Vertical bone augmentation and regular implants versus short implants in the vertically deficient posterior mandible:a systematic review and meta-analysis of randomized studies

Item does not contain fulltextThe aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the outcomes of short dental implants (≤7mm) versus vertical bone augmentation followed by regular dental implants (>7mm) in the deficient posterior mandible. In total, eight RCTs (six using interpositional sandwich grafting and two using a guided bone regeneration technique) were reported in 17 articles at different time points. In the meta-analysis of the sandwich group, the relative risk (RR) for implant loss at 1year was in favour of short implants (RR 0.41, P=0.02), while no significant difference was found at 3 years (RR 0.65, P=0.43), 5 years (RR 1.08, P=0.86), or 8 years (RR 1.53, P=0.52). The risk of complications was in favour of short implants (RR 0.34, P=0.0002), as was the mean difference in marginal bone resorption after 1 year (-0.09mm, P=0.17), 3 years (-0.32mm, P<0.00001), 5 years (-0.65mm, P<0.00001), and 8 years (-0.88, P<0.00001). The mean residual osseointegration length of the implants was between 2.94mm and 4.44mm in the short implants group and between 7.97mm and 8.62mm in the regular implants group after 5 years. In conclusion, in the deficient atrophic posterior mandible, short implants and regular implants demonstrate comparable outcomes within the first 5 years. Patients who are fit for surgery should be informed about the risks and benefits of both options

Using distraction osteogenesis in pre-implant surgery

Primaire stabiliteit van een implantaat dat is geplaatst op een prothetisch en esthetisch gunstige positie, is van essentieel belang voor een succesvol eindresultaat. Een beperkende factor voor het verkrijgen van voldoende stabiliteit van een implantaat is een te gering botvolume op de gewenste implantatieplaats. Met behulp van distractieosteogenese kan een voldoende botvolume op de gewenste implantatieplaats worden bewerkstelligd. Distractieosteogenese kan worden toegepast voor het reconstrueren van een extreem atrofische mandibula en van lokale botdefecten. De verschillende distractietechnieken die kunnen worden toegepast om een intraoraal botdefect te reconstrueren, zijn enossale, extracorticale en gecombineerd verticale en horizontale distractie.Primary stability for an implant that is placed in a prostheticaly and aesthetically desirable position is of essential importance for a successful result. A limiting factor for achieving sufficient stability for an implant is insufficient volume of bone at the implant site. With the help of distraction osteogenesis, sufficient volume of bone can be generated at the desired implant site. Distraction osteogenesis can be adapted for reconstructing both extremely resorbed mandibles and local bone defects. The various distraction techniques for intra-oral bone defects are enossal, extra-cortical, and a combination of vertical and horizontal distraction.</p