. Initial stability, intraoperative and postoperative complications, crestal bone loss, and survival rate of the implant were prospectively evaluated. Results : The primary stability of a 6-mm implant was lower than that of a 7-mm implant. The marginal bone loss of short implants measuring less than 7mm was minimal. Complications such as wound dehiscence, implant mobility, and peri-implant mucositis developed, and these were associated with initial implant failure. The short-term survival rate of 6-mm implant was 93.7%, and that of 7-mm implant, 96.6%. Conclusion : Short implant for the mandible with insufficient height for the residual ridge can be selectively used. Poor primary stability and wound dehiscence can cause osseointegration failure and alveolar bone loss.

A two-short-implant-supported molar restoration in atrophic posterior maxilla: A finite element analysis

Song, Ho-Yong,Huh, Yoon-Hyuk,Park, Chan-Jin,Cho, Lee-Ra The Korean Academy of Prosthodonitics 2016 The Journal of Advanced Prosthodontics Vol.8 No.4

PURPOSE. The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS. Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS. The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION. 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.

A two-short-implant-supported molar restoration in atrophic posterior maxilla: A finite element analysis

송호용,허윤혁,박찬진,조리라 대한치과보철학회 2016 The Journal of Advanced Prosthodontics Vol.8 No.4

PURPOSE. The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS. Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS. The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION. 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.

A two-short-implant-supported molar restoration in atrophic posterior maxilla: A finite element analysis

Ho-Yong Song,Yoon-Hyuk Huh,Chan-Jin Park,Lee-Ra Cho 대한치과보철학회 2016 The Journal of Advanced Prosthodontics Vol.8 No.4

PURPOSE The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.

A retrospective study on the factors associated with marginal bone loss of short implants placed in posterior regions

Hae-Seok Lee,Tae-Wan Kim,Ik-Sang Moon,Dong-Won Lee 대한치과이식임플란트학회 2023 The Korean Academy of Implant Dentistry Vol.42 No.3

Purpose: This retrospective cohort study was performed to assess marginal bone loss (MBL) and its risk factors in patients with a short-er-than-conventional length implant in the posterior regions of the mandible or maxilla. Materials and Methods: The study sample was composed of short implants (7-mm length, 4-mm diameter). Periapical radiographs were taken immediately after functional loading, 6 months after prosthesis delivery, and at all follow-up visits. Measurements were per-formed using radiographs. The potential risk factors assessed by univariate and multivariate regression analysis were history of guided bone regeneration (GBR), prosthesis type, crown-to-implant ratio, and soft-tissue thickness. Results: In total, 105 implants in 78 patients were included. Mean follow-up period was 22.27±9.69 months, and mean cumulative peri-implant bone loss during follow-up was 0.13±0.19 mm (range, 0.0∼0.83 mm). MBL risk did not increase significantly according to a history of GBR, prosthesis type, or crown-to-implant ratio. Simple linear regression showed soft-tissue thickness was a risk factor of MBL. However, multiple linear regression failed to identify any significant risk factor of MBL. Conclusions: The results of this study suggest that insufficient soft-tissue thickness is a risk factor for MBL in patients with a short implant.

A clinical study of wide implants with 5-6 mm lengths in mandible

( Kyo-jin Ahn ),( Sang-yun Kim ),( Yang-jin Yi ),( Young-kyun Kim ),( Su-gwan Kim ) 조선대학교 구강생물학연구소 2016 Oral Biology Research (Oral Biol Res) Vol.40 No.2

In patients with a severely atrophic mandibular alveolar ridge, short implants (5-6 mm) were successfully placed and functional without the need for an invasive surgical procedure. We placed 19 implants 5 to 7 mm in diameter and 5 to 6 mm in length in 13 patients. During an average observation of 40.7 months, we measured marginal bone loss, survival rates, and success rates of the implants and analyzed the outcomes based on a review of the literature. During the clinical observation period, we recorded an implant survival rate of 100% and an average success rate of 94.7%. Average marginal bone loss was 0.23 mm, with marginal bone loss exceeding 1 mm at 1 year in only one case. On short-term observation, placement of implants having a wide diameter and 5 to 6 mm in length showed outstanding clinical results in patients with severe atrophy of the mandibular molar region. Therefore, favorable results can be expected with short implants as a possible treatment option without the need for complex surgical procedures.

짧은 코의 교정 : 실리콘 삽입물을 이용한 비익, 연골의 재배치

백무현,임강원,김종찬,김승홍 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.4

Short nose is characterized by decreased distance from the nasion to tip defining point and increased nasolabial angle with increased nostril show. Lengthening the short nose is arguably the most difficult operation in aesthetic rhinoplasty. We have described here a simple and easy technique that lengthen the short nose by using silicone implant has been popular among Asian for augmentation rhinoplasty. Through open rhinoplastic approach, wide undermining of the nasal skin is performed to allow redraping of the skin over the lengthened skeletal framework without excessive tension. Alar cartilage is released from upper lateral cartilage and relocated caudally. After relocation of alar cartilage, silicone implant is inserted in subperiosteal pocket and immobilized by nonabsorbable suture material at dorsal aspect of septal cartilage. Narrow caudal end of implant is sutured between medial crura of alar cartilage which were caudally rotated. This implant not only raise the nasion but can move the tip-defining point caudally by keeping the alar cartilage in new position. Tip graft is done with conchal cartilage. We have got the satisfactory result in cosmetic aspect without any complications.