Six millimeter implants with a SLActive(®) moderately rough surface supporting single crowns in the posterior region and loaded after 6-7 weeks maintained full function for at least 5 year with low marginal bone resorption.
Objectives
To evaluate prospectively the clinical and radiographic outcomes after ten years of short (6 mm) implants with a moderately rough surface supporting single crowns in the posterior region.
Material and Methods
Forty 6 mm modified sandblasted large‐grit acid‐etched (mod‐SLA), soft tissue level implants were installed in the distal segments of 35 consecutive patients. After 6 weeks of healing, abutments were tightened, and single porcelain‐fused‐to‐metal crowns were cemented. Implant survival, marginal bone loss, and clinical crown/implant ratio were evaluated at various time intervals up to 10 years after loading.
Results
Two out of the 40 implants were lost before loading, one implant was lost after 7 years because of peri‐implantitis. One patient with two implants died and was excluded from analysis. Two patients did not come at the 10‐year follow‐up and were considered as drop out (2 implants). The survival rate was 91.7% (n = 36). Thirty‐three implants were available for marginal bone loss evaluation. A mean marginal bone loss after 10 years of function was 0.8 ± 0.7 mm. Between 5 and 10 years, the loss was 0.2 ± 0.4 mm. No technical complications were registered during the 10‐year period. The clinical crown/implant ratio increased with time from 1.6 at the delivery of the prosthesis to 2.0 after 10 years of loading with no increase between 5 and 10 years.
Conclusion
Short (6 mm) implants with a moderately rough surface supporting single crowns in the posterior region and loaded after 6–7 weeks maintained full function for at least 10 years with low marginal bone resorption.
The survival of short implants was 90% owing to two bridges losses in the maxilla. However, the success rate of FRCRBFDPs over 5 years was only at 70%.
The use of short (<8 mm long) and ultra-short (<6 mm long) implants allows the prosthetic rehabilitation of the posterior ridges of the jaws avoiding reconstructive procedures. Nevertheless, this approach requires vast experience to ensure the primary stability of the fixture in a correct position. Computer-aided implantology (CAI) achieves better results than the free-hand one in terms of placement accuracy, reducing the surgical risks and the operative timings. Dynamic navigation (DN) allows the surgeon to track the position and movements of the drill in real-time on the CT imaging data set. It is more versatile than the computed static system, enabling the operator to change the guidance coordinates according to the intra-operative feedbacks. A mono-edentulous upper right first molar site was rehabilitated with a four mm-long implant to avoid reconstructive techniques, drastically rejected by the patients. The case was managed within a DN protocol considering the minimal available bone and the prosthetic demands. The phases of this procedure were strictly documented up to a 3-year follow-up. No intra-operative problems occurred, and adequate primary stability of the implant was obtained. The prosthetic loading was carried out within only six weeks without any complications. No variation of the baseline clinical scenario as evidenced clinically and radiographically at the end of follow-up. No similar cases are reported in the literature.
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