Romeo E, Bivio A, Mosca D, Scanferla M, Ghisolfi M, Storelli S
Department of Implantology, University of Milan, Milan, Italy.
Minerva Stomatol. 2010 Jan-Feb;59(1-2):23-31.
When anatomic structures and ridge resorption limit the placement of a standard implant, the clinician can apply augmentation techniques or use short implants. A literature review was carried out to evaluate the differences in survival rate and the rational use of short implants. Electronic search (MEDLINE) and manual search have been performed to select papers from 2000 to 2008. Of all the inclusion criteria the most relevant were: 1) studies with data on short implants; 2) studies on humans; 3) prospective, longitudinal, retrospective and multicenter studies; 4) no restrictions were applied about study design; 5) no implant type selection was applied. Exclusion criteria were: 1) studies concerning treatment of patients with conditions possibly affecting survival or success rates of implant treatment; 2) studies concerning treatment of patients with non-treated periodontal disease; 3) implants placed in non-healed ridge, such as postextractive short implants. A total of 13 studies fulfilled the inclusion criteria. Most of the studies have reported different survival rate for short and standard implants. The difference is not significant. The recent literature have demonstrated a similar survival rate for short and standard implants. Older articles have demonstrated a lower survival rate for short implants. The treatment planning is a key factor for success in the use of short implants. Some of the parameters the clinician should consider are: 1) area to rehabilitate as well as bone quality; 2) length of the implant; 3) implant diameter; 4) type of implant and surface treatment; 5) crown to implant ratio of the final prostheses; 6) type of prostheses; 7) connection to other implants; 8) occlusal/ parafunctional load; 9) prosthetic complications. Although in the literature there are no studies that analyze short implant survival from the point of view of each key factors, it can be assumed that a careful treatment planning can lead the clinician to obtain a successful rehabilitation.
当解剖结构和牙槽嵴吸收限制了标准种植体的植入时,临床医生可以采用增量技术或使用短种植体。进行了一项文献综述,以评估短种植体的生存率差异及合理应用。通过电子检索(MEDLINE)和手工检索,选取了2000年至2008年的相关论文。所有纳入标准中,最相关的有:1)包含短种植体数据的研究;2)人体研究;3)前瞻性、纵向、回顾性和多中心研究;4)对研究设计无限制;5)不限制种植体类型的选择。排除标准为:1)关于可能影响种植治疗生存率或成功率的患者病情治疗的研究;2)关于未治疗牙周病患者治疗的研究;3)植入未愈合牙槽嵴的种植体,如拔牙后短种植体。共有13项研究符合纳入标准。大多数研究报告了短种植体和标准种植体不同的生存率。差异不显著。近期文献表明短种植体和标准种植体的生存率相似。早期文章显示短种植体的生存率较低。治疗计划是成功使用短种植体的关键因素。临床医生应考虑的一些参数包括:1)需要修复的区域以及骨质;2)种植体长度;3)种植体直径;4)种植体类型和表面处理;5)最终修复体的冠根比;6)修复体类型;7)与其他种植体的连接;8)咬合/副功能负荷;9)修复并发症。尽管文献中没有从每个关键因素的角度分析短种植体生存率的研究,但可以认为仔细的治疗计划能使临床医生获得成功的修复。