Title	Short and Long Implants
Clinical Question	When Placing Dental Implants, Do Short Implants or Longer Length Implants Have a Higher Long Term Success Rate?
Clinical Bottom Line	The evidence found gives implant length a significant factor in long term success. Although longer implants have taken the preference over time, shorter implants may be suitable for certain conditions. Depending on the patient's oral status, bone heights, and needs for procedures such as sinus floor elevations, short implants may be indicated. (See Comments on the CAT below)
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 19905941 Kotsovilis/2009 edentulous or partially edentulous Meta Analysis Key results The evidence of this study focused on the survival of long and short implants, particularly in edentulous or partially edentulous patients. A meta analysis and systematic review was conducted on articles up and including to 2007. Further filtering out the results by two reviewers, 37 articles reporting on 22 patient cohorts were selected. The results were that there was no significant difference in the longevity between the short and conventional implants. 11885179 Winkler/2000 A total of 124 patients had 335 8-mm-long implants placed over the course of two years. Of the 124 total patients, 35 were men and 89 were women. Randomized Control trial Key results A three year study concerning the survival and stability of various implant lengths (4 different types) and of two different diameters. The implants were randomized to different jaw regions to compare each implant's survival. Findings show that the p-value for implants 3mm and higher were p<.05. Implants 4+ were p=.01. Implant survival percentages increased as length got longer, and the greater the diameter (when comparing 3 mm and 4mm), the more the stability. 16584416 Ferrigno/2006 Five hundred and eighty-eight total implants were placed in 323 consecutive patients over the course of 12 years. Prospective Case Series/Comparative study Key results Implants were placed by elevating the sinus floor and placing the implant at the same time. The analysis of implant subgroups showed slightly more favorable overall success rates for 12 mm long implants when compared with 10 and 8 mm long implants. Shorter implants did not significantly fail when compared to the longer ones. When making results from a clinical standpoint, the use of short implants in conjunction with osteotome sinus floor elevation may reduce the indication for complex invasive procedures such as sinus lifts and bone grafting procedures.
Evidence Search	Search long term success, Systematic ReviewsSearch long length dental implants successSearch short dental implants
Comments on The Evidence	The evidence found was of a good spectrum. There was a meta analysis that compared the heights of implants and their longevity. There was also a randomized controlled trial that exhibited different results but clearly stated that longer implants had a higher survival rate.
Applicability	Knowledge of the long term use of implants is important, because it allows clinicians to evaluate their patient better. Given different scenarios and case presentations, the clinician will choose the better length for long term use.
Specialty	(Periodontics)
Keywords
ID#	618
Date of submission	05/12/2010
E-mail	vermas@uthscsa.edu
Author	Shelly Verma
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Richard Finlayson, DDS
Faculty mentor e-mail	finlaysonr@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Kia Zeram (South Jordan, UT) on 10/04/2012 On October 3, 2012 according to the current Meta-Analysis studies conducted on short and long implants, it can be concluded that in areas of reduced alveolar bone height the use of short implants may reduce the need for invasive bone augmentation procedures. This indicates that there seems to be a difference in implants length success when considering alveolar bone height.