Treatment concepts for the posterior maxilla and mandible: short implants versus long implants in augmented bone

Abstract

The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.

Keywords: Alveolar ridge augmentation; Dental implants; Sinus floor augmentation.

Figure 1

(A) A treatment option for the posterior maxilla with a vertical bone height of 6–8 mm. (B, C) A short dental implant is recommended.

Figure 2

(A) A treatment option for the posterior maxilla with a vertical bone height of more than 8 mm. (B, C) A transcrestal sinus elevation approach can be chosen for a vertical ridge dimension exceeding 8 mm and if standard-length implants are the preferred option.

Figure 3

(A) A treatment option for the posterior mandible with a remaining ridge height of less than 8 mm. (B) Primary vertical bone augmentation should be performed, (C) followed by the placement of standard-length implants.

Figure 4

(A) A treatment option for the posterior mandible with a remaining ridge height of 8–10 mm. (B, C) A short dental implant is recommended.

Figure 5

(A) A treatment option for the posterior mandible with a vertical bone height of more than 10 mm. (B, C) Standard-length implants are recommended.

Figure 6

Decision-making process for the posterior maxilla and mandible.