Fixed restoration on two short implants splinted in the posterior edentulous atrophic maxilla: A case report.

Abstract

Background: A problem when planning implants in long-standing toothless areas is the atrophy of the alveolar ridge close to the maxillary sinus1. Additional surgical procedures (maxillary sinus lift and grafts) are usually performed to install conventional implants (≥10mm in length), involving high morbidity, invasiveness, prolonged healing periods, and high treatment costs2. A solution to this problem is the use of short implants (<10mm in length).

The objective is to document the use of short implants as a successful alternative in implant-supported rehabilitation of the free end span in the posterior maxillary area with low bone height. 

Clinical Presentation: Female patient, 62 years old, with no relevant medical history, consulted for the rehabilitation of teeth 14 and 15 extracted 10 years ago. On clinical examination, the scarce bone height of the left posterior maxillary space was evidenced. Radiographically there was proximity to the maxillary sinus.

Short implants of 5 mm wide and 7 long were installed for tooth 14 and 5 mm wide and 6 long for tooth 15 (Unitite Prime Compact, SIN Brand), being rehabilitated and splinted using a fixed prosthesis cemented on an abutment of titanium. 12 months after rehabilitation, she maintained excellent functional results.

Clinical Relevance: The literature reports that short implants are a viable treatment alternative in atrophic ridges, demonstrating a satisfactory survival rate similar to long implants but with less marginal bone loss, risk of complications, surgical time, and cost of treatment3,4.

When multiple short implants are required, splinted restorations can be performed, increasing the area of occlusal resistance to axial forces, distributing less load towards the cement, implant abutment, and peri-implant interface. Rehabilitations of this type have shown fewer prosthetic complications, screw loosening, and the number of failed implants4. 

Conclusion: Rehabilitation using short splinted implants is a valid option for rehabilitating posterior areas of the atrophic maxilla, avoiding the need for complementary surgeries, obtaining satisfactory survival rates with low complications and better prosthetic prognosis than long implants after additional surgical techniques and short non-splinted implants.