Short implants - bone graft alternative - minimally invasive implants
The following abstract compares the benefits of placing short dental implants
vs bone graft surgery.
The purpose of posting this article is not to prove a point that short dental implants
are better than standard implants placed in vertically augmented bone.
One should take into consideration the surgeon's experience with a certain technique. For example, a surgeon who specializes in vertical augmentations, may achieve the opposite results.
The reason to post this study is to show that now there is a reliable alternative for patients with deficient bone seeking minimally invasive, simple and predictable solution with dental implants
Vertical bone augmentation vs. 7 mm long implants in posterior atrophic mandibles. Results up to 1 year after loading
Presenter: Felice P
University of Bologna, Bologna, Italy
Co-authors: Felice P1, Checchi L1, Marchetti C1, Pellegrino G1, Lizio G1, Esposito M2
University of Bologna, Bologna, Italy, 2University of Manchester, Manchester, UK
Background and aim: To compare the outcomes obtained with the placement of 7 mm long implants vs. the placement of longer implants in vertically augmented bone for the treatment of atrophic posterior mandibles.
Materials and methods: Sixty partially edentulous patients, with a residual bone height above mandibular canal of 7–8 mm were distributed in two treatment groups: the ﬁrst group (30 patients) underwent the insertion of two/three submerged 7 mm long implants, whereas the second one (30 patients) underwent inlay augmentation procedure and subsequent insertion of 10 mm long implants.
After the elevation of a mucoperiosteal ﬂap a horizontal osteotomy and two oblique cuts were made in the coronal third of the mandibular bone; the osteotomised segment was then raised in a coronal direction sparing the lingual periosteum and Bio-Oss blocks were interposed between the raised fragment and the mandibular basal bone. The grafts were left healing for 5 months before inserting the implants. Provisional and deﬁnitive prostheses were placed 4 and 8 months, respectively, thereafter both in the short implant group and in the augmented group.
Results: Three implants in three patients failed in the augmented group vs. one implant in the 7 mm short implant group up to the placement of the ﬁnal prostheses. Consequently three prostheses vs. one prosthesis could not be placed at the planned time, though all implants were successfully replaced and loaded. Four complications (dehiscence) occurred in four patients of the augmented bone group vs. none in the 7 mm short implant group (no signiﬁcant statistical difference). In two cases a partial loss of the graft occurred. Only patients subjected to vertical augmentation complained of temporary mental nerve sensitivity disturbances. No permanent sensitivity alterations of the alveolar inferior nerve occurred in both groups.
Conclusion: The results of this study suggest that, when the residual bone height over the mandibular canal is between 7 and 8 mm, 7 mm short implants might a preferable choice since the treatment is faster, cheaper and associated with less morbidity than vertical bone augmentation.