The use of short dental implants in clinical practice: literature review

When anatomic structures and ridge resorption limit the placement of a standard implant, the clinician can apply augmentation techniques or use short implants. A literature review was carried out to evaluate the differences in survival rate and the rational use of short implants. Electronic search (MEDLINE) and manual search have been performed to select papers from 2000 to 2008. Of all the inclusion criteria the most relevant were: 1) studies with data on short implants; 2) studies on humans; 3) prospective, longitudinal, retrospective and multicenter studies; 4) no restrictions were applied about study design; 5) no implant type selection was applied. Exclusion criteria were: 1) studies concerning treatment of patients with conditions possibly affecting survival or success rates of implant treatment; 2) studies concerning treatment of patients with non-treated periodontal disease; 3) implants placed in non-healed ridge, such as postextractive short implants. A total of 13 studies fulfilled the inclusion criteria. Most of the studies have reported different survival rate for short and standard implants. The difference is not significant. The recent literature have demonstrated a similar survival rate for short and standard implants. Older articles have demonstrated a lower survival rate for short implants. The treatment planning is a key factor for success in the use of short implants. Some of the parameters the clinician should consider are: 1) area to rehabilitate as well as bone quality; 2) length of the implant; 3) implant diameter; 4) type of implant and surface treatment; 5) crown to implant ratio of the final prostheses; 6) type of prostheses; 7) connection to other implants; 8) occlusal/ parafunctional load; 9) prosthetic complications. Although in the literature there are no studies that analyze short implant survival from the point of view of each key factors, it can be assumed that a careful treatment planning can lead the clinician to obtain a successful rehabilitation.