Kısa Dental İmplantların Klinik Çalışmalar İle Değerlendirilmesi: Derleme

Yıl 2018, , 59 - 65, 29.01.2018

Mustafa Hayati Atala , Kübra Değirmenci

https://doi.org/10.21673/anadoluklin.326977

Öz

Kaybedilen
doğal dişlerin yerine dental implantlar başarıyla uygulanmaktadır. Ancak, aşırı
kemik kaybı standart implant uygulamaları öncesinde ileri cerrahi işlemler
gerektirebilmektedir. Son dönemde, ileri cerrahinin dezavantajlarından kaçınmak
için kısa implantların kullanımları değerlendirilmektedir. Etkili ve pratik bir
uygulama sağlayan kısa implantların klinik başarıları araştırılmaktadır.
Çalışmalarda, implantların yüzey özelliği, kemik yapısı, marjinal kemik kaybı,
kron/implant oranı, implant üstü restorasyonların tasarımı ve periodontal
yapıların sağlığı başlıca değerlendirilen faktörlerdir. Bu derlemede, klinik
çalışmalar dikkate alınarak, kısa implant kavramı ve çalışmalarda
değerlendirilen faktörlerin kısa implantların başarısı ile ilişkisi
sunulacaktır.

Anahtar Kelimeler

Kısa dental implantlar; marjinal kemik kaybı; kron/implant oranı.

Assesment of Short Dental Implants with Clinical Trials: A Review

Öz

Dental
implants can be applied succesfully when natural teeth are lost. Hovewer,
excessive loss of bone can require advanced surgical treatments before dental
implants placement. Recently, use of short dental implants are evaluated to
avoid disadvantages of advanced surgical operations. Clinical success of short
implants is being explored, providing an effective and practical application.
In researches, surface properties of implants, bone characteristics,
marginal bone loss, crown/ implant ratio, design of implant restorations and
the health of periodontal structures are the main factors to be evaluated. In
this review, considering clinical studies, the concept of short implants will
be presented in relation to the success of the short implants in the factors
assessed in the studies.

Anahtar Kelimeler

Short dental implants; marginal bone loss; crown/implant ratio.

Kaynakça

• 1. Lai HC, Si MS, Zhuang LF, Shen H, Liu YL,Wismeijer D. Long-term Outcomes of Short Dental Implants Supporting Single Crowns in Posterior Region: A Clinical Retrospective Study of 5-10 years. Clin Oral Impl Res. 2013;24(2):230-7. 2. Lekholm U, van Steenberghe D, Herrmann I. Osseointegrated implants in the treatment of partially edentulous jaws: A prospective 5-year multicenter study. Int J Oral Maxillofac Implants. 1994;9(1): 627–35. 3. Omran MT, Miley DD, McLeod DE, Garcia MN. Retrospective Assessment of Survival Rate for Short Endosseous Dental Implants. Implant Dent.2015;24(2) 185-91. 4. Busenlechner D, Fürhauser R, Haas R, Watzek G, Mailath G, Pommer B. Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis. J Periodontal Implant Sci.2014; 44(3):102-8. 5. Buser D, Ingimarsson S, Dula K. Long-term stability of osseointegrated implants in augmented bone: A 5-year prospective study in partially edentulous patients. Int J Periodontics Restorative Dent. 2002;22(2):109–17. 6. Lekholm U, Gunne J, Henry P. Survival of the Brånemark implant in the partially edentulous jaw. A 10-year prospective multicenter study. Int J Oral Maxillofac Implants. 1999;14(5):639–45. 7. Kılıç E, Kılıç K, Er N, Aral CA, Yağan AE, Alkan A. Kısa Dental İmplantların Klinik ve Radyolojik Takibi: Retrospektif Çalışma. Cumhuriyet Dent J 2011;14(3):211-8. 8. De Boever AL, Quirynen M, Coucke W, Theuniers G, De Boever JA. Clinical and radiographic study of implant treatment outcome in periodontally susceptible and nonsusceptible patients: a prospective long term study. Clin Oral Implants Res. 2009;20(12):1341-50. 9. Al-Hashedi AA, Taiyeb Ali TB, Yunus N. Short Dental Implants: An Emerging Concept in Implant Treatment. Quintessence Int. 2014;45(6):499– 514. 10. Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res. 2006;17(2):35–51. 11. Andersson B, Odman P, Carlsson GE. A study of 184 consecutive patients referred for single tooth replacement. Clin Oral Implants Res. 1995;6(4): 232-7. 12. Farina R, Pramstraller M, Franceschetti G, Pramstraller C, Trombelli L. Alveolar ridge dimensions in maxillary posterior sextants: a retrospective comparative study of dentate and edentulous sites using computerized tomography data. Clin Oral Implants Res.2011; 22(10):1138–44. 13. das Neves FD, Fones D, Bernardes SR, do Prado CJ Neto AJ. Short implants- an analysis of longitudinal studies. The Int J Oral Maxillofac Implants. 2006;21(1): 86–93. 14. Merli M, Migani M, Esposito M. Vertical ridge augmentation with autogenous bone grafts: resorbable barriers supported by ostheosynthesis plates versus titanium-reinforced barriers. A preliminary report of a blinded, randomized controlled clinical trial. The Int J Oral Maxillofac Implants.2007;22(3): 373–82. 15. Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6): 625–42. 16. Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique. J Clin Periodontol.2008;35(8): 241–54. 17. Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006 ;17(2): 136–59. 18. Malmstorm H, Gupta B, Ghanem A, Cacciato R, Ren Y, Romanos GE. Succes rate of short dental implants supporting single crowns and fixed bridges. Clin Oral Implants Res. 2016;27(9):1093-98. 19. Pierrisnard L, Renouard F, Renault P, Barquinis M. Influence of implant length and bicortical anchorage on implant stress distribution. Clin Implant Dent Relat Res. 2003;5(4):254–62. 20. Block MS, Delgado A, Fontenot MG. The effect of diameter and length of hydroxyapatite-coated dental implants on ultimate pullout force in dog alveolar bone. J Oral Maxillofac Surg. 1990;48(2):174–8. 21. Lum LB. A biomechanical rationale for the use of short implants. J Oral Implantol. 1991;17(2):126–31. 22. Kitamura E, Stegaroiu R, Nomura S, Miyakawa O. Influence of marginal bone resorption on stress around an implant—a three dimensional finite element analysis. J Oral Rehabil 2005;32(4):279–86. 23. Bernard JP, Szmukler-Moncler S, Pessotto S, Vazquez L, Belser UC. The anchorage of Brånemark and ITI implants of diffrent lenghts. I. An experimental study in the canine mandible. Clin Oral Implants Res.2003;14(5):593–600. 24. Testori T, Del Fabbro M, Capelli M,Zuffetti F,Weinstein RL.Immediate occlusal loading and tilted implants for the rehabilitation of the atrophic edentulous maxilla: 1-year interim results of a multicenter prospective study. Clin Oral Implants Res. 2008;19(3):227–32. 25. Griffin TJ, Cheung WS. The use of short, wide implants in posterior areas with reduced bone height: a retrospective investigation. J Prosthet Dent.2004;92(2):139–44. 26. Goiato MC, de Medeiros RA, Sônego MV, de Lima TM, Pesqueira AA, Dos Santos DM. Stress distribution on short implants with different designs: a photoelastic analysis. J Med Eng Technol. 2017;41(2):115-21. 27. Papaspyridakos P, White GS, Lal K: Flapless CAD/CAM-guided surgery for staged transition from failing dentition to complete arch implant rehabilitation: a 3- year clinical report: a 3-year clinical report. J Prosthet Dent. 2012;107(3): 143-50. 28. Felice P, Checchi V, Pistilli R, Scarano A, Pellegrino G, Esposito M. Bone augmentation versus 5-mm dental implants in posterior atrophic jaws. Four-month post-loading results from a randomised controlled clinical trial. Eur J Oral Implantol. 2009;2(4):267–81. 29. Grant BT, Pancko FX, Kraut RA. Outcomes of placing short dental implants in the posterior mandible: A retrospective study of 124 cases. J Oral Maxillofac Surg. 2009;67(4):713–7. 30. Pommer B, Busenlechner D, Fürhauser R,Watzek G, Mailath-Pokorny G, Haas R. Trends in techniques to avoid bone augmentation surgery: Application of short implants, narrow-diameter implants and guided surgery. J Craniomaxillofac Surg. 2016;44(10):1630-4. 31. Sotto-Maior BS, Senna PM, Silva-Neto JP, de Arruda Nobilo MA, Cury AA. Influence of crown-to-implant ratio on stress around single short-wide implants: a photoelastic stress analysis. J Prosthodont. 2015;24(1):52–6. 32. Schincaglia GP, Thoma DS, Haas R,Tutak M, Garcia A, Taylor TD, Hämmerle CH. Randomized controlled multicentre study comparing short dental implants (6mm) versus longer dental implants (11-15mm) in combination with sinus floor elevation procedures. Part 1: Demographics and Patient-Reported outcomes at 1 year of loading. J Clin Periodontol. 2015;42(11):72-80. 33. Esposito M, Pistilli R, Barausse C, Felice P. Three-year results from a randomised controlled trial comparing prostheses supported by 5-mm long implants or by longer implants in augmented bone in posterior atrophic edentulous jaws. Eur J Oral Implantol. 2014;7(4): 383–95. 34. Cannizzaro G, Felice P, Minciarelli AF, Leone M, Viola P, Esposito M. Early implant loading in the atrophic posterior maxilla: 1-stage lateral versus crestal sinus lift and 8 mm hydroxyapatite-coated implants: a 5-year randomised controlled trial. Eur J Oral Implantol. 2013;6(1):13–25. 35. Pistilli R, Felice P, Cannizzaro G, Piatelli M, Corvino V, Barausse C,Buti J, Soardi E, Esposito M. Posterior atrophic jaws rehabilitated with prostheses supported by 6 mm long 4 mm wide implants or by longer implants in augmented bone: one-year post-loading results from a pilot randomised controlled trial. Eur J Oral Implantol. 2013 ;6(4)359–72. 36. Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant treatment, Cochrane Database Syst Rev.2009;7(4):1-5. 37. Tan WC, Krishnaswamy G, Ong MM, Lang NP. Patient-reported outcome measures after routine periodontal and implant surgical procedures. J Clin Periodontol.2014;41(6):618–24. 38. Atieh MA, Zadeh H, Stanford CM, Cooper LF. (2012) Survival of short dental implants for treatment of posterior partial edentulism: a systematic review. Int J Oral Maxillofac Implants 2012;27(6):1323–31. 39. Mertens C, Meyer-B€aumer A, Kappel H, Hoffmann J, Steveling HG. Use of 8-mm and 9-mm implants in atrophic alveolar ridges: 10-year results. Int J Oral Maxillofac Implants.2012; 27(6): 1501–8. 40. Bratu E, Chan HL, Mihali S, Karancsi O, Bratu DC, Fu JH, Wang HL. (2014) Implant survival rate and marginal bone loss of 6-mm short implants: a 2-year clinical report. Int J Oral Maxillofac Implants.2014; 29(6): 1425–28. 41. Mangano FG, Shibli JA, Sammons RL, Iaculli F, Piattelli A, Mangano C. Short (8-mm) locking-taper implants supporting single crowns in posterior region: a prospective clinical study with 1- to 10-years of follow-up. Clin Oral Implants Res. 2014;25(8): 933–40. 42. Hof M, Tepper G, Semo B, Arnhart C,Watzek G, Pommer B. Patients' perspectives on dental implant and bone graft surgery: questionnaire-based interview survey. Clin Oral Implants Res.2014;25(1): 42-5. 43. Thoma DS, Zeltner M, Husler J, Hammerle CH, Jung RE. EAO Supplement Working Group 4 – EAO CC 2015 Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res.2015;26(11):154–69. 44. Tutak M, Smektala T, Schneider K, Golebiewska E, Sporniak-Tutak K.Short dental implants in reduced alveolar bone height: a review of the literature. Med Sci Monit. 2013;21(19): 1037-42. 45. Weng D, Jacobson Z, Tarnow D,Hürzeler MB, Faehn O, Sanavi F, Barkvoll P, Stach RM. A prospective multicenter clinical trial of 3i machined-surface implants: results after 6 years of follow-up. Int J Oral Maxillofac Implants. 2003;18(3):417–23. 46. Tawil G, Younan R. Clinical evaluation of short, machined-surface implants followed for 12 to 92 months. Int J Oral Maxillofac Implants. 2003;18(6):894–901. 47. Mezzomo LA, Miller R, Triches D, Alonso F, Shinkai RS. Meta-analysis of single crowns supported by short (<10 mm) implants in the posterior region. J Clin Periodontol. 2014;41(2): 191–213. 48. Telleman G, Raghoebar GM, Vissink A, L. den Hartog, J.J. Huddleston Slater, H. J. Meijer, A systematic review of the prognosis of short (<10 mm) dental implants placed in the partially edentulous patient. J Clin Periodontol. 2011;38(7): 667–76. 49. Monje A, Chan HL, Fu JH, Suarez F, Galindo- Moreno P, Wang HL. Are short dental implants (<10 mm) effective? A meta-analysis on prospective clinical trials. J Periodontol. 2013;84(7):895-904. 50. Morand M, Irinakis T. The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants. J Oral Implantol 2007;33(5): 257–66. 51. Lee SA, Lee CT,. Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited vertical height in the posterior region: short implants (5 to 8 mm) vs longer implants (>8 mm) in vertically augmented sites. Int J Oral Maxillofac Implants. 2014;29(5):1085–97. 52. Friberg B, Grondahl K, Lekholm U, Brånemark PI. Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants. Clin Implant Dent Relat Res. 2000;2(4):184–9. 53. Hagi D, Deporter DA, Pilliar RM, Arenovich T. A targeted review of study outcomes with short (< or = 7 mm) endosseous dental implants placed in partially edentulous patients. J Periodontol. 2004;75(6): 798–804. 54. Anitua E, Alkhraist MH, Pinas L, Begona L, Orive G. Implant survival and crestal bone loss around extra-short implants supporting a fixed denture: the effect of crown height space, crown-to-implant ratio, and offset placement of the prosthesis. Int J Oral Maxillofac Implants. 2014;29(3):682–9. 55. Monje A, Suarez F, Galindo-Moreno P, Garcia-Nogales A, Fu JH, Wang HL. A systematic review on marginal bone loss around short dental implants (<10 mm) for implant-supported fixed prosthesis. Clin Oral Implants Res. 2014;25(10):1119-24. 56. Queiroz TP, Aguiar SC, Margonar R, de Souza Faloni AP, Gruber R, Luvizuto ER. Clinical study on survival rate of short implants placed in the posterior mandibular region: resonance frequency analysis. Clin Oral Implants Res. 2015;26(9):1036–42. 57. Tawil G, Aboujaoude N, Younan R. Influence of prosthetic parameters on the survival and complication rates of short implants, Int J Oral Maxillofac Implants. 2006;21(2): 275–82. 58. Gapski R, Wang HL, Mascarenhas P, Lang NP. Critical review of immediate implant loading. Clin Oral Implants Res. 2003;(14):515–27. 59. Winkler S, Morris HF, Ochi S. Implant survival to 36 months as related to length and diameter. Ann Periodontol.2000;5(1): 22–31. 60. Pommer B, Frantal S,Willer J, Posch M,Watzek G, Tepper G. Impact of dental implant length on early failure rates: a meta-analysis of observational studies. J Clin Periodontol. 2011;38(9):856-63. 61. Bahat O. Treatment planning and placement of implants in the posterior maxillae: Report of 732 consecutive Nobelpharma implants. Int J Oral Maxillofac Implants. 1993;8(2):151–61. 62. Pierrisnard L, Renouard F, Renault P, Barquinis M. Influence of implant length and bicortical anchorage on implant stress distribution. Clin Implant Dent Relat Res. 2003;5:254–262. 63. Sun HL, Huang C, Wu YR, Shi B. Failure rates of short (≤10 mm) dental implants and factors influencing their failure: a systematic review. Int J Oral Maxillofac Implants. 2011;26(4): 816–25. 64. Elias N,Yoshiki O, Lima J, Muller CA. Relationship between surface properties of titanium and dental implant removal torque. J Mech Behav Biomed Mater. 2008;1(3):234-42. 65. Renouard F, Nisand D. Short implants in the severely resorbed maxilla: a 2-year retrospective clinical study. Clin Implant Dent Relat Res. 2005;7(1): 104–10. 66. Ellingsen JE, Johansson CB, Wennerberg A, Holmén A. Improved retention and bone to implant contact with fluoride-modified titanium implants. Int J Oral Maxillofac Implants. 2004;19(5): 659–66. 67. Berglundh T, Abrahamsson I, Albouy JP, Lindhe J. Bone healing at implants with a fluoride-modified surface: an experimental study in dogs. Clin Oral Implants Res. 2007; 18(2): 147–52. 68. Deporter D. Short dental implants: what works and what doesn’t? A literature interpretation. Int J Periodontics Restorative Dent. 2013; 33(4): 457–64. 69. Annibali S, Cristalli MP, Dell’Aquila D, Bignozzi I, La Monaca G, Pilloni A. Short dental implants: a systematic review. J Dent Res. 2012;91(1):25–32. 70. Malo P, Nobre M, Lopes A. Short implants in posterior jaws. A prospective 1-year study. Eur J Oral Implantol. 2011;4(1):47–53. 71. Anitua E, Orive G, Aguirre JJ, Andía I. Five-Year Clinical evaluation of short dental implants placed in posterior areas: a retrospective study. J Periodontol.2008;79(1) : 42–8. 72. Anitua E, Orive G. Short implants in maxilla and mandibles: a retrospective study with 1 to 8 Years of follow-up. J Periodontol. 2010;81(6): 819–26. 73. Lee JH, Frias V, Lee KW, Wright RF. Effect of implant size and shape on implant success rates: a literature review. J Prosthet Dent. 2005;94(4):377-81. 74. Pilliar RM, Sagals G, Meguid SA, Oyonoarte R, Deporter DA. Threaded versus porous-surfaced implants as anchorage units for orthodontic treatment: Three-dimensional finite element analysis of peri-implant bone tissue stresses. Int J Oral Maxillofac Implants 2006;21(6):879-89. 75. Deporter DA, Watson P, Pharoah M, Todescan R, Tomlinson G. Ten-year results of prospective study using poroussurfaced dental implants and a mandibular overdenture. Clin Implant Dent Relat Res 2002;4(4):183-9. 76. Nedir R, Bischof M, Briaux JM, Beyer S, Szmukler- Moncler S, Bernard JP. A 7- Year Life table analysis from a prospective study on ITI implants with special emphasis on the use of short implants. Clin Oral Implant Res.2004; 15(2): 150–7. 77. Thoma DS, Haas R, Tutak M, Garcia A, Schincaglia GP, Hämmerle CH. Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11–15 mm) in combination with sinus floor elevation procedures. Part 1: demographics and patient-reported outcomes at 1 year of loading. J Clin Periodontol 2015;42(11): 72–80. 78. Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt HP, Belser UC, Lang NP. Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res 1997;8(3):161-172. 79. Jemt T, Lekholm U. Implant treatment in edentulous maxillae. A 5-year follow-up report on patients with different degrees of jaw resorption. Int J Oral Maxillofac Implants 1995;10(3):303-11. 80. Perelli M,Abundo R,Corrente G,Saccone C.Short( 5 and 7 mm long) porous implants in the posterior atrophic maxilla: a 5-year report of a prospective single-cohort study. Eur J Oral Implantol. 2012;5(3):265–72. 81. Gotfredsen K, Karlsson U. A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface. J Prosthodont.2001; 10(1): 2–7. 82. Goiato MC, dos Santos DM, Santiago JF Jr, Moreno A, Pellizzer EP. Longevity of dental implants in type IV bone: a systematic review. Int J Oral Maxillofac Surg. 2014;43(9):1108–16. 83. Al-Emran S. Prevalence of tooth loss in Saudi Arabian school children: An epidemiological study of Saudi male children. Saudi Dental J. 1990; 2(4): 137–40. 84. Oikarinen K, Raustia AM, Hartikainen M: General and local contraindications for endosseal implants--an epidemiological panoramic radiograph study in 65-year-old subjects. Community Dent Oral Epidemiol. 1995; 23(2): 114–18. 85. Nisand D, Renouard F. Short implant in limited bone volume. Periodontol 2000. 2014;66(1):72–96. 86. Felice P, Soardi E, Pellegrino G, Pistilli R, Marchetti C, Gessaroli M, Esposito M. Treatment of the atrophic edentulous maxilla: short implants versus bone augmentation for placing longer implants. Five-month post-loading results of a pilot randomised controlled trial. Eur J Oral Implantol. 2011;4(3):191–202. 87. Deporter D, Ogiso B, Sohn DS, Ruljancich K, Pharoah M. Ultrashort sintered porous-surfaced dental implants used to replace posterior teeth. J Periodontol.2008;79(7): 1280–86. 88. Fugazzotto PA. Shorter implants in clinical practice: rationale and treat¬ment results. Int J Oral Maxillofac Implants. 2008; 23(3): 487–96 89. Sánchez-Garcés A, Costa-Berenguer X, Gay-Escoda C: Short implants: a de¬scriptive study of 273 implants. Clin Implant Dent Relat Res. 2012; 14(4): 508–16. 90. French D, Larjava H, Ofec R. Retrospective cohort study of 4591 Straumann implants in private practice setting, with up to 10-year follow- up. Part 1: multivariate survival analysis. Clin Oral Implants Res. 2015;26(11):1345-54. 91. Esposito M, Pellegrino G, Pistilli R, Felice P. Rehabilitation of posterior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One-year results from a pilot randomised clinical trial. Eur J Oral Implantol. 2011;4(1):21-30. 92. Felice P, Cannizzaro G, Checchi V, Pellegrino G, Censi P, Esposito M. Vertical bone augmentation versus 7-mm-long dental implants in posterior atrophic mandibles. Results of a randomised controlled clinical trial of up to 4 months after loading. Eur J Oral Implantol. 2009;2(1):7-20. 93. Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7 mm-long implants in posterior mandibles: 1-year results of a randomised clinical trial. Clin Oral Implants Res 2010;21(12):1394-403. 94. Mendonca JA, Francischone CE, Senna PM, Matos de Oliveira AE, Sotto- Maior BS. A retrospective evaluation of the survival rates of splinted and non-splinted short dental implants in posterior partially edentulous jaws. J Periodontol. 2014;85(6)787–94. 95. Randow K, Ercisson I, Nilner K, Petersson A. Glantz PO. Immediate functional loading of branemark dental implants An 18 month clinical followup study. Clin Oral Impl Res. 1999;10(1):8-15. 96. Peñarrocha-Diago MA, Flichy-Fernández AJ, Alonso-González R, Peñarrocha-Oltra D, Balaguer-Martínez J, Peñarrocha-Diago M. Influence of implant neck design and implant abutment connection type on peri-implant health. Radiological study. Clin Oral Implants Res.2013;24(11):1192-200. 97. Qian J, Wennerberg A, Albrektsson T. Reasons for marginal bone loss around oral implants. Clin Implant Dent Relat Res.2012;14(6): 792–807. 98. Cardaropoli G, Lekholm U, Wennström JL. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res.2006;17(2): 165–71. 99. Canullo L, Bignozzi I, Cocchetto R, Cristalli MP, Iannello G. Immediate positioning of a definitive abutment versus repeated abutment replacements in post-extractive implants: 3-year follow-up of a randomised multicentre clinical trial. Eur J Oral Implantol.2010;3(4): 285–96. 100. Galindo-Moreno P, Fauri M, Avila-Ortiz G, Fernández-Barbero JE, Cabrera-León A, Sánchez-Fernández E. Influence of alcohol and tobacco habits on peri-implant marginal bone loss: a prospective study. Clin Oral Implants Res.2005;16(5): 579–86. 101. Isidor F. Influence of forces on peri-implant bone. Clin Oral Implants Res.2006;17(2): 8–18. 102. Blanes RJ. To what extent does the crown implant ratio affect the survival and complications of implant-supported reconstructions? A systematic review. Clin Oral Implants Res. 2009;20(4): 67–72. 103. Gomez-Polo M, Bartens F, Sala L, Tamini F, Celemin A, Del Rio J. The correlation between crown-implant ratios and marginal bone resorption: A preliminary clinical study. Int J Prosthodont 2010;23(1):33–7. 104. Hasan I, Heinemann F, Aitlahrach M, Bourauel C. Biomechanical finite element analysis of small diameter and short dental implant. Biomed Tech.2010;55(69):341–50. 105. Isidor F. Loss of osseointegration caused by occlusal load of oral implants. A clinical and radiographic study in monkeys. Clin Oral Implants Res.1996;7(2): 143–52. 106. Glantz PO, Nilner K. Biomechanical aspects of prosthetic implant-borne reconstructions. Periodontol 2000. 1998;17(6):119–24. 107. Ramos Verri F, Santiago Junior JF, de Faria Almeida DA, de Oliveira GB, de Souza Batista VE, Marques Honório H, Noritomi PY, Pellizzer EP. Biomechanical influence of crown-to-implant ratio on stress distribution over internal hexagon short implant: 3-D finite element analysis with statistical test. J Biomech. 2015;48(1):138–45. 108. Quaranta A, Piemontese M, Rappelli G, Sammartino G, Procaccini M. Technical and biological complications related to crown to implant ratio: a systematic review. Implant Dent. 2014;23(2):180–7. 109. Sun SP, Moon IS, Park KH, Lee DW. Effect of crown to implant ratio and anatomical crown length on clinical conditions in a single implant: a retrospective cohort study. Clin Implant Dent Relat Res. 2015;17(4):724–31. 110. Maló P, de Araújo NM, Rangert B: Short implants placed onestage in max¬illae and mandibles: a retrospective clinical study with 1 to 9 years of fol¬low-up. Clin Implant Dent Relat Res.2007; 9(1): 15–21. 111. Birdi H, Schulte J, Kovacs A,Weed M,Chuang SK. Crown-to-implant ratios of short-length implants. J Oral Implantol. 2010;36(6): 425–33. 112. Bidez MW, Misch CE. Force transfer in implant dentistry: Basic concepts and principles. J Oral Implantol.1992;18(3):264–74. 113. Nunes M, Almeida RF, Felino AC, Malo P, de Araújo Nobre M. The Influence of crown-to-Implant Ratio on short implant marginal bone loss. Int J Oral Maxillofac Implants.2016;31(5):1156-63. 114. Nissan J, Ghelfan O, Gross O, Priel I, Gross M, Chaushu G. The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations. J Oral and Maxillofac Surg.2011; 69(7):1934–9. 115. Sanz M, Naert I. Biomechanics/risk management (Working Group 2). Clin Oral Implants Res. 2009;20(4):107–11. 116. Nissan J, Ghelfan O, Gross M, Chaushu G. Analysis of load transfer and stress distribution by splinted and unsplinted implant-supported fixed cemented restorations. Journal of Oral Rehabilitation 2010;37(9): 658–62. 117. Misch CE. Short dental implants: a literature review and rationale for use. Dent Today.2005; 24(8): 64–8. 118. Anitua E, Alkhraisat MH, Orive G. Novel technique for the treatment of the severely atrophied posterior mandible. Int J Oral Maxillofac Implants. 2013;28(5):1338–46. 119. Rossi F, Lang NP, Ricci E, Ferraioli L, Marchetti C, Botticelli D. Early loading of 6-mm-short implants with a moderately rough surface supporting single crowns—a prospective 5-year cohort study. Clin. Oral Implants Res. 2015;26(4): 471–7. 120. Slotte C, Grønningsaeter A, Halmøy AM, Öhrnell LO, Mordenfeld A, Isaksson S, Johansson LÅ. Four-millimeter-long posterior-mandible implants: 5-year outcomes of a prospective multicenter study. Clin Implant Dent Relat Res. 2015;17(2):385-95. 121. Bechara S, Kubilius R, Veronesi G, Pires JT, Shibli JA, Mangano FG. Short (6mm) dental implants versus sinus floor elevation and placement of longer (≥10 mm) dental implants: a randomized controlled trial with a 3-year follow-up. Clin Oral Implants Res. 2016;12(7)1-11.