Comparing short dental implant and standard dental implant in terms of marginal bone level changes: A systematic review and meta-analysis of randomized controlled trials.

PURPOSE: To compare short implants (SH; 4-8 mm) to standard implants (ST; longer than 8 mm) in edentulous jaws, evaluating pri-implant marginal bone levels (MBLs) changes, implant failures (IFs), complications, and prosthesis failures (PFs). MATERIALS AND METHODS: Electronic searches were conducted through the PubMed, Web of Science, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov to locate all randomized controlled trials (RCTs) comparing SH to ST. Meta-analysis procedures were performed on the weighted mean difference (WMD) and standardized mean difference (SMD) of MBLs using Stata. RESULTS: Twenty-three articles were included in this review. The WMD of MBLs when comparing SH to ST in both jaws up to 1-year follow-up was statistically significant preferring SH (WMD: -0.09 [CI: -0.12, -0.06], I2 : 67.0%). The efficacy of SH vs ST on SMD of MBLs was moderate (SMD: -0.43 [CI: -0.57, -0.28], I2 : 55.7%). There were no significant differences in IF (RR: 0.75 [0.44,1.27]) and PF (RR: 0.58 (0.22,1.581), and significantly higher biological complications (RR: 0.25 [0.15, 0.40]) for SH was observed compared to the ST in both jaws up to 1-year follow-up. CONCLUSIONS: SH and ST implants showed the comparable outcomes except biological complication preferring SH. Future systematic review and meta-analysis with longer and larger RCTs are required to confirm the present outcomes.

Comparing Short Dental Implants to Standard Dental Implants: Protocol for a Systematic Review.

BACKGROUND: Short dental implants have been proposed as a simpler, cheaper, and faster alternative for the rehabilitation of atrophic edentulous areas to avoid the disadvantages of surgical techniques for increasing bone volume. OBJECTIVE: This review will compare short implants (4 to 8 mm) to standard implants (larger than 8 mm) in edentulous jaws, evaluating on the basis of marginal bone loss (MBL), survival rate, complications, and prosthesis failure. METHODS: We will electronically search for randomized controlled trials comparing short dental implants to standard dental implants in the following databases: PubMed, Web of Science, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov with English language restrictions. We will manually search the reference lists of relevant reviews and the included articles in this review. The following journals will also be searched: European Journal of Oral Implantology, Clinical Oral Implants Research, and Clinical Implant Dentistry and Related Research. Two reviewers will independently perform the study selection, data extraction and quality assessment (using the Cochrane Collaboration tool) of included studies. All meta-analysis procedures including appropriate effect size combination, sub-group analysis, meta-regression, assessing publication or reporting bias will be performed using Stata (Statacorp, TEXAS) version 12.1. RESULTS: Short implant effectiveness will be assessed using the mean difference of MBL in terms of weighted mean difference (WMD) and standardized mean difference (SMD) using Cohen's method. The combined effect size measures in addition to the related 95% confidence intervals will be estimated by a fixed effect model. The heterogeneity of the related effect size will be assessed using a Q Cochrane test and I2 measure. The MBL will be presented by a standardized mean difference with a 95% confidence interval. The survival rate of implants, prostheses failures, and complications will be reported using a risk ratio at 95% confidence interval (P<.05). CONCLUSIONS: The present protocol illustrates an appropriate method to perform the systematic review and ensures transparency for the completed review. The results will be published in a peer-reviewed journal and social networks. In addition, an ethics approval is not considered necessary. TRIAL REGISTRATION: PROSPERO registration number: CRD42016048363; https://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42016048363 (Archived by WebCite at http://www.webcitation.org/6wZ7Fntry).

Prevalence of peri-implantitis in patients not participating in well-designed supportive periodontal treatments: a cross-sectional study.

OBJECTIVES: This retrospective cross-sectional study aimed to evaluate the prevalence of biologic complications of implants in patients treated by fixed implant supported prosthesis without regular maintenance program. MATERIALS AND METHODS: One hundred thirty-four patients with 478 implants, installed during a 10-year period (2001-2010), were recruited for clinical and radiographic follow-up examinations. The periodontal and implant health status were assessed to determine the prevalence of peri-implant diseases. RESULTS: The mean ± SD loading time for implants was 4.43 ± 2.25 years. Fifty-five percentage of the implants were tissue-level implants. Peri-implantitis was diagnosed in 20% of patients and 8.8% of implants. Subject-based and implant-based prevalence of mucositis amounted to 48.5% and 40%, respectively. Mean crestal bone loss in tissue-level and bone-level implants were 0.28 ± 0.53 mm and 1.37 ± 1.5 mm, respectively. Smoking and lack of keratinized mucosa was associated with peri-implantitis at an odds ratio of OR = 2.57 and 3.89, respectively. CONCLUSIONS: After a 5-year period of loading without any regular maintenance program, one out of five patients would experience peri-implantitis. Tissue-level implants had lower values of peri-implantitis prevalence and crestal bone loss.

Accuracy of Linear Measurements Using Cone Beam Computed Tomography in Comparison with Clinical Measurements.

OBJECTIVES: This study sought to evaluate the accuracy and errors of linear measurements of mesiodistal dimensions of Kennedy Class III edentulous space using cone beam computed tomography (CBCT) in comparison with clinical measurements. MATERIALS AND METHODS: Nineteen Kennedy Class III dental arches were evaluated. An impression was made of each dental arch and poured with dental stone. The distance was measured on dental cast using a digital Vernier caliper with an accuracy of 0.1mm and on CBCT scans. Finally, the linear mesiodistal measurements were compared and the accuracy of CBCT technique was evaluated by calculating absolute value of errors, intra-class correlation coefficient and simple linear regression model. RESULTS: In comparison with the cast method, estimation of size on CBCT scans had an error of -8.46% (underestimation) to 5.21% (overestimation). In 26.5% of the cases, an accepted error of ±1% was found. The absolute value of errors was found to be in the range of 0.21-8.46mm with an average value of 2.86 ±2.30mm. CONCLUSIONS: Although the measurements revealed statistically significant differences, this does not indicate a lower accuracy for the CBCT technique. In fact, CBCT can provide some information as a paraclinical tool and the clinician can combine these data with clinical data and achieve greater accuracy. Undoubtedly, calibration of data collected by clinical and paraclinical techniques and the clinician's expertise in use of CBCT software programs can increase the accuracy of implant placement.