Clinical Solution

Short implants are increasingly being discussed as a treatment alternative in situations characterized by limited vertical bone height. The definition of short implants are usually referred to as short if their designed intrabony length measures ≤ 8 mm with diameters ≥ 3.75 mm. Standard implants are those with lengths > 8 mm and diameters ≥ 3.75 mm.

Indications for short implants are primarily used to avoid bone augmentation procedures in the maxillary and mandibular posterior segments of partially edentulous patients. They are applicable if vertical bone volume is limited by anatomical structures (maxillary sinus, mandibular canal), but there is sufficient alveolar ridge width to permit successful use of implant diameters ≥ 3.75 mm.

Advantages to using Short Dental Implants

1. Time: Typical healing periods after sinus and ridge augmentation procedures can range from six to nine months, significantly increasing the time a patient needs to wait for crown restoration.
2. Involvement: Although technology has improved the degree of surgical invasiveness associated with augmentation procedures, short implants decrease the surgical time needed for implant placement.
3. Morbidity: Augmentation procedures, especially those involving split-thickness flap dissection, increase the patient’s likelihood of morbidity—such as swelling, bruising, inflammation, and pain—compared with short dental implants.
4. Expense: Because augmentation procedures require more surgical time, graft materials, and office visits, there can be a significant increase in treatment costs for the patient as compared with placement of short dental implants alone.

Short dental implants can be successfully placed in cases with limited alveolar bone height to obtain patient satisfaction with less surgical and financial burdens. This case highlights the importance of case discussion, virtual 3D planning, and implant placement in increasing the treatment accuracy, reducing the post operative complications as well as the surgery time.

Treatment Plan

CBCT scan acquisition was done using CS 8100 3D (Carestream Dental) to provide patient relevant 3D data as an initial step for accurate treatment planning, identification of vital structures, and determining any possible additional surgical procedure.  Proper edentulous site assessment was done regarding the available mesio-distal space, bone height, width, density as well as the relation to the adjacent anatomy and vital structures. The case was a good candidate for implant placement; however, the available bone height was only 7 mm.  The possibility of additional surgical procedure (collar or sinus grafting) was declined by the patient due to sinus congestion and blockage, so an informed decision to proceed with a short implant was made. Adin Touareg OS implant was selected for this case (6 x 6.25 mm), the short 6.25 mm length was compatible with the ridge height, while the 6 mm diameter matched the abundant mesio-distal and bucco-palatal bone and helped increase the contact surface area with the bone for enhanced osseointegration and primary stability.  A soft tissue flap was reflected for additional visibility and control over the surgical site. The osteotomy site was prepared following the Adin surgical kit until the final drill that corresponded to the correct length and diameter. Final implant delivery was successful, and implant was torqued down to the planned depth. Four months post operatively, the ISQ reading was 78, so impressions and bite were taken using Kettenbach Dental’s Panasil impression material and Futar bite registration. These impressions and bite were forwarded to the dental laboratory for fabrication of a screw retained abutment and crown. At delivery, the abutment-crown complex was torqued to 35Ncm. Teflon tape was placed followed by composite material in the access hole. The patient was very pleased with the final outcome of the dental implant procedure utilizing the 6mm wide short dental implant from Adin.

About the Author

Dr. Nazarian maintains a private practice in Troy, Michigan, with an emphasis on comprehensive and restorative care. He is a Diplomate in the International Congress of Oral Implantologists (ICOI). His articles have been published in many of today’s popular dental publications and is consistently listed as a top dental educator. He has conducted many lectures and hands-on workshops on aesthetic materials and dental implants throughout the United States, Europe, and Asia.