Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this review was to systematically evaluate clinical studies of implants < 10 mm in length, to determine short implant-supported prosthesis success in the atrophic jaw. Implant survival, incidence of biological and biomechanical complications, and radiographic peri-implant marginal bone loss were evaluated. Screening of eligible studies, quality assessment, and data extraction were conducted by two reviewers independently. Meta-analyses were performed by the pooling of survival data by implant surface, surgical technique, implant location, type of edentulism, and prosthetic restoration. Two randomized controlled trials and 14 observational studies were selected and analyzed for data extraction. In total, 6193 short-implants were investigated from 3848 participants. The observational period was 3.2 ± 1.7 yrs (mean ± SD). The cumulative survival rate (CSR) was 99.1% (95%CI: 98.8-99.4). The biological success rate was 98.8% (95%CI: 97.8-99.8), and the biomechanical success rate was 99.9% (95%CI: 99.4-100.0). A higher CSR was reported for rough-surfaced implants. The provision of short implant–supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

To determine the survival trend of dental implants after functional loading for ≥1 year in diabetic patients. An electronic search of the Cochrane Oral Health Group's Trials Register, Medline and Embase, plus a manual search up to December 2015 was performed. Studies assessing the survival rate of dental implants in patients with a diagnosis of diabetes mellitus were considered eligible. Screening of studies, quality assessment, and data extraction were conducted independently by 2 reviewers. Life-table analysis and Kaplan–Meier survival curves were used to evaluate implant survival and to plot the cumulative survival rate and cumulative hazard ratio. Seven studies, including 1142 implants were identified. The cumulative survival rate was 0.96 ± 0.10 before loading, 0.93 ± 0.10 and 0.91 ± 0.10 at 1 year, and at the end of the follow-up period, respectively. The hazard ratio was 4% during the period of osseointegration, 3% during the first year of loading, and remained constant over the 6-year follow-up. Patients with diabetes mellitus showed an increasing trend of implant failure during the period of osseointegration and the first year of loading.

Objectives: to retrospectively evaluate clinical and radiographic outcomes of immediate, flapless full‐arch prostheses, supported by 4/6 implants according to prosthetic‐driven planning and guided surgery.Materials and Methods: The study involved 28 edentulous patients (20 female/8 males; average age 67.75 ± 8.627 years), 32 prostheses (17 all‐on‐4/15 all‐on‐6) and 164 implants. The Implants survival, prostheses success/survival, peri‐implant marginal bone loss, incidence of biological and prosthetic complications were evaluated. Multiple linear regression analysis was performed to analyze the influence of implant and patient characteristics on marginal bone loss.Results: Cumulative implant survival rate was 89.7% for all‐on‐four (seven failures) and 99.0% for all‐on‐six (one failure) after a mean follow‐up of 6.46 ± 2.236 years (range 1–10 years). Cumulative prosthesis success rate was 51.5% (58.8% for all‐on‐four/ 43.8% for all‐on‐six). Prosthesis survival rate was 88.2% for all‐on‐four. No failure was registered in all‐on‐six. Mean value of marginal bone loss was 1.38 ± 0.1.28 mm at 5‐year and 2.09 ± 0.56 mm at 10‐year follow‐up. No difference was found in the mean value of marginal bone resorption between all‐on‐four (1.56 ± 1.61 mm) and all‐on‐six (1.20 ± 0.85 mm) (p = 0.104) and between tilted (1.22 ± 1.29 mm) and axial implants (1.44 ± 1.27 mm) (p = 0.385) after 5‐year follow‐up. The incidence of biological complications was 1.0% in all‐on‐six (one mucositis) and 10.3% in all‐on‐four (two peri‐implantitis). Prosthetic complications affected teeth of final rehabilitations with 3 detachments, 10 chippings or fractures, and 3 severe occlusal wears.Conclusions: Based on the results and within the limitations of the present study, the implant‐supported hybrid prosthesis according to prosthetic‐driven planning and guided surgery showed to be an efficient, safe, and effective approach to rehabilitate edentulous jaws.

Objectives. To evaluate the performances of six different bone substitute materials used as graft in maxillary sinus augmentation by means of histological and histomorphometric analysis of bone biopsies retrieved from human subjects after a 6-month healing period. Materials and Methods. Six consecutive patients (3 males, 3 females, aged 50-72 years), healthy, nonsmokers, and with good oral hygiene, presenting edentulous posterior maxilla with a residual bone crest measuring ≤ 4 mm in vertical height and 3 to 5 mm in horizontal thickness at radiographic examination, were selected to receive sinus augmentation and delayed implant placement. Under randomized conditions, sinus augmentation procedures were carried out using mineralized solvent-dehydrated bone allograft (MCBA), freeze-dried mineralized bone allograft (FDBA), anorganic bovine bone (ABB), equine-derived bone (EB), synthetic micro-macroporous biphasic calcium-phosphate block consisting of 70% beta-tricalcium phosphate and 30% hydroxyapatite (HA-β-TCP 30/70), or bioapatite-collagen (BC). After 6 months, bone core biopsies were retrieved and 13 implants were placed. Bone samples were processed for histological and histomorphometric analysis. CT scans were taken before and after surgery. After 4 months of healing, patients were restored with a provisional fixed acrylic resin prosthesis, as well as after further 2-4 months with a definitive cemented zirconia or porcelain-fused-to-metal crowns. Results. There were no postoperative complications or implant failures. The histological examination showed that all biomaterials were in close contact with newly formed bone, surrounding the graft granules with a bridge-like network. No signs of acute inflammation were observed. The histomorphometry revealed 20.1% newly formed bone for MCBA, 32.1% for FDBA, 16.1% for ABB, 22.8% for EB, 20.3% for HA-β-TCP 30/70, and 21.4% for BC. Conclusions. Within the limitations of the present investigation, all the six tested biomaterials showed good biocompatibility and osteoconductive properties when used in sinus augmentation procedures, although the FDBA seemed to have a better histomorphometric result in terms of newly formed bone and residual graft material. This trial is registered with ClinicalTrials.gov Identifier (Registration Number): NCT03496688.