Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Oct 28;9(10):e029826.
doi: 10.1136/bmjopen-2019-029826.

Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis

Qi Yan #  1   2 , Xinyu Wu #  1   2 , Meiying Su  2 , Fang Hua  3   4 , Bin Shi  5
Affiliations
Meta-Analysis

Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis

Qi Yan et al. BMJ Open. .

Abstract

Objectives: To compare the use of short implants (≤6 mm) in atrophic posterior maxilla versus longer implants (≥10 mm) with sinus floor elevation.

Design: A systematic review and meta-analysis based on randomised controlled trials (RCTs).

Data sources: Electronic searches were conducted in PubMed, Embase and the Cochrane CENTRAL. Retrospective and prospective hand searches were also performed.

Eligibility criteria: RCTs comparing short implants (≤6 mm) and longer implants (≥10 mm) with sinus floor elevation were included. Outcome measures included implant survival (primary outcome), marginal bone loss (MBL), complications and patient satisfaction.

Data extraction and synthesis: Risks of bias in and across studies were evaluated. Meta-analysis, subgroup analysis and sensitivity analysis were undertaken. Quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation.

Results: A total of seven RCTs involving 310 participants were included. No significant difference in survival rate was found for 1-3 years follow-up (RR 1.01, 95% CI 0.97 to 1.04, p=0.74, I²=0%, moderate-quality evidence) or for 3 years or longer follow-up (RR 1.00, 95% CI 0.97 to 1.04, p=0.79, I²=0%, moderate-quality evidence). However, short implants (≤6 mm) showed significantly less MBL in 1-3 years follow-up (MD=-0.13 mm, 95% CI -0.21 to 0.05; p=0.001, I²=87%, low-quality evidence) and in 3 years or longer follow-up (MD=-0.25 mm, 95% CI -0.40 to 0.10; p=0.001, I²=0%, moderate-quality evidence). In addition, short implant (≤6 mm) resulted in fewer postsurgery reaction (RR 0.11, 95% CI 0.14 to 0.31, p<0.001, I²=40%, moderate-quality evidence) and sinus perforation or infection (RR 0.11, 95% CI 0.02 to 0.63, p=0.01, I²=0%, moderate-quality evidence).

Conclusions: For atrophic posterior maxilla, short implants (≤6 mm) are a promising alternative to sinus floor elevation, with comparable survival rate, less MBL and postsurgery reactions. Additional high-quality studies are needed to evaluate the long-term effectiveness of short implants (≤6 mm).

Trial registeration number: The protocol has been registered at PROSPERO (CRD42018103531).

Keywords: short dental implant; sinus floor augmentation; systematic review.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram for study selection. RCT, randomised controlled trial.
Figure 2
Figure 2
Risk of bias in each included study.
Figure 3
Figure 3
Risk of bias across included studies.
Figure 4
Figure 4
Forest plot for implant survival rate. M-H, Mantel-Haenszel; SI, short implant group; SFE, sinus floor elevation group.
Figure 5
Figure 5
Forest plot for marginal bone loss. SI, short implant group; SFE, sinus floor elevation group.
See this image and copyright information in PMC

References

    1. Spitznagel FA, Horvath SD, Gierthmuehlen PC. Prosthetic protocols in implant-based oral rehabilitations: a systematic review on the clinical outcome of monolithic all-ceramic single- and multi-unit prostheses. Eur J Oral Implantol 2017;10 Suppl 1:89–99. - PubMed
    1. Pjetursson BE, Thoma D, Jung R, et al. . A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 2012;23 Suppl 6:22–38. 10.1111/j.1600-0501.2012.02546.x - DOI - PubMed
    1. Davarpanah M, Martinez H, Etienne D, et al. . A prospective multicenter evaluation of 1,583 3i implants: 1- to 5-year data. International Journal of Oral & Maxillofacial Implants 2002;17:820–8. - PubMed
    1. Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. John Wiley & Sons, Ltd, 2014. - PMC - PubMed
    1. Morand M, Irinakis T. The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants. Journal of Oral Implantology 2007;33:257–66. 10.1563/1548-1336(2007)33[257:TCOITI]2.0.CO;2 - DOI - PubMed

Publication types

Substances

LinkOut - more resources