title: 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.
abstract: OBJECTIVE
  To evaluate whether short (5 to 8.5 mm) dental implants could be a suitable alternative to longer (>11.5 mm) implants placed in atrophic maxillae augmented with autogenous bone for supporting dental prostheses.
  
  
  METHODS
  Twenty-eight patients with fully edentulous atrophic maxillae having 5 to 9 mm of residual crestal bone height at least 5 mm thick, as measured on computerised tomography scans, were randomised into two groups either to receive 4 to 8 short (5 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mmlong implants (13 patients). Bone blocks and the windows at maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants, which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar-retained overdentures were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin cross-arch fixed dental prostheses. Outcome measures were: prosthesis and implant failures, any complications (including prolonged postoperative pain) and patient satisfaction. All patients were followed for 5 months after loading.
  
  
  RESULTS
  All patients could be rehabilitated with implant-supported prostheses and none dropped out. One bilateral sinus lift procedure failed due to infection, though short implants could be placed. One implant failed in the augmented group versus 2 short implants in 2 patients. All failures occurred before loading. Significantly more complications occurred in augmented patients: 8 complications occurred in 5 augmented patients (all complained of pain 1 month after bone harvesting from the iliac crest). No complications occurred in the short implant group. All patients were fully satisfied with the treatment and would do it again.
  
  
  CONCLUSIONS
  This pilot study suggests that short implants may be a suitable, cheaper and faster alternative to longer implants placed in bone augmented with autogenous bone for rehabilitating edentulous atrophic maxillae. However, these preliminary results need to be confirmed by larger trials with follow-ups of at least 5 years.
authors: Department of Peridontology and Implantology, Univeristy of Bologna, Italy.
authors: Pietro
authors: P
authors: Felice
authors: Elisa
authors: E
authors: Soardi
authors: Gerardo
authors: G
authors: Pellegrino
authors: Roberto
authors: R
authors: Pistilli
authors: Claudio
authors: C
authors: Marchetti
authors: Manlio
authors: M
authors: Gessaroli
authors: Marco
authors: M
authors: Esposito
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D003828:Denture, Overlay; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D007575:Jaw, Edentulous / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011183:Postoperative Complications; D011859:Radiography; D059546:Sinus Floor Augmentation
chemical_list: D015921:Dental Implants