Are Nongrafting Solutions Viable for Dental Implant Treatment in Limited Bone Volume?

Dental implant therapies must be planned and executed to meet both the immediate and longer-term expectations of patients. The early developmental success of dental implants was dependent on the quality and quantity of a patient's bone. Implants were commonly placed into the parasymphyseal mandibular and anterior maxillary bone. Building on this success, bone grafting allowed patients lacking sufficient bone to obtain implant-supported prosthetic solutions for treatment of partial or complete edentulism. More recently, several nongrafting solutions for implant therapy, including pterygoid implants, zygomatic implants, tilted implants, and short implants, have reported success. This article will consider the rationale for graftless solutions in implant therapy as well as the data supporting the use of various graftless protocols as alternatives to grafting and conventional dental implant therapy. It will discuss factors concerning graftless versus grafted approaches to treatment of patients with limited bone volume and will describe the use of short dental implants as a graftless solution in the edentulous maxilla.