Use of short implants in atrophic mandible UNIVERSITY “G. D’ANNUNZIO” OF CHIETI-PESCARA DEPARTMENT Of ODONTOSTOMATOLOGIC SCIENCES Director: Prof. Sergio Caputi Use of short implants in atrophic mandible E. Di Iorio, M.L. Sacco , A. Scarano Objectives: In the last decade, several investigators have reported that short implants achieved excellent results with a two-stage technique. Implant prostheses are often used to restore partially or completely edentulous patients, but limited bone height, especially in the posterior mandible, may restrict the use of dental implants. Short implants may be selected in these situations. They have several advantages: it is possible to reduce the need for sophisticated and expensive surgical procedures like sinus lift, bone grafting and mandibular nerve transposition, it is possible to place short-span dentures and it is possible to avoid cantilevers in the posterior regions. The purpose of this study was to test the hypothesis that short implants in prosthetic rehabilitation of atrophied jaws might give similar long-term implant survival rates as longer implants used in larger bone volumes. 1 Materials and methods: from March 2007 to January 2010, 9 healthy patients (6 women and 3 men, age range 45–68 years) were included in this study. A total of 24 titanium short implants 4,5 X 6 mm (P.H.I., S.Vittore Olona, Milano, Italy) were inserted in atrophic mandible. A one-stage surgical protocol with delayed loading was used. The patients were followed for at least 2 years after loading. The marginal bone resorption was assessed by radiographic readings. The success of implants was determined as absence of mobility, pain or signs of infection. Fig. 1 Impianto short P.H.I. Results: One implant was removed for mobility after the loading. The overall survival rate of implants placed was 95,83%. Discussion: Short-length implants should be at a performance disadvantage because of the more limited surface area with which to resist occlusal forces. Nevertheless, anecdotal observations find many short implants performing well in different restorative conditions. Although the predictability of endosseous dental implants is well documented, the restoration of the posterior region of the jaws remains a challenge. The placement of short implants is one therapeutic option that reduces the need for augmentation therapy. This study demonstrates that the use of short implants maybe considered for prosthetic rehabilitation of the severely resorbed jaws as an alternative to more complicated surgical techniques. Conclusion: Short implants are used in case of reduced bone height as they avoid the need for additional surgical procedures for bone augmentation or mandibular nerve transposition. The overall success rate compares favorably with the available literature for the performance of implants in general, and short implants in particular. In conclusion short implants can be a solution in cases of limited bone height. Fig. 2 Visione occlusale dell'arcata inferiore Fig. 3 Visione laterale Fig. 5 La Tc dental-scan mostra la posizione del nervo alveolare inferiore (freccia)‏ Fig. 4 Ortopantomografia eseguita prima del trattamento Fig. 6 Dopo scollamento del lembo si evidenzia l'emergenza del nervo mentoniero (freccia)‏ Fig. 7 Preparazione dei siti implantari Fig. 8 Posizionamento delle viti di guarigione che avverrà per via transmucosa Fig. 9 Radiografia endorale post-operatoria nella quale si nota l'emergenza del nervo mentoniero (freccia)‏ Fig. 11 Visione laterale del lavoro protesico (particolare)‏ Fig. 10 Visione occlusale del lavoro protesico (particolare)‏ Fig. 12 Ortopantomografia eseguita a 2 anni dal carico protesico