SHORT & NARROW DENTAL IMPLANTS- clinical and costs considerations
Short dental implant – a dental implant with 5-8 mm length.
Narrow dental implant – a dental implant with 2-3.5 mm diameter.
Short dental implants avoid possible injury associated with bone augmentation procedures and are an effective option in situations of reduced bone height.Long dental implants became very popular in ’80 and a lot of data and experience already exist. Short dental implants with length less than 8 mm became popular in the last 20 years. Lack of practice and training however describe them with “a higher variability and lower predictability in survival rates” (1).
Short implants may be a consistent possibility when used in the rehabilitation of total edentulous upper or lower jaw. Analysis showed no significant difference between of short implants (5-8 mm) and long implants (≥10 mm) survival rates. The marginal bone loss changes in short implants are same or lower than those in long implants (2,3,4).
Regarding bone augmentation: studies suggest that short implants may be a proper, cheaper and faster option to longer implants placed in graft bone for rehabilitating edentulous atrophic mandible or maxillae (4-7).
Short dental implants could be definitely indicated to sustain fixed dentures an removable dentures as well. The implants could be placed through a 1- or 2-stage surgery.
Several studies demonstrate a high survival rate of short dental implants sometimes higher than long implants. More than this short implants are recommended in vertical bone augmentation in the meantime the treatment is quicker and cheaper (2-5).
Narrow-diameter dental implants are demanded to be a rational alternative to bone augmentation procedures. The implant survival rate of narrow implants and standard diameter implants have been compared and some guidelines provided for application of Narrow implants (9-11).
Narrow-diameter implants ≤ 3 mm diameter performed statistically poor than standard diameter implants and were mostly used for the rehabilitation of the highly atrophic maxilla or mandible. Narrow implants 3-3.5 mm diameter presented no variance in implant survival compared to standard diameter implants. Narrow implants 3-3.5 mm diameter are used for the rehabilitation of limited interdental spaces in anterior and posterior restorations.
Narrow diameter implants offer an opportunity to restore small single-tooth edentulous areas. The use of the two-piece narrow 3.0-mm titanium dental implant for the restoration of upper lateral or lower incisors is safe and results in stable marginal bone levels (11). For esthetical motives a zirconia abutment can be satisfactory.
5-mm short implants achieved similar results as longer implants in anterior and posterior ridge zone. Short implants may be a proper, cheaper and faster option to longer implants placed in graft bone for rehabilitating edentulous atrophic mandible or maxillae.
Short implants could also be a helpful, low-cost solution for elders who demand to decrease troubles with full denture instability especially regarding edentulous atrophic mandible.
Narrow-diameter implants ≤ 3 mm diameter are not recommended in single or multiple dental reconstructions. Carefully can be used in anterior single tooth reconstruction.
Narrow implants 3-3.5 mm diameter can be safety used in anterior and posterior ridges as well.
Our concept–TRUEFORMER DENTAL IMPLANT
The TRUEFORMER’s design is driven by simplicity: its innovation revolves around short implants with an expandable system, capable of improving stability of the implant and osseointegration. This new system is easy to administer for dentists allowing them to use the same surgical procedures as conventional dental implants.
Allowing better stability and fixation into the jaw bone is one of the benefits of BOLERO TRUEFORMER’s design. The four wings in the implant’s third apical part contribute to primary stabilization, improving the osseointegration process due to minimization of micro movements after insertion.
TRUEFROMER Intended Use: TRUEFORMER is intended for surgical placement in the upper or lower jaw to provide a means for prosthetic attachment in single tooth restorations and in partial or full edentulous spans with multiple single teeth, as a terminal or intermediary abutment for fixed or removable bridgework, and to retain over dentures.
The implants are intended for delayed and immediate implantation after extraction on single tooth or multiple teeth. The implant can be immediately loaded only in delayed implantation (several months after extraction). Prosthetic restorations – crowns, bridges, prosthesis applications – are to be attached to the implant when good primary stability has been achieved with appropriate occlusal loading in order to restore chewing function.
References: 1. Jung R E, Al-Nawas B, Araujo M, Avila-Ortiz G, Barter S, Brodala N, Chappuis V, Chen B, De Souza A, Almeida R, Fickl S, Finelle G, Ganeles , Gholami H, Hammerle C, Jensen S, Jokstad A, Katsuyama H, Kleinheinz J, Kunavisarut C, Mardas N, Monje A, Papaspyridakos P, Payer M, Schiegnitz E, Smeets R, Stefanini M, Ten Bruggenkate C, Vazouras K, Weber HP, Weingart D, Windisch P . Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes.Clin Oral Implants Res. 2018 Oct;29 Suppl 16:69-77. doi: 10.1111/clr.13342 2. Guida L, Annunziata M, Esposito U, Sirignano M, Torrisi P, Cecchinato D. 6 mm short and 11 mm long implants compared in the full-arch rehabilitation of the edentulous mandible: a 3-year multicenter randomised controlled trial..Clin Oral Implants Res. 2019 Oct 12. doi: 10.1111/clr.13547. 3. Chen S, Ou Q, Wang Y, Lin X. Short Implants (5-8 mm) Versus Long Implants (≥10 mm) with Augmentation in Atrophic Posterior Jaws: A Meta-Analysis of Randomized Controlled Trials.J Oral Rehabil. 2019 Jul 11. doi: 10.1111/joor.12860. 4. Felice P, Checchi L, Barausse C, Pistilli R, Sammartino G, Masi I, Ippolito DR, Esposito M. Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: One-year post-loading results from a multicenter randomised controlled trial.Eur J Oral Implantol. 2016 Spring;9(1):35-45. 5. Esposito M, Pistilli R, Barausse C, Felice P.Three-year results from a randomised controlled trial comparing prostheses supported by 5-mm long implants or by longer implants in augmented bone in posterior atrophic edentulous jaws. Eur J Oral Implantol. 2014 Winter;7(4):383-95 6. Srinivasan M, Vazquez L, Rieder P, Moraguez O, Bernard JP, Belser UC. Survival rates of short (6 mm) micro-rough surface implants: a review of literature and meta-analysis.Clin Oral Implants Res. 2014 May;25(5):539-45. doi: 10.1111/clr.12125. Epub 2013 Feb 18 7. Esposito M, Barausse C, Pistilli R, Sammartino G, Grandi G, Felice P. Short implants versus bone augmentation for placing longer implants in atrophic maxillae: One-year post-loading results of a pilot randomised controlled trial. Eur J Oral Implantol. 2015 Autumn;8(3):257-68 8. Anitua, Eduardo; Alkhraisat, Mohammad Hamdan Fifteen-Year Follow-up of Short Dental Implants in the Completely Edentulous Jaw .Submerged Versus Nonsubmerged Healing. Implant Dentistry: September 12, 2019 – Volume Publish Ahead of Print – Issue – pdoi: 10.1097/ID.0000000000000935 9. Schiegnitz E, Al-Nawas B. Narrow-diameter implants: A systematic review and meta-analysis. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:21-40. doi: 10.1111/clr.13272 10. Nilsson A, Johansson LÅ, Lindh C, Ekfeldt A. One-piece internal zirconia abutments for single-tooth restorations on narrow and regular diameter implants: A 5-year prospective follow-up study. Clin Implant Dent Relat Res. 2017 Oct;19(5):916-925. doi: 10.1111/cid.12515. Epub 2017 Aug 9 11. Galindo-Moreno P, Nilsson P, King P, Worsaae N, Schramm A, Padial-Molina M, Maiorana C. Clinical and radiographic evaluation of early loaded narrow-diameter implants: 5-year follow-up of a multicenter prospective clinical study. Clin Oral Implants Res. 2017 Dec;28(12):1584-1591. doi: 10.1111/clr.13029. Epub 2017 Jun 18.12. Sohrabi K, Mushantat A, Esfandiari S, Feine J. How successful are small-diameter implants? A literature review. Clin Oral Implants Res. 2012 May;23(5):515-25. doi: 10.1111/j.1600-0501.2011.02410.x. Epub 2012 Feb 7 12. Grandi T, Svezia L, Grandi G. Narrow implants (2.75 and 3.25 mm diameter) supporting a fixed splinted prosthesis in posterior regions of mandible: one-year results from a prospective cohort study. Int J Implant Dent. 2017;3(1):43. doi:10.1186/s40729-017-0102-6.