Clinical implant dentistry and related research | 2021
Ultra-short versus standard-length dental implants in conjunction with osteotome-mediated sinus floor elevation: A randomized controlled clinical trial.
Abstract
BACKGROUND\nThe 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\u2009mm, respectively.\n\n\nPURPOSE\nThe 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\u2009mm in posterior maxillary rehabilitation with reduced bone height.\n\n\nMATERIALS AND METHODS\nThe study was conducted as a prospective parallel group controlled clinical trial with a 12\u2009month follow-up, where 48 implants were randomized into two groups; US-group (5.5\u2009mm) and SL-group (10\u2009mm) 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.\n\n\nRESULTS\nMesial CBL was 1.13\u2009±\u20090.52\u2009mm in SL- and 0.72\u2009±\u20090.52\u2009mm in US-group (P = .021), while distal CBL was 1.44\u2009±\u20090.72\u2009mm in SL- and 0.91\u2009±\u20090.69\u2009mm in US-group at 12\u2009months (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).\n\n\nCONCLUSIONS\nWithin 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.