Clinical and Patient Outcomes of 4 mm Ultra-Short vs. 8 mm Implants With Bone Augmentation in the Back Upper Jaw

Clinical- and Patient-related Outcomes of 4 mm Ultra-short Implants Compared to 8 Mm-long Implants With Bone Augmentation for the Rehabilitation of Posterior Atrophic Maxilla: a Randomized Controlled Clinical Trial.

This study aims to compare 2 different groups of patients with both a healed site in the upper posterior sector after extractions, one treated with ultra-short implants, and another with long implants with bone regeneration. The objective is to evaluate if short-implants are superior in terms of better clinical outcomes, survival rates and safety, reduced surgical time, postoperative discomfort, and complication risk compared to conventional implants and bone regeneration.

inclusion criteria:

• Inform consent signed.
• Adult patients (≥18 years old).
• No pregnant women or without the desire to stay.
• Periodontal and peri-implant health in a pristine or reduced periodontium.
• Full mouth plaque score < 20% (O'Leary, 1972)
• Maxillary multiple posterior maxillary healed sites at least 4 months after extraction (with antagonist teeth with a good prognosis (Lindhe et al. 2008)) presenting ≥ 6.5 mm of bone width and 5-6 mm in height from the bone crest to the floor of the sinus.
• Need for a multiple splinted implant supported restoration with distal adjacent teeth or distal free-end in the posterior maxilla

exclusion criteria

• Patients with uncontrolled systemic diseases.
• Smoker patients (≥10 cig/day).
• Patients taking medications that affect bone metabolism or immunologic disorders.
• Patients allergic to penicillin.
• Patients presenting acute or chronic maxillary sinus lesions.
• Advanced vertical crestal bone atrophy in the posterior maxilla (Type V and IV, Cawood-Howell Classification)
• Vertical space of < 6 mm for a screw-retained implant restoration.
• Patients referring allergy to titanium or to any component of the implant/restoration.
• No previous attempts of implant installation in the same surgical site.
• Pregnant or lactating women.
• Patients willing to start or in course of an orthodontic therapy.