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Comparing short implants to standard dental implants: a systematic review and meta-analysis of randomized controlled trials with extended follow-up

Evidence-Based Dentistry volume 24, pages 192–193 (2023)Cite this article

Subjects

Abstract

Purpose

To compare the difference of marginal level changes (MBL), implant failure (IF), biological and prosthetic complications (BC and PC), and prosthetic failure (PF) of short implants (SH) and standard implants (ST).

Materials and methods

Electronic searches (PubMed, Web of Science, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and manual searches were performed to identify all randomized controlled trials (RCTs) evaluating SH to ST. Applying Stata, a meta-analysis was conducted on the weighted mean difference (WMD) and standardized mean difference (SMD) of MBL and the risk difference (RD) of the secondary outcome.

Results

Twenty-four articles were involved in the present study. There were statistically significant differences in MBLs, preferring short implants in the maxilla (WMD: −0.147 (CI: −0.224, −0.070), I2: 76.6%; SMD: −0.757 (CI: −1.226, −0.289), I2: 89.2%) and in the mandible (WMD: −0.377 (CI: −0.656, −0.098), I2: 85.8%; SMD: −0.811 (CI: −1.418, −0.204), I2: 78.8%). There were no significant differences in IF (RD: 0.011 (−0.002, 0.023), I2: 0.0%), PF (RD:0.003 (−0.007, 0.014), I2: 0.0%), and PC (RD:0.001 (−0.008, 0.010), I2: 0.0%). There were significantly higher biological complications (RD: −0.071 (−0.106, −0.036), I2: 0.82.9%) for ST compared to SH in both jaws up to a 10-year follow-up.

Conclusion

SH and ST had comparable overall outcomes, but short implants had less marginal bone loss and lower biological complications. However, more research is needed to confirm these findings.

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Fig. 1: PRISMA flowchart.
Fig. 2: Forest plots.
Fig. 3: Forest plots.

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References

  1. Anitua E, Alkhraist MH, Pinas L, Begona L, Orive G. Implant survival and crestal bone loss around extra-short implants supporting a fixed denture: the effect of crown height space, crown-to-implant ratio, and offset placement of the prosthesis. Int J Oral Maxillofac Implants. 2014;29:682–9.

    Article  PubMed  Google Scholar 

  2. Jung RE, Al-Nawas B, Araujo M, Avila-Ortiz G, Barter S, Brodala N, et al. Group 1 ITI Consensus Report: the influence of implant length and design and medications on clinical and patient-reported outcomes. Clin Oral Implants Res. 2018;29:69–77.

    Article  PubMed  Google Scholar 

  3. Lee SA, Lee CT, Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited vertical height in the posterior region: short implants (5 to 8 mm) vs longer implants (> 8 mm) in vertically augmented sites. Int J Oral Maxillofac Implants. 2014;29:1085–97.

    Article  PubMed  Google Scholar 

  4. Papaspyridakos P, De Souza A, Vazouras K, Gholami H, Pagni S, Weber HP. 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. 2018;29:8–20.

    Article  PubMed  Google Scholar 

  5. Lemos CA, Ferro-Alves ML, Okamoto R, Mendonca MR, Pellizzer EP. Short dental implants versus standard dental implants placed in the posterior jaws: a systematic review and meta-analysis. J Dent. 2016;47:8–17.

    Article  PubMed  Google Scholar 

  6. Chaware SH, Thakare V, Chaudhary R, Jankar A, Thakkar S, Borse S. The rehabilitation of posterior atrophic maxilla by using the graftless option of short implant versus conventional long implant with sinus graft: a systematic review and meta-analysis of randomized controlled clinical trial. J Indian Prosthodont Soc. 2021;21:28–44.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Esposito M, Buti J, Barausse C, Gasparro R, Sammartino G, Felice P. 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. 2019;12:267–80.

    Google Scholar 

  8. Lemos CAA, Verri FR, Bonfante EA, Santiago Junior JF, Pellizzer EP. Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis. J Dent. 2018;70:14–22.

    Article  PubMed  Google Scholar 

  9. Atieh MA, Alsabeeha N, Duncan WJ. Stability of tapered and parallel-walled dental implants: a systematic review and meta-analysis. Clin Implant Dent Relat Res. 2018;20:634–45.

    Article  PubMed  Google Scholar 

  10. Bitaraf T, Keshtkar A, Rokn AR, Monzavi A, Geramy A, Hashemi K. Comparing short dental implant and standard dental implant in terms of marginal bone level changes: a systematic review and meta-analysis of randomized controlled trials. Clin Implant Dent Relat Res. 2019;21:796–812.

    Article  PubMed  Google Scholar 

  11. Rokn AR, Keshtkar A, Monzavi A, Hashemi K, Bitaraf T. Comparing short dental implants to standard dental implants: protocol for a systematic review. JMIR Res Protoc. 2018;7:e16.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rokn AR, Monzavi A, Panjnoush M, Hashemi HM, Kharazifard MJ, Bitaraf T. Comparing 4-mm dental implants to longer implants placed in augmented bones in the atrophic posterior mandibles: one-year results of a randomized controlled trial. Clin Implant Dent Relat Res. 2018;20:997–1002.

    Article  PubMed  Google Scholar 

  13. Geraets W, Zhang L, Liu Y, Wismeijer D. Annual bone loss and success rates of dental implants based on radiographic measurements. Dentomaxillofac Radiol. 2014;43:20140007.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Schrover R, Evans K, Giugliani R, Noble I, Bhattacharya K. Minimal clinically important difference for the 6-min walk test: literature review and application to Morquio A syndrome. Orphanet J Rare Dis. 2017;12:78.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Rahlfs V, Zimmermann H. Effect size measures and their benchmark values for quantifying benefit or risk of medicinal products. Biom J. 2019;61:973–82.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kraemer HC, Morgan GA, Leech NL, Gliner JA, Vaske JJ, Harmon RJ. Measures of clinical significance. J Am Acad Child Adolesc Psychiatry. 2003;42:1524–9.

    Article  PubMed  Google Scholar 

  17. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.

    Article  PubMed  Google Scholar 

  18. Thoma DS, Haas R, Sporniak-Tutak K, Garcia A, Taylor TD, Hammerle CHF. Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures: 5-Year data. J Clin Periodontol. 2018;45:1465–74.

    Article  PubMed  Google Scholar 

  19. Yu H, Wang X, Qiu L. Outcomes of 6.5-mm hydrophilic implants and long implants placed with lateral sinus floor elevation in the atrophic posterior maxilla: a prospective, randomized controlled clinical comparison. Clin Implant Dent Relat Res. 2017;19:111–22.

    Article  PubMed  Google Scholar 

  20. Bolle C, Felice P, Barausse C, Pistilli V, Trullenque-Eriksson A, Esposito M. 4 mm long vs longer implants in augmented bone in posterior atrophic jaws: 1-year post-loading results from a multicentre randomised controlled trial. Eur J Oral Implantol. 2018;11:31–47.

    PubMed  Google Scholar 

  21. Bechara S, Kubilius R, Veronesi G, Pires JT, Shibli JA, Mangano FG. Short (6-mm) dental implants versus sinus floor elevation and placement of longer (>/=10-mm) dental implants: a randomized controlled trial with a 3-year follow-up. Clin Oral Implants Res. 2017;28:1097–107.

    Article  PubMed  Google Scholar 

  22. Rossi F, Botticelli D, Cesaretti G, De Santis E, Storelli S, Lang NP. 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. 2016;27:458–64.

    Article  PubMed  Google Scholar 

  23. Felice P, Checchi L, Barausse C, Pistilli R, Sammartino G, Masi I, et al. 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 Implantol. 2016;9:35–45.

    PubMed  Google Scholar 

  24. Gastaldi G, Felice P, Pistilli R, Barausse C, Trullenque-Eriksson A, Esposito M. Short implants as an alternative to crestal sinus lift: a 3-year multicentre randomised controlled trial. Eur J Oral Implantol. 2017;10:391–400.

    PubMed  Google Scholar 

  25. Esposito M, Barausse C, Pistilli R, Sammartino G, Grandi G, Felice P. Short implants versus bone augmentation for placing longer implants in atrophic maxillae: one-year post-loading results of a pilot randomised controlled trial. Eur J Oral Implantol. 2015;8:257–68.

    PubMed  Google Scholar 

  26. Felice P, Barausse C, Pistilli R, Ippolito DR, Esposito M. Short implants versus longer implants in vertically augmented posterior mandibles: result at 8 years after loading from a randomised controlled trial. Eur J Oral Implantol. 2018;11:385–95.

    PubMed  Google Scholar 

  27. Felice P, Barausse C, Pistilli R, Ippolito DR, Esposito M. Five-year results from a randomised controlled trial comparing prostheses supported by 5-mm long implants or by longer implants in augmented bone in posterior atrophic edentulous jaws. Int J Oral Implantol. 2019;12:25–37.

    Google Scholar 

  28. Storelli S, Abba A, Scanferla M, Botticelli D, Romeo E. 6 mm vs 10 mm-long implants in the rehabilitation of posterior jaws: a 10-year follow-up of a randomised controlled trial. Eur J Oral Implantol. 2018;11:283–92.

    PubMed  Google Scholar 

  29. Gulje FL, Raghoebar GM, Vissink A, Meijer HJA. Single crowns in the resorbed posterior maxilla supported by either 11-mm implants combined with sinus floor elevation or 6-mm implants: a 5-year randomised controlled trial. Int J Oral Implantol. 2019;12:315–26.

    Google Scholar 

  30. Felice P, Pistilli R, Barausse C, Piattelli M, Buti J, Esposito M. 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 Implantol. 2019;12:57–72.

    Google Scholar 

  31. Esposito M, Barausse C, Pistilli R, Piattelli M, Di Simone S, Ippolito DR, et al. Posterior atrophic jaws rehabilitated with prostheses supported by 5 x 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 Implantol. 2019;12:39–54.

    Google Scholar 

  32. Cannizzaro G, Felice P, Minciarelli AF, Leone M, Viola P, Esposito M. Early implant loading in the atrophic posterior maxilla: 1-stage lateral versus crestal sinus lift and 8 mm hydroxyapatite-coated implants. A 5-year randomised controlled trial. Eur J Oral Implantol. 2013;6:13–25.

    PubMed  Google Scholar 

  33. Zadeh HH, Gulje F, Palmer PJ, Abrahamsson I, Chen S, Mahallati R, et al. Marginal bone level and survival of short and standard-length implants after 3 years: an open multi-center randomized controlled clinical trial. Clin Oral Implants Res. 2018;29:894–906.

    Article  PubMed  Google Scholar 

  34. Shah SN, Chung J, Kim DM, Machtei EE. Can extra-short dental implants serve as alternatives to bone augmentation? A preliminary longitudinal randomized controlled clinical trial. Quintessence Int. 2018;49:635–43.

    PubMed  Google Scholar 

  35. Guida L, Annunziata M, Esposito U, Sirignano M, Torrisi P, Cecchinato D. 6-mm-short and 11-mm-long implants compared in the full-arch rehabilitation of the edentulous mandible: a 3-year multicenter randomized controlled trial. Clin Oral Implants Res. 2020;31:64–73.

    Article  PubMed  Google Scholar 

  36. Naenni N, Sahrmann P, Schmidlin PR, Attin T, Wiedemeier DB, Sapata V, et al. Five-year survival of short single-tooth implants (6 mm): a randomized controlled clinical trial. J Dent Res. 2018;97:887–92.

    Article  PubMed  Google Scholar 

  37. Shi JY, Li Y, Qiao SC, Gu YX, Xiong YY, Lai HC. Short versus longer implants with osteotome sinus floor elevation for moderately atrophic posterior maxillae: a 1-year randomized clinical trial. J Clin Periodontol. 2019;46:855–62.

    Article  PubMed  Google Scholar 

  38. Weerapong K, Sirimongkolwattana S, Sastraruji T, Khongkhunthian P. Comparative study of immediate loading on short dental implants and conventional dental implants in the posterior mandible: a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34:141–9.

    Article  PubMed  Google Scholar 

  39. Taschieri S, Lolato A, Testori T, Francetti L, Del Fabbro M. Short dental implants as compared to maxillary sinus augmentation procedure for the rehabilitation of edentulous posterior maxilla: three-year results of a randomized clinical study. Clin Implant Dent Relat Res. 2018;20:9–20.

    Article  PubMed  Google Scholar 

  40. Adanez MH, Brezavscek M, Vach K, Fonseca M, Att W. Clinical and radiographic evaluation of short implants placed in the posterior mandible: a 1-year pilot split-mouth study. J Oral Implantol. 2018;44:250–9.

    Article  PubMed  Google Scholar 

  41. Al Amri MD, Abduljabbar TS, Al-Johany SS, Al Rifaiy MQ, Alfarraj Aldosari AM, Al-Kheraif AA. Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3-year follow-up results. Clin Oral Implants Res. 2017;28:1182–7.

    Article  PubMed  Google Scholar 

  42. Anitua E, Flores C, Flores J, Alkhraisat MH. Clinical effectiveness of 6.5-mm-long implants to support two-implant fixed prostheses in premolar-molar region: the influence of immediate loading and the length of splinting implant. J Prosthodont. 2019;28:e688–93.

    Article  PubMed  Google Scholar 

  43. Benlidayi ME, Ucar Y, Tatli U, Ekren O, Evlice B, Kisa HI, et al. Short implants versus standard implants: midterm outcomes of a clinical study. Implant Dent. 2018;27:95–100.

    Article  PubMed  Google Scholar 

  44. Calvo-Guirado JL, Lopez Torres JA, Dard M, Javed F, Perez-Albacete Martinez C, Mate Sanchez de Val JE. Evaluation of extrashort 4-mm implants in mandibular edentulous patients with reduced bone height in comparison with standard implants: a 12-month results. Clin Oral Implants Res. 2016;27:867–74.

    Article  PubMed  Google Scholar 

  45. Dursun E, Keceli HG, Uysal S, Gungor H, Muhtarogullari M, Tozum TF. Management of limited vertical bone height in the posterior mandible: short dental implants versus nerve lateralization with standard length implants. J Craniofac Surg. 2016;27:578–85.

    Article  PubMed  Google Scholar 

  46. Guarnieri R, Di Nardo D, Gaimari G, Miccoli G, Testarelli L. Short vs. standard laser-microgrooved implants supporting single and splinted crowns: a prospective study with 3 years follow-up. J Prosthodont. 2019;28:e771–9.

    Article  PubMed  Google Scholar 

  47. Gurlek O, Kaval ME, Buduneli N, Nizam N. Extra-short implants in the prosthetic rehabilitation of the posterior maxilla. Aust Dent J. 2019;64:353–8.

    Article  PubMed  Google Scholar 

  48. Malmstrom H, Gupta B, Ghanem A, Cacciato R, Ren Y, Romanos GE. Success rate of short dental implants supporting single crowns and fixed bridges. Clin Oral Implants Res. 2016;27:1093–8.

    Article  PubMed  Google Scholar 

  49. Scarano A, Mortellaro C, Brucoli M, Lucchina AG, Assenza B, Lorusso F. Short implants: analysis of 69 implants loaded in mandible compared with longer implants. J Craniofac Surg. 2018;29:2272–6.

    Article  PubMed  Google Scholar 

  50. Van Assche N, Michels S, Quirynen M, Naert I. Extra short dental implants supporting an overdenture in the edentulous maxilla: a proof of concept. Clin Oral Implants Res. 2012;23:567–76.

    Article  PubMed  Google Scholar 

  51. Bernardi S, Gatto R, Severino M, Botticelli G, Caruso S, Rastelli C, et al. Short versus longer implants in mandibular alveolar ridge augmented using osteogenic distraction: one-year follow-up of a randomized split-mouth trial. J Oral Implantol. 2018;44:184–91.

    Article  PubMed  Google Scholar 

  52. Felice P, Checchi V, Pistilli R, Scarano A, Pellegrino G, Esposito M. Bone augmentation versus 5-mm dental implants in posterior atrophic jaws. Four-month post-loading results from a randomised controlled clinical trial. Eur J Oral Implantol. 2009;2:267–81.

    PubMed  Google Scholar 

  53. Felice P, Soardi E, Pellegrino G, Pistilli R, Marchetti C, Gessaroli M, et al. Treatment of the atrophic edentulous maxilla: short implants versus bone augmentation for placing longer implants. Five-month post-loading results of a pilot randomised controlled trial. Eur J Oral Implantol. 2011;4:191–202.

    PubMed  Google Scholar 

  54. Sahrmann P, Schoen P, Naenni N, Jung R, Attin T, Schmidlin PR. Peri-implant bone density around implants of different lengths: a 3-year follow-up of a randomized clinical trial. J Clin Periodontol. 2017;44:762–8.

    Article  PubMed  Google Scholar 

  55. Teixeira ER, Wadamoto M, Akagawa Y, Kimoto T. Clinical application of short hydroxylapatite-coated dental implants to the posterior mandible: a five-year survival study. J Prosthet Dent. 1997;78:166–1.

    Article  PubMed  Google Scholar 

  56. Thoma DS, Haas R, Tutak M, Garcia A, Schincaglia GP, Hammerle CH. Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 1: demographics and patient-reported outcomes at 1 year of loading. J Clin Periodontol. 2015;42:72–80.

    Article  PubMed  Google Scholar 

  57. Zhang XM, Shi JY, Gu YX, Qiao SC, Mo JJ, Lai HC. Clinical investigation and patient satisfaction of short implants versus longer implants with osteotome sinus floor elevation in atrophic posterior maxillae: a pilot randomized trial. Clin Implant Dent Relat Res. 2017;19:161–6.

    Article  PubMed  Google Scholar 

  58. Kermanshah H, Bitaraf T. A technique for the management of screw access opening in cement-retained implant restorations. Dental Hypotheses. 2014;5:25–7.

    Article  Google Scholar 

  59. Kermanshah H, Geramy A, Ebrahimi SF, Bitaraf T. IPS-Empress II inlay-retained fixed partial denture reinforced with zirconia bar: three-dimensional finite element and in-vitro studies. Acta Odontol Scand. 2012;70:569–6.

    Article  PubMed  Google Scholar 

  60. Nasermostofy S, Jalalian E, Valaie N, Mohtashamrad Z, Haeri A, Bitaraf T. Study of the effect of GapSeal on microgap and microleakage in internal hex connection after cyclic loading. J Res Dent Maxillofac Sci. 2019;4:36–42.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

    Hamid Kermanshah

  2. Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Abbasali Keshtkar

  3. Department of Oral and Maxillofacial Surgery, Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

    Ali Hassani

  4. Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, 19585/175, Tehran, Iran

    Tahereh Bitaraf

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Contributions

The study was designed, conducted, and interpreted by HK, AK, AL, and TB, who also drafted and revised the paper, ensuring its accuracy. TB and AH were responsible for data extraction and methodology, while AK contributed to the analysis and interpretation of the data. All authors approved the final version of the manuscript for submission.

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Correspondence to Tahereh Bitaraf.

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Kermanshah, H., Keshtkar, A., Hassani, A. et al. Comparing short implants to standard dental implants: a systematic review and meta-analysis of randomized controlled trials with extended follow-up. Evid Based Dent 24, 192–193 (2023). https://doi.org/10.1038/s41432-023-00924-1

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