Short Versus Standard Dental Implants in Atrophic Posterior Maxilla/Mandible: Meta-analysis

Objectives: To perform a meta-analysis to determine the difference between short and standard dental implants for cumulative survival rates (CSRs), success, marginal bone loss (MBL) and complications with a one year follow-up.
Methods: Study Selection inclusionary criteria described atrophic posterior maxilla with marginal bone height 5-8mm and width ≥5mm, randomized sampling, randomized clinical trials (RCTs) with at-least ten subjects per study, human subjects 18 years and older, implants (short <10mm; standard ≥10mm with osteotome and lateral sinus floor elevation surgical techniques), and follow-up for at-least one year. Search strategy had temporal features from January 1, 2014 to February 28, 2017. Electronic database was Medline library with all articles published in English. Keywords: dental implants, RCTs, CSRs, and MBL. Data extraction determined quality of the study with a Jadad scale and a funnel plot to assess publication bias. Statistical analysis utilized Comprehensive Meta-Analysis Software, Version III. Heterogeneity value for CSRs was assessed with the Cochran Q-value (0.014) df (2), p-value (0.129), I-squared (0.0), Tau squared (0.0) and standard error (0.0). The point estimate for CSRs with a fixed effect model was 0.986(0.747-1.303) with a p-value (0.923) and a Z-score of (-0.097).
Results: Three RCTs had 215 patients with 515 total implants. There was no statistical significant difference between the CSRs for short and standard dental implants with the fixed effect model. Since the sample size was relatively small and follow-up time only one year, we are cautiously interpreting the data. There was limited bias between the studies. Sinus augmentation procedures increased the patient’s susceptibility to complications and patients’ morbidity. Short implants had compatible CSRs to standard implants. More RCTS are needed to determine the internal and external validity of short implants.
Conclusions: Short dental implants were an alternative for standard dental implants because of high CSR and lower complications.