Journal of Prevention and Treatment for Stomatological Diseases ›› 2020, Vol. 28 ›› Issue (3): 137-145.doi: 10.12016/j.issn.2096-1456.2020.03.001

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Clinical application and complications of short implants (≤6 mm)

SHI Bin(),YAN Qi,WU Xinyu   

  1. Department of Oral Implantology, School & Hospital of Stomatology, Wuhan university, Wuhan 430079, China
  • Received:2019-08-01 Revised:2019-11-05 Online:2020-03-20 Published:2020-03-20
  • Contact: Bin SHI E-mail:shibin_dentist@whu.edu.cn

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Abstract:

Short implants can be used as an alternative in cases of insufficient vertical bone volume after dentition defect or absence of dentition to simplify or avoid bone augmentation procedures. Short implants (≤ 6 mm) are reported to have a mean survival rate of 96% after a period of 1-5 years in function and have been widely used in cases of dentition defects or absence of dentition. Compared with conventional implants (≥ 10 mm) combined with bone augmentation procedures, short implants have fewer surgery-related complications, less marginal bone loss, shortened treatment times and reduced costs, and are preferred by patients. Due to a lack of evidence, a high crown-implant ratio should not be an obstacle for the use of short implants. In addition, most of the current literature has not enough follow-up time, the long-term implant survival data of short implants remain unclear. To improve the clinical outcomes of short implants, attention should be paid to the implant site, bone quality, and occlusal force as well as to the presence of oral health maintenance, periodontal diseases and habits through a careful intraoral and radiographic examination. The choices of wider implant use and splint restoration are recommended, occlusal force should be paid attention during implant maintenance. Inappropriate stress on restorations should be avoided. Future studies should be focused on the long-term clinical outcomes of short implants.

Key words: implant prosthesis, insufficient bone mass, dentition defect, absence of dentition, short implant, crown-to-root ratio, occlusal force, survival rate, marginal bone loss, complication

CLC Number: 

  • R783.4

Figure 1

Short implant-supported mandibular overdentures a： presurgery panoramic tomography showed an edentulous mandible with insufficient bone height;b：two Bicon short implants （4.5 × 6 mm） were inserted;c：panoramic tomography after the final restoration;d： intraoral photo after the final restoration;e：panoramic tomography 3 years after loading showed stable peri-implant bone levels; f： intraoral photo 3 years after loading showed healthy peri-implant soft tissues"

Figure 2

Application of short implant-supported single crowns for restoration of multiple missing posterior teeth a： presurgery panoramic tomography;16 and 17 were missing. Alveolar bone surrounding 26, 35, 36 and 37 was severely absorbed. Residual bone height was insufficient for a conventional implant;b： panoramic tomography showed that 16 and 17 were rehabilitated with short implant-supported single crowns;c： panoramic tomography showed that 26 site was rehabilitated with two short implant-supported single crowns 3.5 years after the delivery of 16 and 17 crowns;d： panoramic tomography showed that 35 to 37 were rehabilitated with short implant-supported single crowns, 6 months after the delivery of the implant-supported single crowns in 26 site, 4 years after the delivery of 16 and 17 crowns. No obvious changes in the peri-implant bone level were observed"

Table 1

Survival rate and marginal bone loss of short implants (≤ 6 mm) in randomized controlled clinical trials"

literature Position Number of subjects
（implants）		 Implant length
（ mm）		 Follow-up after
loading（y）		 Implant survival
（%）		 Marginal bone
loss（ mm）		 Difference between
groups （mm）
Bolle, 2018[25] MAX, MAN 30（80） 4 1 92.50 0.57 ± 0.031） -0.18
MAX 20（37） 91.90 0.63 ± 0.051） -0.26
MAN 20（43） 95.35 0.51 ± 0.04 -0.09
Rokn, 2018[26] MAN 11（25） 4 1 100.00 0.30 ± 0.34 -0.16
Esposito, 2014[27] MAX, MAN 30（64） 5 3 95.30 1.22 ± 0.491） -0.32
MAX 15（34） 91.18 1.02 ± 0.471） -0.41
MAN 15（30） 93.33 1.44 ± 0.44 -0.24
Gastaldi, 2018[28] MAX, MAN 40（68） 5 3 97.06 1.07 ± 0.301） -0.34
MAX 20（36） 97.22 1.04 ± 0.35 -0.39
MAN 20（32） 96.88 1.10 ± 0.251） -0.29
Gastaldi, 2017[29] MAX 16（16） 5 3 100.00 0.89 ± 0.25 -0.19
Guljé, 2014[30] MAX 21（21） 6 1 100.00 0.10 ± 0.20 -
Pohl, 2017[31] MAX 50（67） 6 3 100.00 0.44 ± 0.56 -
Felice, 2018[32] MAX, MAN 40（80） 6 3 97.50 1.27 ± 0.351） -1.25
MAX 20（39） 94.87 1.28 ± 0.371） -1.22
MAN 20（41） 100.00 1.25 ± 0.351） -1.29
Bechara, 2017[33] MAX 33（45） 6 3 100.00 0.201） -
Romeo, 2014[34] MAX, MAN 11（26） 6 5 96.15 0.43 ± 0.34 -0.19
Naenni, 2018[35] MAX, MAN 40（40） 6 5 90.00 0.29 -
MAX 12（12） 91.67 -
MAN 28（28） 89.29 -
Zadeh, 2017[36] MAX, MAN 48（105） 6 3 96.20 0.23 ± 0.411） -
Rossi, 2016[37] MAX, MAN 30（30） 6 5 86.67 0.52 -
Weerapong, 2019[38] MAN 23（23） 6 1 91.30 0.33 ± 0.47 -
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