Short implants--an analysis of longitudinal studies.
OBJECTIVE
The purpose of this study was to consider the therapeutic decision whether to use advanced surgery or short implants based on data concerning the use of these implants found in follow-up studies.


METHODS
The MEDLINE database was consulted for follow-up studies published between the years 1980 and 2004. For those studies that met the inclusion and exclusion criteria, data concerning the number of implants 7, 8.5, or 10 mm long placed and lost, the time at which the failure occurred, and related risk factors were gathered for 33 studies arranged in tables and subjected to analysis. The studies included 16,344 implant placements with 786 failures (4.8%). Implants were analyzed according to the time of failure (i.e., before or after prosthesis seating) and risk factors implicated in the failures.


RESULTS
The total rate of failures was 4.8%. Implants 3.75 mm wide and 7 mm long failed at a rate of 9.7%, compared to 6.3% for 3.75 x 10-mm implants. It was found that 54.9% of failures occurred before the prosthesis connection. Finally, 66.7% of all failures were attributed to poor bone quality, 45.4% to the location (maxilla or mandible), 27.2% to occlusal overload, 24.2% to location within the jaw, and 15.1% to infections (an implant could be associated with multiple risk factors).


CONCLUSIONS
The analysis revealed that among the risk factors, poor bone quality in association with short implants seemed to be relevant to failure. The use of implants 4 mm in diameter appeared to minimize failure in these situations. The 3.75 x 7-mm implant presented the highest failure rate (9.7%) of 1894 implants analyzed (excluding implant designs with higher failure rates but few total implants).


CONCLUSIONS
Short implants should be considered as an alternative to advanced bone augmentation surgeries, since surgeries can involve higher morbidity, require extended clinical periods, and involve higher costs to the patient.
das Neves
Flávio Domingues
FD
Department of Occlusion, Fixed Prostheses, and Dental Materials, Federal University of Uberlândia, School of Dentistry, Uberlândia, Brazil. neves@triang.com.br
Fones
Dennis
D
Bernardes
Sérgio Rocha
SR
do Prado
Célio Jesus
CJ
Neto
Alfredo Júlio Fernandes
AJ
D000539:Alveolar Process / Q000737:chemistry; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects*; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants; D019232:Dental Restoration Failure; D006801:Humans; D008137:Longitudinal Studies; D012307:Risk Factors
D015921:Dental Implants