Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Oct 2007

The Challenge of Implant Therapy in the Posterior Maxilla: Providing a Rationale for the Use of Short Implants

DMD and
DDS, MSc, FRCD(C)
Page Range: 257 – 266
DOI: 10.1563/1548-1336(2007)33[257:TCOITI]2.0.CO;2
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Abstract

Rehabilitating patients with a resorbed maxilla presents several challenges when the desired treatment plan involves the placement of endosseous implants. Correct diagnosis requires knowledge on jaw healing patterns, systemic effects, and the impact of bone quality changes on implant success rates. Appropriate treatment planning requires an in-depth understanding of the materials and methods available to the contemporary implant surgeon. The clinician must be able to persist on evidence-based techniques and adhere to those proven methods. Successful surgical placement requires correct use of the available armamentarium and acceptance of the limitations that implant dentistry still presents. Especially challenging is the implant treatment of maxillary molars due to the plethora of complicating factors such as limited bone availability, interarch space challenges, sinus problems, etc. These are just a few of the factors that may lead us to placement of short implants in these sites. An extensive review of the literature that is available for short implants (implants <10 mm in length) indicates that although they are commonly used in areas of the mouth under increased stress (posterior region), their success rates mimic those of longer implants when careful case selection criteria have been used. The available studies and case-series offer a valid rationale for placement of short implants so long as one understands the limitations, indications, risk factors, and limited studies that actually follow-up success rates of short implants for over 5 years. This review of the literature will provide the reader an in-depth view of the evidence in using short implants as an alternative treatment modality for the maxillary molar region.

Copyright: American Academy of Implant Dentistry
Figure 1.
Figure 1.

A Nobel Replace Tapered Groovy implant 8 mm in length and 5 mm wide by Nobel Biocare. The surface of this implant is “rough” (acid etched) named “Ti-Unite.” This implant has an internal abutment connection system; namely the “tri-channel” connection.


Figures 2
Figures 2

and 3. A Straumann-ITI implant 6 mm in length and 4.8 mm in width with a 6.5 mm wide neck collar. The surface of this implant is “rough” SLA (Sand blasted; Large grit; Acid etched). This implant has an internal abutment connection system; namely the “morse-taper” connection.


Figure 4.
Figure 4.

A Branemark implant 7 mm in length and 5 mm wide by Nobel Biocare with a Ti-Unite surface. This implant has an external connection system; namely the “external hex.”


Contributor Notes

Marianne Morand, DMD, is a private practitioner in Quebec, Canada.

Tassos Irinakis, DDS, MSc, FRCD(C), is associate clinical professor in periodontics and director of graduate periodontics and implant surgery at the University of British Columbia, Vancouver, British Columbia, Canada. He is also director of the Institute for Dental Education and Advanced Surgeries and a periodontal surgeon and consultant at Vancouver General Hospital; a fellow of the Royal College of Dentists of Canada; a certified specialist in periodontics; and a private practitioner in Coquitlam, British Columbia, Canada. Address correspondence to Dr Irinakis at University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3 (bone.grafting@gmail.com).

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