As a continuation of our prospective cohort study for a total of 18 patients with 72 implants in severely atrophic maxillae corresponding to Cawood and Howell class V and VI (1988) [1] with four 4.0 × 5.0 mm ultrashort locking taper implants Ewers et al., 2018 [2], we now present a prospective cohort study with a total of 9 patients. The special feature of this newly modified study is the reduction of the number of implants to only three 4.0 × 5.0 mm or 4.5 × 6.0 mm or 5.0 × 6.0 mm calcium phosphate-coated Bicon Integra CP implants. Reducing the number of implants is possible by inserting the middle implant into the incisal foramen and the nasopalatine canal. All patients were restored with metal-free prostheses made of a glass fiber-reinforced hybrid resin material. Neither were any implants lost during the observation period, nor did any patient experience any sensory alteration due to the placement of an implant into the nasopalatine canal. Three implants were sufficient in all patients to stabilize their 12-unit prosthesis.

There is limited information regarding implant and prosthetic survival after osseous microvascular free flap (OMFF). This case series aims to describe the placement of short and extra short implants in osseous microvascular free flaps to support prostheses, and present an up to 40-month retrospective follow-up. Short and extra short dental implants were placed in six fibula free flaps (FFF) and in two microvascular deep circumflex iliac artery (DCIA) flaps. In total, 27 short and extra short dental implants have been placed into two different types of free flaps. Kaplan–Meyer (K-M) survival analyses were performed to evaluate the survival and success outcomes of implants and prostheses. Out of the eight patients reconstructed with free flap, five were rehabilitated with prostheses, one patient has a temporary prosthesis, and two patients are in the process of prosthetic rehabilitation. Twenty-seven implants were followed up for up to 40 months, and K-M analyses showed 100% implant survival probability (95% confidence interval: 100%), while the implant success probability was 91.0% (95% confidence interval: 68.6–97.7%). Short and extra short dental implants placed in OMFF presented high survival and success rates in a retrospective case series after up to 40 months.