Can extra-short dental implants serve as alternatives to bone augmentation? A preliminary longitudinal randomized controlled clinical trial

Objective: A randomized trial to assess clinical and radiographic outcomes of short versus standard dental implants placed with concomitant vertical bone augmentation. Method and Materials: Patients requiring dental implants were randomized to receive either 6-mm implants (experimental) or 10-mm implants with vertical augmentation (control). Custom load-bearing healing abutments were connected to allow for indirect resonance frequency analysis measurements. Standardized radiographs were taken at implant placement (baseline), and at 3 and 12 months. Implants were restored at 3 to 6 months, and final measurements were taken at 12 months. Results: Fifty patients with 25 implants per group were included. Five implants failed, four experimental and one control (84% and 96% cumulative survival rate, respectively). Short implants required significantly less surgical time (51.6 ± 23 versus 68.5 ± 35 minutes, P = .05). Implant stability quotients at baseline (67.9 ± 8.3 experimental and 70.8 ± 7.6 control, P = .215) and 12 weeks (70.17 ± 7.4 and 72.03 ± 5.9, respectively, P = .513) were similar and unchanged. Positive correlation was found between the two measurement methods (r2 = .6, P = .025). One-year average marginal bone loss was slightly lower for the experimental group (0.6 ± 0.16 mm) compared to the control group (0.86 ± 0.19 mm); however, this was not statistically significant (P = .287). Conclusion: Short dental implants may offer an alternative for implant placement in an atrophic jaw; however, they are associated with reduced first-year survival rate. Short dental implants should be used judiciously in light of this potential predicament, and alternatives assessed. Keywords: bone loss, immediate restoration, regeneration, short implants, success, survival