Short dental implant as alternative to long implant with bone augmentation of the atrophic posterior ridge: a systematic review and meta-analysis of RCTs

Objective: To evaluate if short implants without augmentation can be considered a successful alternative treatment modality in the rehabilitation of posterior atrophic ridges when compared to standard-length implants with augmentation. Method and materials: Electronic searches were performed in the PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Randomized controlled trials (RCTs) that compared short implants and standard implants with augmentation were the only articles included. Titles and abstracts were screened, data were extracted, and articles were assessed for risk of bias. Meta-analyses were performed for 13 of the included RCTs that had similar outcome measures. Results: Of the total 17 relevant studies identified, 13 RCTs fulfilled the inclusion criteria. The meta-analysis showed no significant differences regarding the implant failure rate at 1 year (I2 = 67%, P = .13; risk difference [RD]: −0.05, 95% confidence interval [CI]: −0.11, 0.01), at 3 years (I2 = 58%, P = .17; RD: −0.04, 95% CI: −0.01, 0.02), and at 5 to 10 years (I2 = 0%, P = .47; RD: −0.05, 95% CI: −0.19, 0.09). However, the meta-analyses of 10 trials regarding the postoperative complications of short- and standard-length dental implants showed a significantly higher rate of postoperative complications in the standard-length dental implant group at 1 year (I2 = 93%, P = .02; RD: −0.21, 95% CI: −0.39, −0.04). Conclusions: Short dental implants seem to be an effective alternative treatment for the atrophic posterior ridge. The pooled data revealed that short dental implants have statistically less marginal bone loss and fewer postoperative complications when compared to standard-length dental implants with augmentation. However, there are no statistically significant differences in regard to implant failure. Keywords: bone graft, dental implants, implantology, implants, systematic review