Dental Tribune United Kingdom Edition

C onventional dental im- plantation concepts have been questioned1 . For several years, short implants have been inserted without the need of a bone augmentation. An implant is considered as short if its thread has a length of less than 10mm. Short Champi- ons® implants are now available as well. The one-piece Champi- ons® are available in lengths including 8mm and 6mm. The two-piece Champions® (R)Evo- lution implants are available in lengths including 8mm and 6.5mm. Results from a recent study and the 97.5 per cent suc- cess rate of short implants have shown that the short implants are as beneficial as those with thread lengths ranging from 10- 24mm. The following clinical cases of the online forum show the good treatment results with short implants. Bone augmentations like an external sinus lift, an iliac crest transplantation or a bone distraction can be traumatic for the patient and can increase health risks. Therefore, our thesis is: “the best augmenta- tion is no augmentation at all!” In addition, it is very important to inform the patient about all dental treatment approaches, including the minimally inva- sive method as an alternative therapy in comparison with the conventional implant treat- ments. Some theses, which were considered as accepted truths in the 80s, have now proven con- troversial. For instance, studies have shown that it is not abso- lutely necessary to place im- plants with a length of 12mm and a diameter of 4.7mm! In addition, the dogma that there should be a large amount of titanium in bone has been questioned. Since according to the conventional Implantol- ogy theory, the implant length should be 2:1 in relation to the length of the crown, I had pre- viously doubted the efficiency of the short implants and had not planned to insert a short implant such as a 6mm long im- plant. However, from our expe- riences as dentists and current scientific studies2,3 , these theses against short implants are prov- en wrong. Therapy with short implants does not necessarily require bone augmentation, and it is beneficial and also affordable. In this way, the crestal bone site can be treated. Our experience with several implant systems has shown that the first 3-4mm in the crestal implant site are particularly crucial. Certain implant systems are equipped with a micro-thread, allowing for placement in the crestal implant site. In order to suc- cessfully insert and restore the short implants, primary stabil- ity of at least 35Ncm4 should be achieved. Mechanical stimuli will be converted into biological impulsions during the transi- tion from Primary Osseointe- gration Stability to Secondary Osseointegration Stability. Bone condensation, ensured through MIMI®, has proven highly ben- eficial for patients15 .You must avoid micro-traumata which overload the interface between the implant and the bone5 . In addition, lateral shear forces must be avoided during the first two to eight weeks after implan- tation. Conclusion Currently, conventional Implan- tology theories which argued that short implants were less effective than long ones have been questioned1,16. Over the past few years, recent studies have shown that short implants with a thread length of less than 10 mm ensure good soft and hard tissue regeneration on the long-term2,3 . In this way, maxi- mally invasive augmentations can be avoided in many cases. Implant therapy, especially min- imally invasive implant therapy, can be incorporated as an ad- ditional treatment in the den- tal office. The implants which integrate Platform-Switching prevent crestal bone loss.6,19 In order to ensure the successful placement of short implants, a certain number of implants/ teeth and primary stability of at least 35Ncm4 are necessary. The minimally invasive meth- od of implantation (MIMI®) has proven to be optimal to ensure peri-implant nutrition and good periost preserva- tion7,14,15,20 . Your patients will ap- preciate it. DT Short Implant Placement Does Not Require Bone Augmentation Armin Nedjat discusses short implants Figs 1&2 We placed two one-piece Champions® implants in region16 in the 1st quadrant in the maxilla. We had performed an internal sinus lift without a bone augmen- tation. The 4.5mm diameter and 6mm long Champions® implant was placed distally. The two Champions® implants were restored with zircon Prep-Caps, which allowed for adjustment of insertion divergences. Then, we fitted a fixed prosthodontic restoration. Fig 1 Fig 2 Fig 3 Figs 3-6 X-rays of the Champions® implant with a length of 6 mm and of the one with a length of 8mm, after the indirect sinuslift and after the transition from Primary Osseointegration Stability to Secondary Osseointegration Stability eight weeks after implantation. Fig 4 Fig 5 Fig 6 ‘Our thesis is: “the best augmentation is no augmentation at all!’ January 21-27, 201318 Implant Tribune United Kingdom Edition