Two short implants versus one short implant with a cantilever: 5‐Year results of a randomized clinical trial

Thoma, Daniel S.; Wolleb, Karin; Schellenberg, Roman; Strauß, Franz Josef; Hämmerle, Christoph H. F.; Jung, Ronald E.

doi:10.1111/jcpe.13541

Cited by 19 publications

(30 citation statements)

References 42 publications

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“…The present study is a secondary analysis of a previously published randomized controlled clinical trial with two parallel study groups comparing short implants (6 mm) with and without cantilevers. 21 The study was performed in compliance with the Consolidated Standards of Reporting Trials. 27 • no general medical condition representing a contraindication to implant treatment 28 • two adjacent missing teeth in the maxilla or mandible in positions of premolars and molars…”

Section: Study Design and Subjectsmentioning

confidence: 99%

“…Details on the clinical intervention and follow-up examinations can be found elsewhere. 21 In brief, implant placement was performed after raising a mucoperiosteal flap. The patients were then randomized to either group TWO or group ONE-C. Implants were then placed following the manufacturer's instructions.…”

Section: Clinical Interventionmentioning

confidence: 99%

“…A sample size calculation based on the anticipated differences in the radiographic marginal bone loss between both treatment groups was carried out as previously described. 21 The sample size calculation was performed with a two-sample t-test using data from previous studies. 30,31 Assuming a difference of 0.5 mm between both treatment arms in the primary outcome along with a common standard deviation of 0.46 mm, the two-tailed effect size for a t-test amounted to 1.086.…”

Section: Sample Sizementioning

confidence: 99%

“…18,19 Cantilevers on standard dental implants offer survival rates in a similar range to single implant-borne restorations. 20,21 The combination of shorter dental implants with cantilevers decreases the surface to bear the forces of occlusion. In this context, it has been hypothesized that the remodeling of the implant integration might adapt according to the applied occlusal forces, resulting in an increase in bone density measured by radiographs.…”

Section: Introductionmentioning

confidence: 99%

“…Further modifications of treatment protocols aimed at reducing costs and efforts for fixed implants‐supported restorations, including the use of cantilevers 18,19 . Cantilevers on standard dental implants offer survival rates in a similar range to single implant‐borne restorations 20,21 …”

Section: Introductionmentioning

confidence: 99%

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Radiographic density changes may be associated with overloading and implant loss on short implants: A 5‐year analysis of a randomized controlled clinical trial

Gil

Strauß

Hämmerle

et al. 2022

Clin Implant Dent Rel Res

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Objectives To analyze changes in radiographic bone density around short implants with and without cantilevers at 5 years post‐loading. Materials and Methods Thirty‐six patients with two adjacent posterior missing teeth participated in this randomized controlled clinical trial. All patients were randomly allocated to receive either two short implants (6 mm) with single‐unit restorations (group TWO) or one single short implant (6 mm) with a cantilever restoration (group ONE‐C). Patients were followed up at 6 months, 1, 3, and 5 years. Radiographic analysis was performed, through an arbitrary gray scale value (GSV) of the peri‐implant bone, assessing the changes in radiographic density between groups and between time points. Differences in GSV between groups and over time were calculated using a generalized estimating equation to allow for adjustments for the correlation within individuals and between time points. Results At 5 years, 26 patients remained in the study (15 in group ONE‐C; 11 in group TWO). Implant survival rates were 80.4% in group TWO and 84.2% in group ONE‐C (p = 0.894). The radiographic analysis revealed that GSVs increased in both groups over time (p < 0.001). The overall radiographic density was higher in group ONE‐C than in group TWO in the maxilla (p = 0.030). Conversely, in the mandible, these significant differences between the groups were not found (p > 0.05). Compared to the implants that survived, the implants that failed demonstrated a distinct radiographic density pattern (p < 0.05). Conclusion Within the limitations of the present study, the radiographic bone density in the maxilla appears to increase distinctly around short implants when cantilevers are used. In contrast, the radiographic density in the mandible appears to be unaffected by the use of a cantilever, suggesting a lower threshold of adaptation to occlusal forces and thus a higher susceptibility to overload and implant loss at earlier time points.

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Section: Study Design and Subjectsmentioning

confidence: 99%

Section: Clinical Interventionmentioning

confidence: 99%

Section: Sample Sizementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Radiographic density changes may be associated with overloading and implant loss on short implants: A 5‐year analysis of a randomized controlled clinical trial

Gil

Strauß

Hämmerle

et al. 2022

Clin Implant Dent Rel Res

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Long-Term Clinical Outcomes of Single Crowns or Short Fixed Partial Dentures Supported by Short (≤6 mm) Dental Implants: A Systematic Review

Hashemi,

Tabatabaei,

Baghaei

et al. 2023

Eur J Dent

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Long-term clinical outcomes of short dental implants (≤6 mm) supporting single crowns or short fixed partial dentures have been reported differently in different studies and need more clarification. This systematic study evaluated the rate of bone loss (BL), the durability of implants equal to or shorter than 6 mm supporting single crowns or short fixed partial dentures, and prosthetic-related side effects during 5 years of follow-up. Five databases (PubMed, MEDLINE, Scopus, Google Scholar, and Cochrane) were electronically and manually searched for longitudinal studies with a follow-up period of 5 years or more until January 2023. The study question was, “Does the implant equal to or shorter than 6 mm affect BL and survival rate of the implant-supported prosthesis after 5 years of follow-up?”. From 752 identified articles, nine studies were selected for further evaluation. After 5 years of follow-up, most studies had more than 90% survival rate and the maximum BL was 0.54 mm. Still, in internal and external connections, these changes were not substantial. For example, screw loosening was the most common problem with implanted prostheses. Implants of 6 mm or shorter are a suitable treatment option in atrophic ridges with good durability and fewer side effects during a follow-up period of more than 5 years.

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Biomechanical Basis for Bone Healing and Osseointegration of Implants in Sinus Grafts

Stacchi,

Coyac,

Helms

2024

Clin Implant Dent Rel Res

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A thorough comprehension of the mechanisms controlling new bone formation and implant osseointegration after maxillary sinus floor elevation is crucial for aligning our treatment choices with biological principles and enhancing clinical outcomes. The goal of bone regeneration in sinus lift procedures is to provide a sufficient amount of newly‐formed tissue to support implant osseointegration. However, it is still unclear whether there is a minimum quantity of vital bone within the newly‐formed tissue required for effective support, though it is generally assumed that vital bone is essential for this process. The source and integration of new bone in maxillary sinus floor elevation procedures remain debated. Most clinical studies suggest a paramount role for sinus floor and bony walls, with a centripetal pattern of new bone formation, while conflicting reports exist regarding the osteogenic role of the Schneiderian membrane. The influence of mechanical input on peri‐implant bone formation, mineralization, and maturation is significant, with bone remodeling regulated by mechanical strains generated during loading. Defining optimal loading for implants, particularly in sinus lift procedures, is challenging, as early loading may damage interfacial tissue, interfering with osteogenesis. Differences in osseointegration dynamics between native and augmented bone may arise from biological and mechanical factors, but also from patient‐specific factors which should be evaluated in treatment planning. Factors to consider include sinus anatomy, patient and site‐specific regenerative potential, and the selection of graft material that matches the osteogenic and mechanical requirements. Tailored approaches integrating patient‐specific considerations and refined implant strategies will enhance predictability and longevity of treatment.

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Two short implants versus one short implant with a cantilever: 5‐Year results of a randomized clinical trial

Cited by 19 publications

References 42 publications

Radiographic density changes may be associated with overloading and implant loss on short implants: A 5‐year analysis of a randomized controlled clinical trial

Radiographic density changes may be associated with overloading and implant loss on short implants: A 5‐year analysis of a randomized controlled clinical trial

Long-Term Clinical Outcomes of Single Crowns or Short Fixed Partial Dentures Supported by Short (≤6 mm) Dental Implants: A Systematic Review

Biomechanical Basis for Bone Healing and Osseointegration of Implants in Sinus Grafts

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