Ultra-short versus standard-length dental implants in conjunction with osteotome-mediated sinus floor elevation: A randomized controlled clinical trial.
buccal bone
implant stability
short implant
sinus floor augmentation
Journal
Clinical implant dentistry and related research
ISSN: 1708-8208
Titre abrégé: Clin Implant Dent Relat Res
Pays: United States
ID NLM: 100888977
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
08
03
2021
received:
27
10
2020
accepted:
08
03
2021
pubmed:
9
6
2021
medline:
27
8
2021
entrez:
8
6
2021
Statut:
ppublish
Résumé
The ability to restore missing teeth with dental implants is dictated by the available bone and by the presence of anatomical structures. The potential to insert ultrashort implants avoids additional surgical procedures and its inherent complications. The last European Association of Dental Implantologists consensus in 2016 defined ultrashort implants and standard-length dental implants as <6 and >8 mm, respectively. The present study aimed to investigate whether single standing ultrashort dental implants (US) could provide a viable therapeutic alternative to osteotome mediated sinus floor elevation in combination with standard-length dental implants (SL) 10 mm in posterior maxillary rehabilitation with reduced bone height. The study was conducted as a prospective parallel group controlled clinical trial with a 12 month follow-up, where 48 implants were randomized into two groups; US-group (5.5 mm) and SL-group (10 mm) implants placed with osteotome-mediated sinus floor elevation. Crestal bone loss (CBL) was defined as the study's primary outcome, while implant survival, buccal bone thickness, implant stability, probing depth, gingival recession, and adverse effects were assessed as secondary outcomes. Mesial CBL was 1.13 ± 0.52 mm in SL- and 0.72 ± 0.52 mm in US-group (P = .021), while distal CBL was 1.44 ± 0.72 mm in SL- and 0.91 ± 0.69 mm in US-group at 12 months (P = .0179). Regarding implant stability, probing depth, and gingival recession there was no statistically significant difference between the two groups. Regarding implants' survival, three implants were lost in the US-while only one implant was lost in the SL-group (P = .6085; Fisher's exact test). Nevertheless, the ultrashort implants were associated with a tripling of the failure rate and uncertainty where the true failure rate is uncertain (relative risk 3.0; confidence interval 0.3-26.8). Within the current trial's limitations, US-appear appear promising as they are associated less postoperative discomfort, minimal invasiveness and less CBL. However, larger sample size is required to determine whether the ultrashort have an acceptable survival rate.
Sections du résumé
BACKGROUND
BACKGROUND
The ability to restore missing teeth with dental implants is dictated by the available bone and by the presence of anatomical structures. The potential to insert ultrashort implants avoids additional surgical procedures and its inherent complications. The last European Association of Dental Implantologists consensus in 2016 defined ultrashort implants and standard-length dental implants as <6 and >8 mm, respectively.
PURPOSE
OBJECTIVE
The present study aimed to investigate whether single standing ultrashort dental implants (US) could provide a viable therapeutic alternative to osteotome mediated sinus floor elevation in combination with standard-length dental implants (SL) 10 mm in posterior maxillary rehabilitation with reduced bone height.
MATERIALS AND METHODS
METHODS
The study was conducted as a prospective parallel group controlled clinical trial with a 12 month follow-up, where 48 implants were randomized into two groups; US-group (5.5 mm) and SL-group (10 mm) implants placed with osteotome-mediated sinus floor elevation. Crestal bone loss (CBL) was defined as the study's primary outcome, while implant survival, buccal bone thickness, implant stability, probing depth, gingival recession, and adverse effects were assessed as secondary outcomes.
RESULTS
RESULTS
Mesial CBL was 1.13 ± 0.52 mm in SL- and 0.72 ± 0.52 mm in US-group (P = .021), while distal CBL was 1.44 ± 0.72 mm in SL- and 0.91 ± 0.69 mm in US-group at 12 months (P = .0179). Regarding implant stability, probing depth, and gingival recession there was no statistically significant difference between the two groups. Regarding implants' survival, three implants were lost in the US-while only one implant was lost in the SL-group (P = .6085; Fisher's exact test). Nevertheless, the ultrashort implants were associated with a tripling of the failure rate and uncertainty where the true failure rate is uncertain (relative risk 3.0; confidence interval 0.3-26.8).
CONCLUSIONS
CONCLUSIONS
Within the current trial's limitations, US-appear appear promising as they are associated less postoperative discomfort, minimal invasiveness and less CBL. However, larger sample size is required to determine whether the ultrashort have an acceptable survival rate.
Substances chimiques
Dental Implants
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
520-529Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Aghaloo TL, Moy PK. Are the most successful in furnishing bony support for implant placement? 2007:49-73.
von Arx T, Fodich I, Bornstein MM. Proximity of premolar roots to maxillary sinus: a radiographic survey using cone-beam computed tomography. J Endod. 2014;40(10):1541-1548.
Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994;15(2):152 154-156.
Marincola M, Ewers R, Lombardo G, Pallares M. Sinus elevation with short implant. Implant Dent. 2017;2:20-24.
Atieh MA. Survival of short dental implants. 2012.
Iezzi G, Perrotti V, Felice P, Barausse C, Piattelli A, Del Fabbro M. Are <7-mm long implants in native bone as effective as longer implants in augmented bone for the rehabilitation of posterior atrophic jaws? A systematic review and meta-analysis. Clin Implant Dent Relat Res. 2020;22(5):552-566.
Al-Johany S. Survival rates of short dental implants (≤6.5 mm) placed in posterior edentulous ridges and factors affecting their survival after a 12-month follow-up period: systematic review. Int J Oral Maxillofac Implants. 2019;34(3):605-621. https://doi.org/10.11607/jomi.7187.
Xu X, Huang J, Fu X, et al. Short implants versus longer implants in the posterior alveolar region after an observation period of at least five years: a systematic review and meta-analysis. J Dent. 2020;100:103386.
Torres-Alemany A, Fernández-Estevan L, Agustín-Panadero R, Montiel-Company JM, Labaig-Rueda C, Mañes-Ferrer JF. Clinical behavior of short dental implants: systematic review and meta-analysis. J Clin Med Res. 2020;9(10). http://blog.mdpi.com/2015/12/01/a-new-look-for-mdpi-papers/.
Afrashtehfar KI, Katsoulis J, Koka S, Igarashi K. Single versus splinted short implants at sinus augmented sites: a systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2020. https://doi.org/10.1016/j.jormas.2020.08.013.
Neldam CA, Pinholt EM. State of the art of short dental implants: a systematic review of the literature. Clin Implant Dent Relat Res. 2012;14(4):622-632.
Atieh MA, Zadeh H, Stanford CM, Cooper LF. Survival of short dental implants for treatment of posterior partial edentulism: a systematic review. Int J Oral Maxillofac Implants. 2012;27(6):1323-1331.
Schetritt A. Short and ultra-short implants. Implant Dent. 2019;28(3):218-219. https://doi.org/10.1097/id.0000000000000875.
Lombardo G, Marincola M, Signoriello A, Corrocher G, Nocini PF. Single-crown, short and ultra-short implants, in association with simultaneous internal sinus lift in the atrophic posterior maxilla: a three-year retrospective study. Materials. 2020;13(9):2208. https://doi.org/10.3390/ma13092208.
Lombardo G, Pighi J, Marincola M, Corrocher G, Simancas-Pallares M, Nocini PF. Cumulative success rate of short and ultrashort implants supporting single crowns in the posterior maxilla: a 3-year retrospective study. Int J Dent. 2017;2017:8434281.
Bolle C, Felice P, Barausse C, Pistilli V, Trullenque-Eriksson A, Esposito M. Four 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(1):31-47.
Gastaldi G, Felice P, Pistilli V, Barausse C, Ippolito DR, Esposito M. Posterior atrophic jaws rehabilitated with prostheses supported by 5 × 5 mm implants with a nanostructured calcium-incorporated titanium surface or by longer implants in augmented bone. 3-year results from a randomised controlled trial. Eur J Oral Implantol. 2018;11(1):49-61.
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(4):391-400.
Yan Q, Wu X, Su M, Hua F, Shi B. Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis. BMJ Open. 2019;9(10):e029826.
Xu X, Hu B, Xu Y, Liu Q, Ding H, Xu L. Short versus standard implants for single-crown restorations in the posterior region: a systematic review and meta-analysis. J Prosthet Dent. 2020;124(5):530-538.
Guljé F, Abrahamsson I, Chen S, Stanford C, Zadeh H, Palmer R. Implants of 6 mm vs. 11 mm lengths in the posterior maxilla and mandible: a 1-year multicenter randomized controlled trial. Clin Oral Implants Res. 2013;24(12):1325-1331.
Merheb J, Vercruyssen M, Coucke W, Beckers L, Teughels W, Quirynen M. The fate of buccal bone around dental implants. A 12-month postloading follow-up study. Clin Oral Implants Res. 2017;28(1):103-108.
Romeo E, Storelli S, Casano G, Scanferla M, Botticelli D. Six-mm versus 10-mm long implants in the rehabilitation of posterior edentulous jaws: a 5-year follow-up of a randomised controlled trial. Eur J Oral Implantol. 2014;7(4):371-381.
Pieri F, Aldini NN, Fini M, Marchetti C, Corinaldesi G. Preliminary 2-year report on treatment outcomes for 6-mm-long implants in posterior atrophic mandibles. Int J Prosthodont. 2012;25(3):279-289.
Fugazzotto PA. Shorter implants in clinical practice: rationale and treatment results. Int J Oral Maxillofac Implants. 2008;23(3):487-496.
ten Bruggenkate CM, Asikainen P, Foitzik C, Krekeler G, Sutter F. Short (6-mm) nonsubmerged dental implants: results of a multicenter clinical trial of 1 to 7 years. Int J Oral Maxillofac Implants. 1998;13(6):791-798.
Pistilli R, Felice P, Cannizzaro G, et al. Posterior atrophic jaws rehabilitated with prostheses supported by 6mm long 4mm wide implants or by longer implants in augmented bone. One-year post-loading results from a pilot randomised controlled trial. Eur J Oral Implantol. 2013;6(4):359-372.
Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev. 2014;7:CD003815.
Thoma DS, Zeltner M, Hüsler J, Hämmerle CHF, Jung RE. EAO Supplement Working Group 4-EAO CC 2015 short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res. 2015;26:154-169.
Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil. 2014;41(6):443-476.
Koodaryan R, Hafezeqoran A. Evaluation of implant collar surfaces for marginal bone loss: a systematic review and meta-analysis. Biomed Res Int. 2016;2016(1):1-10. https://doi.org/10.1155/2016/4987526.
Papaspyridakos P, de Souza A, Vazouras K, Gholami H, Pagni S, Weber H-P. 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.
Nielsen HB, Schou S, Isidor F, Christensen A-E, Starch-Jensen T. Short implants (≤8 mm) compared to standard length implants (>8 mm) in conjunction with maxillary sinus floor augmentation: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2019;48(2):239-249.
Kim S, Kim S, Choi H, et al. A three-dimensional finite element analysis of short dental implants in the posterior maxilla. Int J Oral Maxillofac Implants. 2014;29(2):e155-e164.
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(9):1097-1107. https://doi.org/10.1111/clr.12923.
Vanderstuyft T, Tarce M, Sanaan B, Jacobs R, de Faria Vasconcelos K, Quirynen M. Inaccuracy of buccal bone thickness estimation on cone-beam CT due to implant blooming: an ex-vivo study. J Clin Periodontol. 2019;46(11):1134-1143.
Cardaropoli G, Lekholm U, Wennström JL. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res. 2006;17(2):165-171.
Yoda N, Zheng K, Chen J, et al. Bone morphological effects on post-implantation remodeling of maxillary anterior buccal bone: a clinical and biomechanical study. J Prosthodont Res. 2017;61(4):393-402.
van Staden RC, Li X, Guan H, Johnson NW, Reher P, Loo Y-C. A finite element study of short dental implants in the posterior maxilla. Int J Oral Maxillofac Implants. 2014;29(2):e147-e154.