Evidence Supports the Use of Short Implants as a Graftless Solution.

Purpose: To provide clinicians with information to develop a treatment plan to use short implants as either single or splinted restorations.

Materials and methods: The study design was an analytical review of articles that reported clinical data with at least a 1-year follow-up. PubMed was the main source of information, and the years reviewed included 1990 to 2023. The inclusion criteria for this analytical analysis included retrospective and prospective studies. The predictor variable was the use of short implants for fixed restorations. The primary outcome variable was implant status coded as survived or failed. The covariates were the type of restoration using either splinted short implants or short implants used as single-tooth replacements, and time to failure was either less than 1 year or at least 1 year. Bivariate statistics assessed the association between splinting or single implants and failure with a significance of P < .05.

Results: A total of 50 articles were collated and summarized to answer specific clinical situation questions. Of those, 18 articles had retrospective or prospective data available for analysis, 11 articles were found for single-implant restorations, and 7 articles were found for splinted implant restorations. After applying the exclusion criteria, the sample size was 1,683 implants as reported in these articles: 853 single implants (50.7%) and 830 splinted implants (49.3%). A total of 62 (7.3%) single short implants failed compared to 36 of 830 (4.3%) splinted short implants. There were 565 implants that were > 8 mm in length, with 11 (1.9%) implant failures. The comparison between splinted and single-implant restorations for short and long implants was significant (P < .05) for all comparisons except for splinted versus single long implants. The comparison of the covariates single and splinted for both short and long implants separating failure < 1 year to longer loading indicated that short implants had more failure after loading (P < .05). The longer implants had nonsignificant differences comparing early failure to failures after longer loading.

Conclusions: Short implants, when splinted together, have similar success rates compared to longer implants based on evidence from the refereed reports. Single short implants did have an increased risk for failure.