Extra short dental implants supporting an overdenture in the edentulous maxilla: a proof of concept.

Department of Periodontology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium.
Clinical Oral Implants Research (Impact Factor: 3.43). 07/2011; 23(5):567-76. DOI: 10.1111/j.1600-0501.2011.02235.x
Source: PubMed

ABSTRACT This study investigates the outcome of short implants additionally placed with longer implants to support a maxillary overdenture.
Twelve patients received six implants to support a maxillary overdenture. Only one patient still had two molars in the maxilla, while the others had no remaining teeth. The status of the opposing arch was diverse. The distal implant in each quadrant was 6 mm in height (S) and the middle implants ranged between 10 and 14 mm (L). All implants were placed following a one-stage procedure and early loaded (6 weeks). Clinical and radiological parameters were assessed 6, 12 and 24 months after loading.
One short implant failed 2 weeks after surgery, probably due to early mobilization by the provisional prosthesis. The mean bone loss on the rough part of the implant was 0.7 mm (S) vs. 1.3 mm (L) during the first year and 0.3 mm (S) vs. 0.2 mm (L) during the second year after loading. The mean implant stability quotient values were 67 (S) vs. 70 (L) at placement and 75 (S) vs. 78 (L) after 1 year. At the 2-year follow- up, all prostheses were still stable and comfortable.
An overdenture on six implants, of which two have a reduced length, might represent a successful treatment option. No significant difference could be found between both implant lengths at 2 years' follow-up. However, bone loss with short implants may increase the likelihood of failure.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background There is lack of evidence on long-term success of short dental implants in reduced alveolar bone.PurposeIn this prospective 5-year study, survival and marginal bone loss of 4-mm implants, which supported fixed dental prostheses (FDPs) in severely resorbed posterior mandibles, were evaluated.Material and Methods In 28 patients, evaluation of 86 osseointegrated 4-mm-long implants, which supported a 3- or a 4-unit FDP by crown splinting without the use of pontics or cantilevers, was performed over a 5-year period.ResultsThree subjects dropped out for non-study reasons: one subject had her three implants removed after 1 year and two subjects died (six implants). Five implants in three subjects were lost between 3 and 5 years. Twenty-four subjects and 71 implants were active at the 5-year follow-up (92.2% survival). After 1 year, significant (p < .001) mean (standard error of the mean [SEM]) 0.44-mm (0.05) marginal bone loss occurred. At 2, 3, and 5 years, mean (SEM) bone loss of 0.57 mm (0.06), 0.55 mm (0.07), and 0.53 mm (0.08) occurred, respectively (no significant change after 1 year). At 5 years, average plaque levels were 13.3%; 69% of the implants were plaque free. On average, mucosal bleeding occurred at 8.1% of the implants. During 5 years, two subjects experienced uncomplicated bridge loosening. No other complications occurred during the study.Conclusion Four-millimeter implants can support FDPs in severely resorbed posterior mandibles for 5 years with healthy peri-implant conditions.
    Clinical Implant Dentistry and Related Research 08/2014; · 3.82 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rehabilitation of severely resorbed jaws with dental implants remains a surgical and prosthetic challenge for clinicians. The purpose of this review was to evaluate the available data on short-length implants and discuss their indications and limitations in daily clinical practice. A structured review of MEDLINE and a manual search were conducted. Thirty-two case series devoted to short-length implants, 14 reviews and 3 randomized controlled trials were identified. Of this group of papers, we can conclude that short-length implants can be successfully used to support single and multiple fixed reconstructions in posterior atrophied jaws, even in those with increased crown-to-implant ratios. The use of short-length implants allows treatment of patients who are unable to undergo complex surgical techniques for medical, anatomic or financial reasons. Moreover, the use of short-length implants in daily clinical practice reduces the need for complex surgeries, thus reducing morbidity, cost and treatment time. The use of short implants promotes the new concept of stress-minimizing surgery, allowing the surgeon to focus more on the correct three-dimensional positioning of the implant.
    Periodontology 2000 10/2014; 66(1). · 4.01 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Short implants are increasingly used, but there is doubt about their performance being similar to that of regular implants. The aim of this study was to compare the mechanical stability of short implants vs. regular implants placed in the edentulous posterior mandible.Material and methodsTwenty-three patients received a total of 48 short implants (5 × 5.5 mm and 5 × 7 mm) and 42 regular implants (4 × 10 mm and 4 × 11.5 mm) in the posterior mandible. Patients who received short implants had <10 mm of bone height measured from the bone crest to the outer wall of the mandibular canal. Resonance frequency analysis (RFA) was performed at time intervals T0 (immediately after implant placement), T1 (after 15 days), T2 (after 30 days), T3 (after 60 days), and T4 (after 90 days).ResultsThe survival rate after 90 days was 87.5% for the short implants and 100% for regular implants (P < 0.05). There was no significant difference between the implants in time intervals T1, T2, T3, and T4. In T0, the RFA values of 5 × 5.5 implants were higher than values of 5 × 7 and 4 × 11.5 implants (P < 0.05). A total of six short implants that were placed in four patients were lost (three of 5 × 5.5 mm and three of 5 × 7 mm). Three lost implants started with high ISQ values, which progressively decreased. The other three lost implants started with a slightly lower ISQ value, which rose and then began to fall.Conclusions Survival rate of short implants after 90 days was lower than that of regular implants. However, short implants may be considered a reasonable alternative for rehabilitation of severely resorbed mandibles with reduced height, to avoid performing bone reconstruction before implant placement. Patients need to be aware of the reduced survival rate compared with regular implants before implant placement to avoid disappointments.
    Clinical Oral Implants Research 04/2014; · 3.43 Impact Factor