Page 50 - Dental Practice South Asia 18-6

implantology section

AIMING LONG TERM SUCCESS WITH SHORT

IMPLANT: A CASE REPORT

GAURAV GUPTA, D.K.GUPTA, NEELJA GUPTA

ABSTRACT One of the studies concluded that there is sufficient evidence
Placing an implant in the posterior part of the maxilla and mandible showing high success rates with short implants when compared to
has always been critical due to poor quality and quantity of bone. surgical augmentation procedures in the treatment of atrophic
Long implants could be placed in association with complex surgical ridges [8]
procedures such as sinus lift and bone augmentation in the maxilla
and advanced surgical procedures for the mandible but these are GUIDELINES FOR PLACING SHORT IMPLANTS
higher in cost and are time consuming. Hence, there is a need for a TABLE 1: Guidelines for placement of short implants and other
less invasive treatment option in atrophic areas of bone. Here, data therapeutic options based on bone height, bone quality, and certain
related to short implants survival rate is structured with emphasis risk factors such as smoking, history of periodontal disease and
on the indications, advantages, and biomechanical factors to be advanced age are as follows:
taken into consideration while choosing short implants represented
in a clinical case aiming for long term success with short implant.
These can be considered as an effective treatment alternative in Ridge height Bone type History of Treatment
resorbed ridges. Thereby, suggesting length does not decide the suc- (Resorbed maxilla) periodontitis,
cess of the implant but pre-operative planning and case selection smokers,
increase the success rate. Short implants can be considered as a advanced age
viable treatment option in cases with atrophic ridges in order to <5mm Type I, II, III No Sinus lift/short
avoid the complex surgical procedures required to place conven- implant
tional implants. Type IV Yes Sinus lift/short
implant
INTRODUCTION
Choice of implant length for available bone quality and quantity and 5-6mm Type I, II, III No Short implant
biting force is a critical factor in the success of implants and the Type IV Yes Sinus lift/short
longevity of the prosthesis. Long implants have always been consid- implant
ered to be desirable, but in patients with alveolar bone resorption ≥6mm Type I, II, III No Short implant
their placement is problematic due to the anatomic boundaries. Type IV Yes Short implant
Anatomical limitation in resorbed maxillary ridge includes the max-
illary sinus posteriorly, nasal floor and nasopalatine canal anteriorly Ridge height Bone type Treatment
whereas in case of resorbed mandible it is inferior alveolar canal. (Resorbed mandible)
Advanced surgical procedures such as guided bone regeneration,
block grafting, maxillary sinus floor grafting, distraction osteogene- <8mm Type I, II, III, IV Advanced surgical
sis and nerve repositioning can be carried out in order to gain alve- procedure/short implant
olar height in these areas for the placement of long length implants ≥8mm Type I, II, III, IV Short implants
but these are technique sensitive, challenging, costly, and are time
consuming. Short implants are less invasive treatment alternatives
in cases with resorbed ridges [1–3] . There is no general definition of This manuscript describes success is very much dependent on
a short implant; most of the authors have considered implants preoperative planning and proper case selection. Present case report
which are less than 10mm are short implants [4–6] presents with placement of short implant with a flapless surgical
Short implants were found to have similar survival rates, reduced technique that caused minimal discomfort to the patient, thereby
treatment cost and time as compared to long implants assisted by aiming for long term success with short implant in resorbed ridge.
advanced surgical procedures. [7]
CASE REPORT
A 65-year-old diabetic female reported to the clinic with the com-
Article Citation: Gupta, G. Gupta, DK. Gupta, N. (2022) plaint of missing tooth 16 (right maxillary first molar). The tooth
Aiming long term success with short implant: A case had been extracted 2 months earlier due to gross decaying; since
report.Dental Practice, 18(6), 50-53 then she did not wear any prosthesis and was having difficulty in
chewing, so she wanted to have a fixed solution. After intraoral

50 Dental Practice // November-December 2022 // Vol 18 No 6