Implantes curtos X implantes longos em áreas enxertadas: revisão crítica de literatura

Abstract

According to empiric postulations implants of at least 10mm length should be used to guarantee success and predictability in oral rehabilitation with implants. This idea stimulated the development of various techniques for vertical ridge augmentation in posterior jaws, extremely affected areas by the post extraction resorption process. Poor bone density of these areas, also, stimulated the development of rough implant surfaces, which allowed to reach acceptable outcomes with short implants (<10mm). Since different therapeutic methods are available for implant treatment in areas with restricted posterior alveolar ridge high, this licterature review aimed to evaluate if short implants would be a better solution than the longer ones associated to augmentation procedures. The PubMed and Cochrane Library databases were consulted for follow up and randomized controlled clinical trial published between 1990 and 2013. High failures rates were associated to machined implant surface installed in the maxilla, independent of implant length. Short implants survival rates were similar to standard implants placed in pristine bone or areas submitted to bone regeneration. Randomized controlled clinical trial comparing short implants with standard implants in grafted areas presented similar survival rates, however patients preferred short implants due to less morbidity. Short implants should be splinted and submitted to strict oclusal adjustment avoiding parafunctional forces until long term studies with biomechanical parameters analyses reach reliable results.