Skip to main content
SpringerLink
Log in

Kurze Implantate

Ersetzen sie die Rekonstruktion des Alveolarfortsatzes?

Short implants

Do they replace reconstruction of the alveolar crest?

  • Leitthema
  • Published:
Der MKG-Chirurg Aims and scope

Zusammenfassung

Das Abwägen zwischen der Insertion eines kurzen Implantats in den ortständigen Knochen und der Rekonstruktion des Kieferkamms zur Herstellung einer implantierbaren Knochenhöhe von ≥ 10 mm ist eine alltägliche klinische Aufgabe. Die vorliegende Arbeit versucht, zur Klärung der Frage beizutragen, wann kurze Implantate gegenüber Implantaten mit Längen ≥ 10 mm und gleichzeitiger Augmentation bevorzugt werden sollten. Eine Vielzahl von Studien belegt, dass kurze Implantate in der Überlebensrate gegenüber ≥ 10 mm langen Implantaten, die zum Einbringen eine Augmentation des Alveolarfortsatzes erforderten, gleichwertig oder sogar besser sind. Für kurze Implantate werden nach Belastungsphasen von 10 Jahren Überlebensraten von >90 % beschrieben. Allerdings wurde gezeigt, dass bei kurzen Implantaten ein Zusammenhang zwischen zunehmender Länge und steigender Überlebensrate besteht. Unbeantwortet bleiben derzeit Fragen zum Ausmaß des periimplantären Knochenabbaus und der Prävalenz der Periimplantitis an kurzen Implantaten im Langzeitverlauf. Die Analyse der Datenlage vermittelt, dass die hohe Erfolgsrate kurzer Implantate durch die enge Indikationsstellung für dieses Therapiekonzept begründet erscheint. Der Zusammenhang zwischen zunehmender Länge und Steigerung des Überlebens kurzer Implantate deutet darauf hin, dass diese nicht grundsätzlich gegenüber längeren bevorzugt werden müssen. Sie stellen kein generelles Konzept dar, sondern müssen im Hinblick auf ihre Indikation streng geprüft werden. Die Rekonstruktion des Alveolarfortsatzes mit ihrem breiten Einsatzspektrum wird auch weiterhin die breite Indikation implantologischer Versorgungen sichern.

Abstract

Decision-making between placing a short implant and reconstructing the alveolar crest with subsequent installation of implants with lengths ≥ 10 mm has to be frequently performed in clinical practice. The present paper aims at contributing to the clarification of the question on which occasions short implants should be preferred to longer ones that necessitate prior or simultaneous alveolar ridge augmentation. Randomized controlled trials and systematic reviews including meta-analyses have shown that the survival rate of short implants is comparable or even better than that of implants with lengths ≥ 10 mm placed in combination with augmentation procedures. After loading intervals of 10 years survival rates above 90 % have been described; however, a correlation between increasing length of short implants and improved survival rate has been shown. To date it is not possible to find reliable long-term data in the current literature on marginal bone loss and the prevalence of peri-implant disease around short implants. So far it seems that the favorable success rates of short implants are the consequence of keeping the indications of placing these implants limited to a well-defined small number of occasions. Improved survival rates with increasing lengths of short implants indicate that short implants should not be preferred to longer ones. Short implants do not represent a general concept in implant dentistry. Instead, the indications to place these implants have to be thoroughly checked. The reconstruction of the alveolar crest with its wide spectrum of applications is still the intervention which ensures the broad indications for dental implants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Annibali S, Cristalli MP, Dell’Aquila D et al (2012) Short dental implants: a systematic review. J Dent Res 91:25–32

    Article  CAS  PubMed  Google Scholar 

  2. Bernard JP, Szmukler-Moncler S, Pessotto S et al (2003) The anchorage of Brånemark and ITI implants of different lengths. I. An experimental study in the canine mandible. Clin Oral Implants Res 14:593–600

    Article  PubMed  Google Scholar 

  3. Blanes RJ (2009) To what extent does the crown-implant ratio affect the survival and complications of implant-supported reconstructions? A systematic review. Clin Oral Implants Res 20(Suppl 4):67–72

    Article  PubMed  Google Scholar 

  4. Cannizzaro G, Felice P, Leone M et al (2009) Early loading of implants in the atrophic posterior maxilla: lateral sinus lift with autogenous bone and Bio-Oss versus crestal mini sinus lift and 8-mm hydroxyapatite-coated implants. A randomised controlled clinical trial. Eur J Oral Implantol 2:25–38

    PubMed  Google Scholar 

  5. Cannizzaro G, Felice P, Leone M et al (2012) Immediate versus early loading of 6.5 mm-long flapless-placed single implants: a 4-year after loading report of a split-mouth randomised controlled trial. Eur J Oral Implantol 5:111–121

    PubMed  Google Scholar 

  6. Cannizzaro G, Leone M, Torchio C et al (2008) Immediate versus early loading of 7-mm-long flapless-placed single implants: a split-mouth randomised controlled clinical trial. Eur J Oral Implantol 1:277–292

    PubMed  Google Scholar 

  7. Chen ST, Buser D (2009) Clinical and esthetic outcomes of implants placed in postextraction sites. Int J Oral Maxillofac Implants 24(Suppl):186–217

    CAS  PubMed  Google Scholar 

  8. Neves FD das, Fones D, Bernardes SR et al (2006) Short implants – an analysis of longitudinal studies. Int J Oral Maxillofac Implants 21:86–93

    PubMed  Google Scholar 

  9. Waal YC de, Winkelhoff AJ van, Meijer HJ et al (2013) Differences in peri-implant conditions between fully and partially edentulous subjects: a systematic review. J Clin Periodontol 40:266–286

    Article  PubMed  Google Scholar 

  10. Eckert SE, Choi YG, Koka S (2003) Methods for comparing the results of different studies. Int J Oral Maxillofac Implants 18:697–705

    PubMed  Google Scholar 

  11. Esposito M, Cannizarro G, Soardi E et al (2011) A 3-year post-loading report of a randomised controlled trial on the rehabilitation of posterior atrophic mandibles: short implants or longer implants in vertically augmented bone? Eur J Oral Implantol 4:301–311

    PubMed  Google Scholar 

  12. Esposito M, Cannizzaro G, Soardi E et al (2012) Posterior atrophic jaws rehabilitated with prostheses supported by 6 mm-long, 4 mm-wide implants or by longer implants in augmented bone. Preliminary results from a pilot randomised controlled trial. Eur J Oral Implantol 5:19–33

    PubMed  Google Scholar 

  13. Esposito M, Grusovin MG, Felice P et al (2009) The efficacy of horizontal and vertical bone augmentation procedures for dental implants – a Cochrane systematic review. Eur J Oral Implantol 2:167–184

    PubMed  Google Scholar 

  14. Esposito M, Grusovin MG, Rees J et al (2010) Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev 3:CD008397

    PubMed  Google Scholar 

  15. Esposito M, Pellegrino G, Pistilli R et al (2011) Rehabilitation of posterior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One-year results from a pilot randomised clinical study. Eur J Oral Implantol 4:21–30

    PubMed  Google Scholar 

  16. Felice P, Cannizzaro G, Checchi V et al (2009) Vertical bone augmentation versus 7-mm-long implants in posterior atrophic mandibles. Results of a randomised controlled clinical trial of up to 4 months after loading. Eur J Oral Implantol 2:7–20

    PubMed  Google Scholar 

  17. Felice P, Checchi V, Pistilli R et al (2009) Bone augmentation versus 5-mm dental implants in posterior atrophic jaws. Four-month post-loading results of a randomised controlled clinical trial. Eur J Oral Implantol 2:267–281

    PubMed  Google Scholar 

  18. Felice P, Pellegrino G, Checchi V et al (2010) Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomised controlled clinical trial. Clin Oral Implants Res 21:1394–1403

    Article  PubMed  Google Scholar 

  19. Felice P, Pistilli R, Piattelli M et al (2012) Posterior atrophic jaws rehabilitated with prostheses supported by 5 × 5 mm implants with a novel nanostructured calcium-incorporated titanium surface or by longer implants in augmented bone. Preliminary results from a randomised controlled trial. Eur J Oral Implantol 5:149–161

    PubMed  Google Scholar 

  20. Felice P, Soardi E, Pellegrino G et al (2011) Treatment of the atrophic edentulous maxilla: short implants versus bone augmentation for placing longer implants. Five-month post-loading results of a pilot randomised controlled study. Eur J Oral Implantol 4:191–202

    PubMed  Google Scholar 

  21. Friberg B, Gröndahl K, Lekholm U et al (2000) Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants. Clin Implant Dent Relat Res 2:184–189

    Article  CAS  PubMed  Google Scholar 

  22. Gentile MA, Chuang SK, Dodson TB (2005) Survival estimates and risk factors for failure with 6 × 5.7 mm implants. Int J Oral Maxillofac Implants 20:930–936

    PubMed  Google Scholar 

  23. Glantz PO, Nilner K (1998) Biomechanical aspects of prosthetic implant-borne reconstructions. Periodontol 2000 17:119–124

    Article  CAS  PubMed  Google Scholar 

  24. Grant BT, Pancko FX, Kraut RA (2009) Outcomes of placing short dental implants in the posterior mandible: a retrospective study of 124 cases. J Oral Maxillofac Surg 67:713–717

    Article  PubMed  Google Scholar 

  25. Hagi D, Deporter DA, Pilliar RM et al (2004) A targeted review of study outcomes with short (≤ 7 mm) endosseous dental implants in partially edentulous patients. J Periodontol 75:798–804

    Article  CAS  PubMed  Google Scholar 

  26. Karthikeyan I, Desai SR, Singh R (2012) Short implants: a systematic review. J Indian Soc Periodontol 16:302–312

    Article  CAS  PubMed  Google Scholar 

  27. Kotsovilis S, Fourmousis I, Karoussis IK et al (2009) A systematic review and meta-analysis on the effect of implant length on the survival of rough-surface dental implants. J Periodontol 80:1700–1718

    Article  PubMed  Google Scholar 

  28. Lee KJ, Kim YG, Park JW et al (2012) Influence of crown-to-implant ratio on periimplant marginal bone loss in the posterior region: a five-year retrospective study. J Periodontal Implant Sci 42:231–236

    Article  PubMed  Google Scholar 

  29. Lops D, Bressan E, Pisoni G et al (2012) Short implants in partially edentuolous maxillae and mandibles: a 10–20 years retrospective evaluation. Int J Dent 2012:351793. doi:10.1155/2012/351793

    PubMed  Google Scholar 

  30. Lum LB (1991) A biomechanical rationale for the use of short implants. J Oral Implantol 17:126–131

    CAS  PubMed  Google Scholar 

  31. Manfredini D, Poggio CE, Lobbezoo F (2012) Is bruxism a risk factor for dental implants? A systematic review of the literature. Clin Implant Dent Relat Res. DOI 10.1111/cid.12015 (E-pub ahead of print)

  32. Maló P, Araújo Nobre M de, Rangert B (2007) Short implants placed one-stage in maxillae and mandibles: a retrospective clinical study with 1–9 years of follow-up. Clin Implant Dent Relat Res 9:15–21

    Article  PubMed  Google Scholar 

  33. Menchero-Cantalejo E, Barona-Dorado C, Cantero-Álvarez M et al (2011) Meta-analysis on the survival of short implants. Med Oral Patol Oral Cir Bucal 16:e546–e551

    Article  PubMed  Google Scholar 

  34. Misch CE, Steignga J, Barboza E et al (2006) Short dental implants in posterior partial edentulism: a multicenter retrospective 6-year case series study. J Periodontol 77:1340–1347

    Article  PubMed  Google Scholar 

  35. Morand M, Irinakis T (2007) The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants. J Oral Implantol 33:257–266

    Article  PubMed  Google Scholar 

  36. Nedir R, Bischof M, Briaux JM et al (2004) A 7-year life table analysis from a prospective study on ITI implants with special emphasis on the use of short implants. Results from a private practice. Clin Oral Implants Res 15:150–157

    Article  PubMed  Google Scholar 

  37. Neldam CA, Pinholt EM (2010) State of the art of short dental implants: a systematic review of the literature. Clin Implant Dent Relat Res 14:622–632

    Article  PubMed  Google Scholar 

  38. Nkenke E, Hahn M, Weinzierl K et al (2003) Implant stability and histomorphometry: a correlation study in human cadavers using stepped cylinder implants. Clin Oral Implants Res 14:601–609

    Article  PubMed  Google Scholar 

  39. Nkenke E, Radespiel-Tröger M, Wiltfang J et al (2002) Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin Oral Implants Res 13:514–521

    Article  PubMed  Google Scholar 

  40. Nkenke E, Schultze-Mosgau S, Radespiel-Tröger M et al (2001) Morbidity of harvesting of chin grafts: a prospective study. Clin Oral Implants Res 12:495–502

    Article  CAS  PubMed  Google Scholar 

  41. Nkenke E, Stelzle F (2009) Clinical outcomes of sinus floor augmentation for implant placement using autogenous bone or bone substitutes. Clin Oral Implants Res 20(Suppl 4):166–170

    Article  Google Scholar 

  42. Nkenke E, Weisbach V, Winckler E et al (2004) Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: a prospective study. Int J Oral Maxillofac Surg 33:157–163

    Article  CAS  PubMed  Google Scholar 

  43. Pommer B, Frantal S, Willer J et al (2011) Impact of dental implant length on early failure rates: a meta-analysis of observational studies. J Clin Periodontol 38:856–863

    Article  PubMed  Google Scholar 

  44. Rangert BR, Sullivan RM, Jemt TM (1997) Load factor control for implants in the posterior partially edentulous segment. Int J Oral Maxillofac Implants 12:360–370

    CAS  PubMed  Google Scholar 

  45. Raviv E, Turcotte A, Harel-Raviv M (2010) Short dental implants in reduced alveolar bone height. Quintessence Int 41:575–579

    PubMed  Google Scholar 

  46. Renouard F, Nisand D (2006) Impact of implant length and diameter on survival rates. Clin Oral Implants Res 17(Suppl 2):35–51

    Article  PubMed  Google Scholar 

  47. Romeo E, Ghisolfi M, Rozza R et al (2006) Short (8-mm) dental implants in the rehabilitation of partial and complete edentulism: a 3- to 14-year longitudinal study. Int J Prosthodont 19:586–592

    PubMed  Google Scholar 

  48. Schneider D, Witt L, Hämmerle CH (2012) 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. Clin Oral Implants Res 23:169–174

    Article  PubMed  Google Scholar 

  49. Serino G, Ström C (2009) Peri-implantitis in partially edentulous patients: association with inadequate plaque control. Clin Oral Implants Res 20:169–174

    Article  PubMed  Google Scholar 

  50. Stellingsma K, Slagter AP, Stegenga B et al (2005) Masticatory function in patients with an extremely resorbed mandible restored with mandibular implant-retained overdentures: comparison of three types of treatment protocols. J Oral Rehabil 32:403–410

    Article  CAS  PubMed  Google Scholar 

  51. Stellingsma K, Bouma J, Stegenga B et al (2003) Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res 14:166–172

    Article  PubMed  Google Scholar 

  52. Stellingsma K, Raghoebar GM, Meijer HJ et al (2004) The extremely resorbed mandible: a comparative prospective study of 2-year results with 3 treatment strategies. Int J Oral Maxillofac Implants 19:563–577

    PubMed  Google Scholar 

  53. Sun HL, Huang C, Wu YR et al (2011) Failure rates of short (≤ 10 mm) dental implants and factors influencing their failure: a systematic review. Int J Oral Maxillofac Implants 26:816–825

    PubMed  Google Scholar 

  54. Tawil G, Aboujaoude N, Younan R (2006) Influence of prosthetic parameters on the survival and complication rates of short implants. Int J Oral Maxillofac Implants 21:275–282

    PubMed  Google Scholar 

  55. Tawil G, Younan R (2003) Clinical evaluation of short, machined-surface implants followed for 12–92 months. Int J Oral Maxillofac Implants 18:894–901

    PubMed  Google Scholar 

  56. Telleman G, Raghoebar GM, Vissink A et al (2011) A systematic review of the prognosis of short (< 10 mm) dental implants placed in the partially edentulous patient. J Clin Periodontol 38:667–676

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Mund-, Kiefer- und Gesichtschirurgische Klinik, Universitätsklinikum Erlangen, Glückstr. 11, 91054, Erlangen, Deutschland

    E. Nkenke

Authors
  1. E. Nkenke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Nkenke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nkenke, E. Kurze Implantate. MKG-Chirurg 6, 221–227 (2013). https://doi.org/10.1007/s12285-012-0337-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12285-012-0337-4

Schlüsselwörter

Keywords

Search

Navigation