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Abstract：
Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants (>6 mm) in atrophic alveolar ridges in terms of implant survival rates, peri-implant marginal bone loss (MBL), prevalence of peri-implantitis and technical complications. A thorough electronic search was performed until September 2023. RCTs with follow-up of at least 1-year post-loading comparing short implants with rough surfaces to longer implants in the posterior jaws of systemically and periodontally healthy, partially edentulous adults were considered. Studies with incomplete information on the number of patients, follow-up or definition of \"short implants\" were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used for Risk of bias assessment. Fixed-effects meta-analysis of the selected studies was applied to compare the outcome variables. Random-effect meta-analysis was performed, on the basis of within-study comparisons. In total, 16 articles were selected for meta-analysis and incorporated 408 short implants and 475 longer implants inserted in 317 and 388 patients, respectively. The survival rates of longer implants in pristine or augmented bone were significantly increased compared to short implants (95%CI: 2-5%, p < 0.001). Standard-length implants displayed increased, although non-statistically significant MBL (95%CI: -0.17-0.04, p > 0.05), and prevalence of peri-implantitis (95%CI: 0-5%, p > 0.05). No statistically significant differences were observed between short and long implants in terms of technical complications (implant-level 95%CI: -4-6%, p > 0.05). Short implants represent a promising alternative treatment option for the rehabilitation of posterior jaws to avoid additional bone augmentation procedures. Nonetheless, they should be selected cautiously due to a potentially limited survival rate compared to longer implants. A major limitation of this study is the variability in the included studies regarding sample size, patient profile, type of bone, loading protocol, definition of peri-implantitis, among others. This study received no external funding. The study protocol was registered in PROSPERO (CRD42023485514).
摘要：
已提出短的牙科植入物作为骨再生程序的替代治疗选择，以修复被吸收的牙槽脊。本文的目的是系统地回顾随机对照试验（RCTs），比较短的植入物（≤6毫米）和较长的植入物（>6毫米）在萎缩牙槽脊的植入物存活率方面，种植体周围边缘骨丢失（MBL），种植体周围炎的患病率和技术并发症。直到2023年9月进行了彻底的电子搜索。RCTs在加载后至少1年随访，将具有粗糙表面的短植入物与系统和牙周健康的后颌骨中的较长植入物进行比较，考虑了部分缺牙的成年人。关于患者数量信息不完整的研究，随访或“短植入物”的定义被排除。用于随机试验的修订的Cochrane偏倚风险工具用于偏倚风险评估。对选定研究的固定效应荟萃分析用于比较结果变量。进行随机效应荟萃分析，在研究内比较的基础上。总的来说,选择16篇文章进行荟萃分析，并在317和388例患者中插入了408个短植入物和475个较长植入物，分别。与短植入物相比，原始或增强骨的较长植入物的存活率显着提高（95CI：2-5％，p<0.001)。标准长度的植入物显示增加，尽管MBL无统计学意义（95CI：-0.17-0.04，p>0.05），和种植体周围炎的患病率(95CI：0-5%，p>0.05)。在技术并发症方面，短植入物和长植入物之间没有观察到统计学上的显着差异（植入物水平95CI：-4-6％，p>0.05)。短植入物代表了后颌骨康复的一种有希望的替代治疗选择，以避免额外的骨增强程序。尽管如此，由于与更长的植入物相比，它们的存活率可能有限，因此应谨慎选择。这项研究的一个主要限制是纳入研究的样本量的可变性，患者简介,骨头的类型,加载协议,种植体周围炎的定义，在其他人中。这项研究没有获得外部资助。研究方案在PROSPERO(CRD42023485514)中注册。
