IMPLANTES CURTOS

RODRIGO SOARES MARTINS

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Abstract

Os implantes dentários curtos representam uma opção de tratamento previsível, e sua principal indicação reside na possibilidade de evitar técnicas cirúrgicas invasivas. Não existe consenso na literatura sobre a definição de implante curto. O objetivo desse trabalho foi realizar uma revisão da literatura sobre implantes curtos, relatar as modificações incorporadas a estes implantes, bem como os fatores importantes para maximização dos resultados clínicos. A literatura nos mostra que dentre os fatores preponderantes para o sucesso dos implantes curtos destacam-se a geometria dos implantes combinada com largos diâmetros e tratamento de superfície. Pode-se concluir que os implantes curtos representam uma boa alternativa de tratamento, especialmente para casos com leito ósseo reduzido. No entanto deve-se seguir um rigoroso protocolo de indicação e uso para garantir o sucesso do tratamento.

Descritores: Implantes Curtos. Implantes Dentários. Taxa de Sucesso. Biomecânica.

Short dental implants are a predictable treatment option and its main indication is the possibility of avoiding invasive surgical techniques. There is no consensus regarding the definition of short implant. The aim of this study was to review the literature on short implants, reporting the changes incorporated into these implants, as well as the important factors to maximize clinical outcomes. The literature shows that among the important factors for the success of short implants highlight the geometry of combined implants with larger diameters and surface treatment. It can be concluded that the short implants are a good alternative treatment, particularly in cases with low bone bed. However one must follow a strict indication and use of protocol to ensure successful treatment.

Keywords: Short implants. Dental implants. Success rate. Biomechanics.

Referências

{Crown-to-implant ratios of single tooth implant-supported restorations}. Schulte, John; Flores, Arturo M; Weed, Meghan (2007)

{Short implants placed one-stage in maxillae and mandibles: A retrospective clinical study with 1 to 9 years of follow-up}. Maló, Paulo; De Araújo Nobre, Miguel; Rangert, Bo ‒ Clinical Implant Dentistry and Related Research (2007)
BACKGROUND: The use of short implants (7-8.5 mm) has historically been associated with lower survival rates than for longer implants. However, recent clinical studies indicate that short implants ... Abstract: BACKGROUND: The use of short implants (7-8.5 mm) has historically been associated with lower survival rates than for longer implants. However, recent clinical studies indicate that short implants may support most prosthetic restorations quite adequately, but still clinical documentation is sparse. PURPOSE: The purpose of this study was to report on the placement of short Br{\aa}nemark implants, testing the hypothesis that short implants in atrophied jaws might give similar long-term implant survival rates as longer implants used in larger bone volumes. MATERIALS and METHODS: This retrospective clinical study included 237 consecutively treated patients with 408 short Br{\aa}nemark implants supporting 151 fixed prostheses. One hundred thirty-one of the implants were 7-mm long, and 277 were 8.5-mm long. Final abutments were delivered at the time of surgery, and final prostheses were delivered 4 to 6 months later. RESULTS: One hundred and twenty six of the 7-mm implants (96{\%}) have passed the 1-year follow-up; 110 (84{\%}), the 2-year follow-up; and 88 (67{\%}), the 5-year follow-up. Five implants failed in four patients before the 6-month follow-up, giving a cumulative survival rate of 96.2{\%} at 5 years. The average bone resorption was 1 mm (SD=0.6 mm) after the first year and 1.8 mm (SD=0.8 mm) after the fifth year of function. Two hundred sixty nine of the 8.5-mm implants (97{\%}) have passed the 1-year follow-up; 220 (79{\%}), the 2-year follow-up; and 142 (51{\%}), the 5-year follow-up. Eight implants failed in seven patients before the 6-month follow-up, giving a cumulative survival rate of 97.1{\%} at 5 years. The average bone resorption was 1.3 mm (SD=0.8 mm) after the first year and 2.2 mm (SD=0.9 mm) after the fifth year of function. CONCLUSIONS: The cumulative survival rates of 96.2 and 97.1{\%} at 5 years for implants of 7.0- and 8.5-mm length, respectively, indicate that one-stage short Br{\aa}nemark implants used in both jaws is a viable concept.

{Vertical augmentation with interpositional blocks of anorganic bovine bone vs . 7-mm-long implants in posterior mandibles : 1-year results of a randomized clinical trial}. Felice, Pietro; Pellegrino, Gerardo; Checchi Luigi; Pistilli Rober... (2010)

{Previsibilidade de implantes curtos: revisão de literatura}. Fábio Ferreira de Souza Abbott Galvão; Antonio Alves de Almeida Jú... (2011)

Avaliação clínica e radiográfica da reabilitação da região posterior de mandíbula atrófica com implantes curtos. Maciel, J.; Bassi, A.P.F.; Oliveira, J.M.C.; Fontão, F.G.K.; Souza... ‒ 2º Congresso da Faculdade de Odontologia de Araçatuba (2012)

{Alternativas a la elevación de seno maxilar : implantes cortos}. Gonzales Lagunas, J ‒ Rev Esp Cir Oral y Maxilofac (2008) http://scielo.isciii.es/pdf/maxi/v30n6/controv...

Posterior Mandibular Alveolar Distraction Osteogenesis Utilizing an Extraosseous Distractor: A Prospective Study. Wilson C.K. Polo; Patricia R. Cury; Wilson R. Sendyk; Alfredo Grom... ‒ J Periodontol (2005)

Short (8-mm) dental implants in the rehabilitation of partial and complete edentulism: A 3- to 14-year longitudinal study. E. Romeo; M. Ghisolfi; R. Rozza; M. Chiapasco; D. Lops ‒ International Journal of Prosthodontics (2006)

{Previsibilidade de implantes curtos e extracurtos unitários em mandíbula posterior atrófica}. Raphaella Coelho Michel; Carla Andreotti Damante; Maria Lúcia de R... (2015) http://www.upf.br/seer/index.php/rfo/article/v...

{Desempenho clinico dos implantes curtos: um estudo retrospectivo de seis anos}. Eliane Barboza; Waldimir Carvalho; Bianca Francisco; Vinícius Ferreira ‒ Revista de Periodontita (2008)

{Short dental implants as a treatment option: results from an observational study in a single private practice.}. Murray L. Arlin ‒ The International journal of oral & maxillofacial implants (2005)
PURPOSE: The purpose was to evaluate clinical outcome of short (6- and 8-mm) dental implants placed in sites with low bone availability (7 to 11 mm) in a single private practice and to compare the... Abstract: PURPOSE: The purpose was to evaluate clinical outcome of short (6- and 8-mm) dental implants placed in sites with low bone availability (7 to 11 mm) in a single private practice and to compare their survival with that of longer implants. MATERIALS and METHODS: Implants were placed by a single private practitioner in a variety of clinical indications. Exclusion criteria included uncontrolled diabetes mellitus, alcoholism, and systemic immune disorders. Clinical data relating to implant placement and follow-up appointments, including adverse events, were entered into an electronic database. Two-year survival rates were calculated and life table analyses undertaken for implants measuring 6, 8, and 10 to 16 mm. RESULTS: A total of 630 Straumann implants were placed in 264 patients between April 1994 and December 2003. Of these, 35 implants were 6 mm long, 141 were 8 mm long, and 454 were 10 to 16 mm long. Maximum follow-up was 64.6 months, 83.7 months, and 102 months for implants measuring 6 mm, 8 mm, and 10 to 16 mm, respectively. Two-year survival rates were 94.3{\%}, 99.3{\%}, and 97.4{\%} for 6-mm, 8-mm, and 10- to 16-mm implants, respectively. DISCUSSION: The results indicated that the 2-year outcome for 6-mm and 8-mm implants was comparable to that for longer (10- to 16-mm) implants in this patient population. CONCLUSION: In this study, short (6- or 8-mm) implants were used with good reliability in patients with limited bone availability, without the need for ridge augmentation. Shorter implant length was not associated with reduced survival at 2 years, compared with longer implants.

{Investigation of the influence of design details on short implant biomechanics using colorimetric photoelastic analysis: a pilot study}. Zielak, João César; Archetti, Felipe Belmonte; Scotton, Ricardo; F... ‒ Research on biomedical engineering (2015)

{Racionalização biomecânica para o uso de implantes curtos : uma revisão de literatura}. Silva, Geraldo Lúcio de Magalhães ‒ Dentistry in Science (2010)
Tradicionalmente, implantes com comprimentos ≥ 10mm apresentaram desempenhos supe- riores quando comparados com implantes curtos. Contudo, recentemente, estudos publicaram altas taxas de sobreviv{... Abstract: Tradicionalmente, implantes com comprimentos ≥ 10mm apresentaram desempenhos supe- riores quando comparados com implantes curtos. Contudo, recentemente, estudos publicaram altas taxas de sobreviv{\^{e}}ncia de implantes curtos com diferentes sistemas de implantes. O objeti- vo desta revis{\~{a}}o de literatura {\'{e}} o de avaliar os fatores biomec{\^{a}}nicos, possivelmente, respons{\'{a}}veis pelo sucesso do uso de implantes com comprimentos ≤ 8,5mm. Descritores:

{Mandíbulas Edêntulas Severamente Reabsorvidas Tratadas com Implantes Curtos – Apresentação de 4 Casos Clínicos e Controle de 30 a 36 Meses}. Manfro, Rafael; Bortoluzzi, Marcelo Carlos; Pratto, Luciano Melo; ... ‒ J Oral Invest (2013) https://seer.imed.edu.br/index.php/JOI/article...

{Short implants in partially edentulous maxillae and mandibles: A 10 to 20 years retrospective evaluation}. Lops, Diego; Bressan, Eriberto; Pisoni, Gianluca; Cea, Niccol; Cor... ‒ International Journal of Dentistry (2012) http://downloads.hindawi.com/journals/ijd/2012...
Purpose. Evaluation of the short implant (8 mm in height) long-term prognosis and of the implant site influence on the prognosis. Methods. A longitudinal study was carried out on 121 patients (57 ... Abstract: Purpose. Evaluation of the short implant (8 mm in height) long-term prognosis and of the implant site influence on the prognosis. Methods. A longitudinal study was carried out on 121 patients (57 males and 64 females) consecutively treated with 257 implants. 108 implants were short. Results. Four (3.6{\%}) short implants supporting fixed partial prostheses failed. Similarly, three standard implants supporting fixed partial prostheses and one supporting single-crown prosthesis failed. Mean marginal bone loss (MBL) and probing depth (PD) of short and standard implants were statistically comparable (P > .05). The 20-year cumulative survival rates of short and standard implants were 92.3 and 95.9{\%}, respectively. The cumulative success rates were 78.3 and 81.4{\%}. The survival rates of short implants in posterior and anterior regions were comparable: 95 and 96.4{\%}, respectively. The difference between survival rates was not significant (P > .05). Conclusions. The high reliability of short implants in supporting fixed prostheses was confirmed. Short and standard implants long-term prognoses were not significantly different. The prognosis of short implants in posterior regions was comparable to that of in anterior regions. Nevertheless, a larger sample is required to confirm this trend.

{Short dental implants in reduced alveolar bone height: a review of the literature}. Marcin Tutak; Tomasz Smektata; Katarzyna Schneider; Edyta Golebiew... ‒ Medical science monitor: international medical journal of experimental and clinical research (2013) http://www.pubmedcentral.nih.gov/articlerender...
BACKGROUND: The purpose of this study was to evaluate the use of short dental implants in distally reduced alveolar bone height.$\backslash$n$\backslash$nMATERIAL/METHODS: MedLine (PubMed and Ovid... Abstract: BACKGROUND: The purpose of this study was to evaluate the use of short dental implants in distally reduced alveolar bone height.$\backslash$n$\backslash$nMATERIAL/METHODS: MedLine (PubMed and Ovid), ISI Web of Knowledge, and Cochrane databases were used for analysis. Searching was conducted using the search equation: 'Dental Implants' [Majr] and (Short[TIAB] OR Shorter[TIAB]) and (Implant[TIAB] OR Implants[TIAB]). Abstracts were screened by 2 independent reviewers. The articles included in the analysis were published in the English language and reported data on the use of implants with lengths below 10 mm in the posterior region with reduced alveolar bone height making the placement of longer implants impossible without additional surgical interventions. Articles concerning data on orthodontic implants and post-resection surgery reconstruction were excluded from analysis. Any disagreements between the 2 reviewers were resolved by a third reviewer. No time frame was used.$\backslash$n$\backslash$nRESULTS: Of the 791 articles initially found, automatic rejection of duplicates in the Endnotes X5 software resulted in 538 articles. After the selection of studies from databases, a bibliography of 32 eligible articles was searched for other publications. Through this method, 2 more studies were added.$\backslash$n$\backslash$nCONCLUSIONS: The analysis of the results of different studies on the use of short dental implants showed that this treatment could be effective and comparable to the use of standard-length implants. This study revealed that rough-surfaced implants with lengths between 6-10 mm placed in the posterior mandible are the preferred solution. However, more detailed data will require additional prospective studies.

{Implantes curtos VS Implantes standard na região posterior da maxila e da mandíbula}. Susana Filipa de Almeida Ferreira ‒ Universidade Fernando Pessoa (2011)

Implantes dentais curtos: alternativa conservadora na reabilitação bucal. Joel Ferreira Santiago Júnior; Fellipo Ramos Verri; Eduardo Piza P... ‒ Revista de Cirurgia e Traumatologia Buco-Maxilo-Facial (2010)

Estudo sobre o comportamento biomecânico de implantes curtos com variação da espessura cortical óssea por meio do método dos elementos finitos. José Augusto Conde Neto; Matsuyoshi Mori ‒ Faculdade de Odontologia da Universidade de São Paulo (2012)

{Short implants in maxillae and mandibles: a retrospective study with 1 to 8 years of follow-up.}. Anitua, Eduardo; Orive, Gorka ‒ Journal of periodontology (2010) http://www.ncbi.nlm.nih.gov/pubmed/20450361
BACKGROUND: The aims of this study are to evaluate the long-term survival rates of short dental implants in posterior areas in both jaws and analyze the influence of different factors on implant s... Abstract: BACKGROUND: The aims of this study are to evaluate the long-term survival rates of short dental implants in posterior areas in both jaws and analyze the influence of different factors on implant survival.$\backslash$n$\backslash$nMETHODS: A retrospective cohort study design was used. Six hundred and sixty-one patients received 1,287 short implants (<8.5 mm) between 2001 to 2008 in Vitoria, Spain. All implant installations were performed by two experienced surgeons and rehabilitations were done by three prosthodontists. Each implant failure was carefully analyzed. The potential influence of demographic factors, clinical factors, surgery-depending factors, and prosthetic variables on implant survival was studied. Implant survival was analyzed using a life table analysis (Wilcoxon [Gehan] test).$\backslash$n$\backslash$nRESULTS: The overall survival rates of short implants were 99.3{\%} and 98.8{\%} for the implant and subject-based analysis, respectively. The mean follow-up period for the implants was 47.9 +/- 24.46 months. A total of 9 out of 1,287 implants were lost during the observation period. None of the variables studied resulted in statistical association with implant failure because of the low number of failures.$\backslash$n$\backslash$nCONCLUSION: Results of the present retrospective study show that treatment with short implants can be considered safe and predictable if used under strict clinical protocols.

{Impact of dental implant length on early failure rates: A meta-analysis of observational studies}. Bernhard Pommer; Sophie Frantal; Jurgen Willer; Martin Posch; Geor... ‒ Journal of Clinical Periodontology (2011)
Pommer B, Frantal S, Willer J, Posch M, Watzek G, Tepper G. Impact of dental implant length on early failure rates: a meta-analysis of observational studies. J Clin Periodontol 2011; 38: 856-863. ... Abstract: Pommer B, Frantal S, Willer J, Posch M, Watzek G, Tepper G. Impact of dental implant length on early failure rates: a meta-analysis of observational studies. J Clin Periodontol 2011; 38: 856-863. doi: 10.1111/j.1600-051X.2011.01750.x. ABSTRACT: Aim: To test the null hypothesis of no difference in failure rates of short (minimum length: 7 mm) and longer dental implants (10 mm), a meta-analysis was performed on prospective observational trials. Materials and Methods: A systematic electronic and hand search was performed to identify eligible studies. Having additional data supplied by the authors, 54 publications were included (19,083 implants). Results: In case of mandibular implants, the null hypothesis of no impact of reduced implant length on failure within the first year of prosthetic loading could not be rejected. A significant impact of implant length could be substantiated for short machined implants in the anterior [odds ratio (OR) 5.4] and posterior maxilla (OR 3.4), while short rough-surfaced implants demonstrated increased failure rates in the anterior maxillary sites. No influence of implant diameter and denture type on the failure rate of short implants could be revealed. Conclusion: In areas of reduced alveolar bone height the use of short dental implants may reduce the need for invasive bone augmentation procedures.

Estudo da perda precoce de implantes osseointegráveis realizados na Faculdade de Odontologia de Piracicaba – Unicamp no período 18 de julho de 1996 a julho de 2004. Alexander Tadeu Sverzut ‒ Unicamp (2006)

{Meta-analysis of single crowns supported by short (<10 mm) implants in the posterior region}. Luis Andre Mezzomo; Rodrigo Miller; Diego Triches; Fernando Alons... ‒ Journal of Clinical Periodontology (2014)
AIM: To assess the failures and complications of short (<10 mm) implants supporting single crowns in the posterior region and its potential risk factors (RkF).$\backslash$n$\backslash$nMATERIALS a... Abstract: AIM: To assess the failures and complications of short (<10 mm) implants supporting single crowns in the posterior region and its potential risk factors (RkF).$\backslash$n$\backslash$nMATERIALS and METHODS: Prospective studies were screened according to eligibility criteria, followed by contact with authors. Quality assessment was performed using a standardized protocol. Mean implant failure proportion (FP), biological and prosthetic failure proportions (BFP/PFP) and marginal bone loss (MBL) including 95{\%} confidence intervals were estimated using random-effects models for meta-analysis.$\backslash$n$\backslash$nRESULTS: Sixteen studies with a medium methodological quality (mean score: 8 ± 3; 2-14) had data collected. In summary, 762 short implants were followed up for up to 120 months in 360 patients (mean follow-up: 44 ± 33.72 months; mean dropout rate: 5.1{\%}). The means FP, BFP, PFP and MBL were 5.9{\%} (95{\%}CI: 3.7-9.2{\%}), 3.8{\%} (95{\%}CI: 1.9-7.4{\%}), 2.8{\%} (95{\%}CI: 1.4-5.7{\%}) and 0.83 mm (95{\%}CI: 0.54-1.12 mm) respectively. Quantitative analysis showed that placement in the mandible (p = 0.0002) and implants with length ≤8 mm (p = 0.01) increased FP, BFP and MBL, whereas qualitative assessment revealed that crown-to-implant ratio did not influence MBL.$\backslash$n$\backslash$nCONCLUSIONS: Single crowns supported by short implants in the posterior region are a predictable treatment option with reduced failure rates, biological/prosthetic complications and minimal bone loss.

{Effects of splinted prosthesis supported a wide implant or two implants: A three-dimensional finite element analysis}. Huang, Heng Li; Huang, Jehn Shyun; Ko, Ching Chang; Hsu, Jui Ting;... ‒ Clinical Oral Implants Research (2005)
OBJECTIVES: Three-dimensional finite element (FE) models of splinted prosthetic crowns were studied and stress analyses were evaluated with different types of implant support, including standard, ... Abstract: OBJECTIVES: Three-dimensional finite element (FE) models of splinted prosthetic crowns were studied and stress analyses were evaluated with different types of implant support, including standard, wide or two implant(s) for partial, posterior edentulous restorations. MATERIAL and METHODS: The FE models were constructed based on a cadaver mandible containing the 2nd premolar and the 1st molar. The crowns of these two teeth were modeled as connected and disconnected to mimic the splinted and non-splinted designs, respectively. One standard implant was placed at the premolar region, while three types of implant support, one at a time (the standard implant, wide implant and two implants), were used to support the molar crown. A 100 N oblique load was applied to the buccal cusp on each crown. The FE simulation was validated experimentally via strain gauge measurement. RESULTS: The experimental data were well correlated with the FE predictions (r(2)=0.97). When compared with the standard implant used in the molar area, the wide implant and two implants reduced the peak stress in crestal bone by 29-37{\%} for both splinted and non-splinted cases. Inserting the standard implant into both the premolar and molar area, the bone stresses were identical for splinted and non-splinted designs. However, splinting the adjacent crowns has shown to decrease the bone stresses at the premolar region by 25{\%}, while the wide implant or two implants were placed at the molar region. CONCLUSION: The biomechanical advantages of using the wide implant or two implants are almost identical. The benefit of load sharing by the splinted crowns is notable only when the implants on the premolar and molar regions have different supporting ability.

Effect of splinting and interproximal contact tightness on load transfer by implant restorations. David L. Guichet; Diane Yoshinobu; Angelo A. Caputo ‒ School of Dentistry (2002)

Implantes Curtos: Parâmetros a Serem Observados no Planejamento. Aline Barackat Ribeiro Simão ‒ UFMG (2013)

IMPLANTES CURTOS: indicações, vantagens, fatores de risco e taxas de sucesso. Luís Paulo Daloy ‒ FUNORTE (2013)

{Elevación de las tasas de supervivencia clinica de los implantes cortos. Revision de la literatura}. Adri‡án Curto Aguilera ‒ J Odontostomat (2012) http://www.scielo.cl/scielo.php?script=sci{\_}...

{Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant treatment.}. Esposito, Marco; Grusovin, Maria Gabriella; Felice, Pietro; Karatz... ‒ Cochrane database of systematic reviews (Online) (2009)
BACKGROUND: Dental implants require sufficient bone to be adequately stabilised. For some patients implant treatment would not be an option without horizontal or vertical bone augmentation. A vari... Abstract: BACKGROUND: Dental implants require sufficient bone to be adequately stabilised. For some patients implant treatment would not be an option without horizontal or vertical bone augmentation. A variety of materials and surgical techniques are available for bone augmentation. OBJECTIVES: To test whether and when augmentation procedures are necessary and which is the most effective technique for horizontal and vertical bone augmentation. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. More than 55 implant manufacturing companies were also contacted. Last electronic search was conducted on 11 June 2009. SELECTION CRITERIA: Randomised controlled trials (RCTs) of different techniques and materials for augmenting bone horizontally or vertically or both for implant treatment reporting the outcome of implant therapy at least to abutment connection. Trials were divided into two broad categories: horizontal augmentation and vertical augmentation techniques. DATA COLLECTION and ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and odd ratios for dichotomous outcomes with 95{\%} confidence intervals. The statistical unit of the analysis was the patient. MAIN RESULTS: Thirteen RCTs out of 18 potentially eligible trials were suitable for inclusion. Three RCTs (106 patients) dealt with horizontal and 10 trials (218 patients) with vertical augmentation. Since different techniques were evaluated in different trials, only one meta-analysis could be performed. When comparing whether vertical augmentation procedures are advantageous over short implants, a meta-analysis of two trials resulted in more implant failures odds ratio (OR) = 5.74 (95{\%} confidence interval (CI) 0.92 to 35.82; borderline significance, P = 0.06) and statistically more complications OR = 4.97 (95{\%} CI 1.10 to 22.40) in the vertically augmented group. When comparing various horizontal augmentation techniques (three trials) no statistically significant differences were observed. When comparing various vertical bone augmentation techniques (eight trials) no statistically significant differences were observed with the exception of three trials which showed that more vertical bone gain could be obtained with osteodistraction than with inlay autogenous grafts (mean difference 3.25 mm; 95{\%} CI 1.66 to 4.84), and with a bone substitute rather than autogenous bone in guided bone regeneration (mean difference 0.60 mm; 95{\%} CI 0.21 to 0.99) in posterior atrophic mandibles, and that patients preferred a bone substitute block than a block of autogenous bone taken from the iliac crest (OR = 0.03; 95{\%} CI 0.00 to 0.64; P = 0.02). AUTHORS' CONCLUSIONS: These conclusions are based on few trials including few patients, sometimes having short follow-up, and often being judged to be at high risk of bias. Various techniques can augment bone horizontally and vertically, but it is unclear which are the most efficient. Short implants appear to be a better alternative to vertical bone grafting of resorbed mandibles. Complications, especially for vertical augmentation, are common. Some bone substitutes could be a preferable alternative to autogenous bone. Osteodistraction osteogenesis allows for more vertical bone augmentation than other techniques which on the other hand can allow for horizontal augmentation at the same time. Titanium screws may be preferable to resorbable screws to fixate onlay bone grafts.

{Impact of implant length and diameter on survival rates - Renouard - 2006 - Clinical Oral Implants Research - Wiley Online Library}. Renouard, Franck; Nisand, David (2006)

{A systematic review of the prognosis of short (< 10 mm) dental implants placed in the partially edentulous patient}. Telleman, Gerdien; Raghoebar, Gerry M.; Vissink, Arjan; Den Hartog... ‒ Journal of Clinical Periodontology (2011)
This study evaluated, through a systematic review of the literature, the estimated implant survival rate of short ({\textless}10 mm) dental implants installed in partially edentulous patients. Abstract: This study evaluated, through a systematic review of the literature, the estimated implant survival rate of short ({\textless}10 mm) dental implants installed in partially edentulous patients.

Implant Survival and Crestal Bone Loss Around Extra-Short Implants Supporting a Fixed Denture: The Effect of Crown Height Space, Crown-to-Implant Ratio, and Offset Placement of the Prosthesis. Eduardo Anitua; Mohammad Hamdan Alkhraist; Laura Pinas; Leire Bego... ‒ Int J Oral Maxillofac Implants (2014)

{Short Implants - An Analysis of Longitudinal Studies.}. das Neves, Flávio Domingues; Fones, Dennis; Bernardes, Sérgio Roch... ‒ The International Journal of Oral & Maxillofacial Implants (2006) http://www.fo.ufu.br/sites/fo.ufu.br/files/Ane...
The purpose of this study was to consider the therapeutic decision whether to use advanced surgery or short implants based on data concerning the use of these implants found in follow-up studies. Abstract: The purpose of this study was to consider the therapeutic decision whether to use advanced surgery or short implants based on data concerning the use of these implants found in follow-up studies.

{Reabilitação de mandíbula atrófica com implantes curtos e placa de titânio: apresentação de um caso clínico}. López Alvarenga, Rodrigo; Akaki, Emílio; Rodrigues Antunes de Souz... ‒ Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial (2013) http://www.sciencedirect.com/science/article/p...
A reabilita{\c{c}}{\~{a}}o com implantes dent{\'{a}}rios em pacientes com reabsor{\c{c}}{\~{a}}o mandibular acentuada torna-se um procedimento complexo e limitado. Algumas op{\c{c}}{\~{o}}es para ... Abstract: A reabilita{\c{c}}{\~{a}}o com implantes dent{\'{a}}rios em pacientes com reabsor{\c{c}}{\~{a}}o mandibular acentuada torna-se um procedimento complexo e limitado. Algumas op{\c{c}}{\~{o}}es para tratamento diante desta limita{\c{c}}{\~{a}}o est{\~{a}}o dispon{\'{\i}}veis na literatura, sendo que uma destas possibilidades {\'{e}} a utiliza{\c{c}}{\~{a}}o de implantes curtos associados {\`{a}} instala{\c{c}}{\~{a}}o de uma placa de tit{\^{a}}nio para refor{\c{c}}o mandibular, prevenindo-se, assim, uma poss{\'{\i}}vel fratura de mand{\'{\i}}bula quando esta for submetida {\`{a}} fun{\c{c}}{\~{a}}o mastigat{\'{o}}ria. O prop{\'{o}}sito deste trabalho {\'{e}} apresentar os aspectos mais relevantes sobre a reabilita{\c{c}}{\~{a}}o de pacientes com mand{\'{\i}}bula atr{\'{o}}fica, bem como relatar um caso cl{\'{\i}}nico de uma paciente com uma mand{\'{\i}}bula acentuadamente atr{\'{o}}fica tratada atrav{\'{e}}s de implantes dent{\'{a}}rios curtos e placa de tit{\^{a}}nio de 2,4mm de espessura. Oral rehabilitation by means of dental implants in patients with severe atrophic mandible is a complex procedure with some limitations. The use of short dental implants to treat these patients is an alternative but the risk of mandible fracture under chewing function becomes evident. A titanium plate used to reinforce the atrophic mandible in this type of treatment could prevent such complication. The aims of this paper is to report a case of a patient with severe atrophic mandible treated by means of short dental implants and a 2.4mm thickness titanium plate as well as to discuss the relevant aspects of this kind of treatment.

Short Dental Implants in Posterior Partial Edentulism: A Multicenter Retrospective 6-Year Case Series Study. Carl E. Misch; Jennifer Steigenga; Eliane Barboza; Francine Misch ... ‒ J Periodontol (2006)

Systematic review and meta-analysis of randomized controlled trials for the management of limited vertical height in the posterior region: short implants (5 to 8 mm) vs longer implants (> 8 mm) in vertically augmented sites. Lee SA; Lee CT, Fu MM; Elmisalati W; Chuang SK ‒ Int J Oral Maxillofac Implants (2014)

{Performance Clínica Utilizando Implantes Curtos: Revisão de Literatura}. Fernandes, Thaís; Rodrigues, Ricardo; Magalhães, Vinícius De; Mace... (2012) http://www.pgsskroton.com.br/seer/index.php/bi...

{Mais que um implante curto. Um novo mundo de possibilidades.}. Institut Straumann (2014) http://www.straumann.com.br/content/dam/intern...

Four-Millimeter Implants Supporting Fixed Partial Dental Prostheses in the Severely Resorbed Posterior Mandible: Two-Year Results. Slotte, Christer; Gronningsaeter, Arne; Halmoy, Anne Marie; Ohrnel... ‒ Clinical Implant Dentistry and Related Research (2012)
BACKGROUND: Reduced alveolar bone volume complicates implant dentistry. Purpose: In this prospective multicenter study, a new, 4-mm long Straumann SLActive implant ({\O} 4.1 mm) supporting a fixed... Abstract: BACKGROUND: Reduced alveolar bone volume complicates implant dentistry. Purpose: In this prospective multicenter study, a new, 4-mm long Straumann SLActive implant ({\O} 4.1 mm) supporting a fixed dental prosthesis (FDP) in the severely resorbed posterior mandible was evaluated for two years.$\backslash$n$\backslash$nMATERIAL and METHODS: Thirty-two patients (11 men, 21 women; mean age 64.1 years) participated. Ten to 12 weeks after single-stage surgery, a screw-retained FDP was attached to three or four 4-mm implants.$\backslash$n$\backslash$nRESULTS and DISCUSSION: One hundred implants were inserted. Three failed at surgery and four were lost before loading. Twenty-eight patients received FDPs (93 implants). Two patients were discontinued because of secondary exclusion criteria; therefore, 26 patients were followed up from baseline (BL). After 1 year, one patient insisted on removal of all implants and one patient died because of nonstudy-related complications. Twenty-four patients (87 implants) were eligible for examination 2 years post-loading. All implants were found to be stable [survival rate 95.7{\%} (confidence interval, CI 88.8-98.3) after 1 year and 92.3{\%} (CI 84.5-96.2) after 2 years]. The mean change from BL to 12 months was - 0.43 mm (CI 0.31-0.59; p < .001) and from 12 to 24 months - 0.11 mm (CI -0.01-0.23; p = .056). The survival rate is only slightly lower than in similar studies on 6 to 8.5 mm implants. This may be related to high initial stability and effective use of the residual bone volume with high primary bone-to-implant contact in dense bone structures. The surgical handling of the tested implant was found to be similar to that of implants of common length. However, the preparation procedure must be done with great care to avoid overdrilling. Careful planning and design of the prosthetic construction is mandatory to prevent unfavorable occlusion and avoid harmful shear forces.$\backslash$n$\backslash$nCONCLUSION: This study showed that 4 mm implants can support an FDP in severely resorbed posterior mandibles for at least 2 years and with healthy peri-implant conditions.

{Influence of Implant Length and Bicortical Anchorage on Implant Stress Distribution}. Pierrisnard, Laurent; Renouard, Franck; Renault, Patrick; Barquins... ‒ Clinical Implant Dentistry And Related Research (2003)

{Short Implants in the Severely Resorbed Maxilla : A 2-Year Retrospective Clinical Study}. Renouard, Franck; Nisand, David ‒ Clinical Implant Dentistry And Related Research (2005)

{Influence of the crown-to-implant length ratio on the clinical performance of implants supporting single crown restorations : a cross-sectional retrospective 5-year investigation}. Schneider, David; Witt, Lukas; Hammerle, Christoph. H . F (2011)

{Staged reconstruction of the severely atrophic mandible with autogenous bone graft and endosteal implants}. R. Bryan Bell; George H. Blakey; Raymond P. White; Dennis G. Hille... ‒ Journal of Oral and Maxillofacial Surgery (2002)
Purpose: Vastly different surgical techniques have been advocated for osseous reconstruction of the severely atrophic mandible. Endoseous implants placed in autologous bone grafts have been propos... Abstract: Purpose: Vastly different surgical techniques have been advocated for osseous reconstruction of the severely atrophic mandible. Endoseous implants placed in autologous bone grafts have been proposed to minimize graft resorption and restore function; however, sufficient bone must exist to support the implants and prevent pathologic fracture. The purpose of this retrospective analysis was to assess the efficacy of autologous bone grafting and the subsequent placement of endosteal implants as a staged procedure in patients with severely atrophic mandibles. Materials and Methods: The records of all patients presenting to The University of North Carolina for treatment from 1997 to 1999 with atrophic mandibles (vertical mandibular height {\textless}7 mm as measured on panoramic radiographs in at least 1 site at the mandibular midline and at the thinnest portion of the mandibular body) were reviewed. Bone height was assessed preoperatively, immediately postoperatively, at the time of implant placement (4 to 6 months), and again at 12 and 24 months after bone grafting from posterior iliac crest to the mandible via an extraoral approach. Five endosteal implants were subsequently placed in each patient as a delayed procedure 4 to 6 months after bone grafting, and prosthetic rehabilitation was completed with implant supported prostheses. Results: Fourteen consecutive patients were identified with a median preoperative bone height of 9 mm (interquartile range, 25th to 75th percentile [IQ], 7 to 10 mm) in the mandibular midline and 5 mm (IQ, 2 to 5 mm) in the body region. There were no perioperative complications. Median estimated blood loss during the bone graft procedure, as estimated by the surgeon and the anesthesiologist, was 300 mL (IQ, 150 to 1,100 mL), and 1 patient required blood transfusion secondary to symptomatic anemia. The mean loss of vertical bone height after grafting and during the 4 to 6 months before implant placement was 33{\%}. After implant placement and at 12 months, the vertical bone loss was negligible in the implant-supported region and less than 11{\%} in the body region. Conclusion: Reconstruction of the severely atrophic mandible using autogenous corticocancellous bone grafts followed by placement of osseointegrated implants in 4 to 6 months can restore and maintain mandibular bone sufficient to support implants and facilitate successful restoration of occlusion. A prospective study is planned to identify predictors of successful outcomes compared with other surgical/prosthetic treatment. ?? 2002 American Association of Oral and Maxillofacial Surgeons.

Implantes curtos do tipo cone - Morse: Proporção coroa-implante. Pellizer, Eduardo Piza; de Moraes, Sandra Lucia Dantas; Junior, Jo... ‒ Rev. Cir. Traumatol. Buco-Maxilo-Fac (2013)

Implantes Curtos X Enxerto Ósseo Vertical. Protimplant & Dr. Eduardo Dias (2013) https://www.youtube.com/watch?v=NmzTHG1lPV4

The anchorage of Branemark and ITI implants of different lengths. I. An experimental study in the canine mandible. Jean-Pierre Bernard; Serge Szmukler-Moncler; Stéphane Pessotto; Ly... ‒ Clinical Oral Implants Research (2003)

Indications for Splinting Implant Restorations. Yoav Grossmann Israel M. Finger Michael S. Block ‒ J Oral Maxillofac Surg (2005)