Failure Rates of Short (<= 10 mm) Dental Implants and Factors Influencing Their Failure: A Systematic Review

Purpose: The aim of this study was to evaluate the long-term failure rates of short dental implants (= 10 mm) and to analyze the influence of various factors on implant failure. Materials and Methods: The PubMed and Cochrane Library databases were consulted for follow-up studies published between the years 1980 and 2009. For those studies that met the inclusion and exclusion criteria, data concerning the number of implants (= 10 mm) placed and lost and any related risk factors were gathered in tables and subjected to analysis. Univariate and multivariate analyses were performed. Results: The heterogeneity and low quality of the included studies made meta-analysis impossible. A total of 35 human studies fulfilled the criteria. The studies included 14,722 implants, of which 659 failed. The total failure rate was 4.5%. The failure rates of implants with lengths of 6, 7, 7.5, 8, 8.5, 9, and 10 mm were 4.1%, 5.9%, 0%, 2.5%, 3.2%, 0.6%, and 6.5%, respectively. A majority (57.9%) of failures occurred before prosthesis connection. There was no statistically significant difference between the failure rates of short dental implants and standard implants or between those placed in a single stage and those placed in two stages (multivariate analysis). There was a tendency toward higher failure rates for the maxilla and for dental implants with a machined surface compared with the mandible and dental implants with a rough surface, respectively. Conclusions: Among the risk factors examined, most failures of short implants can be attributed to poor bone quality in the maxilla and a machined surface. Although short implants in atrophied jaws can achieve similar long-term prognoses as standard dental implants with a reasonable prosthetic design according to this review, stronger evidence is essential to confirm this finding. Keywords: bone quality, dental implants, implant length, implant position, implant surface